Cancer recording in patients with and without type 2 diabetes in the Clinical Practice Research Datalink primary care data and linked hospital admission data: a cohort study

Rachael Williams; Tjeerd-Pieter van Staa; Arlene M Gallagher; Tarek Hammad; Hubert G M Leufkens; Frank de Vries

doi:10.1136/bmjopen-2017-020827

Cancer recording in patients with and without type 2 diabetes in the Clinical Practice Research Datalink primary care data and linked hospital admission data: a cohort study

Rachael Williams^*, Tjeerd-Pieter van Staa, Arlene M Gallagher, Tarek Hammad, Hubert G M Leufkens, Frank de Vries

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVES AND SETTING: Conflicting results from studies using electronic health records to evaluate the associations between type 2 diabetes and cancer fuel concerns regarding potential biases. This study aimed to describe completeness of cancer recording in UK primary care data linked to hospital admissions records.

DESIGN: Patients aged 40+ years with insulin or oral antidiabetic prescriptions in Clinical Practice Research Datalink (CPRD) primary care without type 1 diabetes were matched by age, sex and general practitioner practice to non-diabetics. Those eligible for linkage to Hospital Episode Statistics Admitted Patient Care (HES APC), and with follow-up during April 1997-December 2006 were included.

PRIMARY AND SECONDARY OUTCOME MEASURES: Cancer recording and date of first record of cancer were compared. Characteristics of patients with cancer most likely to have the diagnosis recorded only in a single data source were assessed. Relative rates of cancer estimated from the two datasets were compared.

PARTICIPANTS: 53 585 patients with type 2 diabetes matched to 47 435 patients without diabetes were included.

RESULTS: Of all cancers (excluding non-melanoma skin cancer) recorded in CPRD, 83% were recorded in HES APC. 94% of cases in HES APC were recorded in CPRD. Concordance was lower when restricted to same-site cancer records, and was negatively associated with increasing age. Relative rates for cancer were similar in both datasets.

CONCLUSIONS: Good concordance in cancer recording was found between CPRD and HES APC among type 2 diabetics and matched controls. Linked data may reduce misclassification and increase case ascertainment when analysis focuses on site-specific cancers.

Original language	English
Article number	020827
Number of pages	8
Journal	BMJ Open
Volume	8
Issue number	5
DOIs	https://doi.org/10.1136/bmjopen-2017-020827
Publication status	Published - 26 May 2018

Keywords

VALIDITY
VALIDATION
DIAGNOSES
REGISTRY

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10.1136/bmjopen-2017-020827Licence: CC BY-NC

Cite this

@article{d6a5975dc49b42468630fcc19bac8b3a,

title = "Cancer recording in patients with and without type 2 diabetes in the Clinical Practice Research Datalink primary care data and linked hospital admission data: a cohort study",

abstract = "OBJECTIVES AND SETTING: Conflicting results from studies using electronic health records to evaluate the associations between type 2 diabetes and cancer fuel concerns regarding potential biases. This study aimed to describe completeness of cancer recording in UK primary care data linked to hospital admissions records.DESIGN: Patients aged 40+ years with insulin or oral antidiabetic prescriptions in Clinical Practice Research Datalink (CPRD) primary care without type 1 diabetes were matched by age, sex and general practitioner practice to non-diabetics. Those eligible for linkage to Hospital Episode Statistics Admitted Patient Care (HES APC), and with follow-up during April 1997-December 2006 were included.PRIMARY AND SECONDARY OUTCOME MEASURES: Cancer recording and date of first record of cancer were compared. Characteristics of patients with cancer most likely to have the diagnosis recorded only in a single data source were assessed. Relative rates of cancer estimated from the two datasets were compared.PARTICIPANTS: 53 585 patients with type 2 diabetes matched to 47 435 patients without diabetes were included.RESULTS: Of all cancers (excluding non-melanoma skin cancer) recorded in CPRD, 83% were recorded in HES APC. 94% of cases in HES APC were recorded in CPRD. Concordance was lower when restricted to same-site cancer records, and was negatively associated with increasing age. Relative rates for cancer were similar in both datasets.CONCLUSIONS: Good concordance in cancer recording was found between CPRD and HES APC among type 2 diabetics and matched controls. Linked data may reduce misclassification and increase case ascertainment when analysis focuses on site-specific cancers.",

keywords = "VALIDITY, VALIDATION, DIAGNOSES, REGISTRY",

author = "Rachael Williams and {van Staa}, Tjeerd-Pieter and Gallagher, {Arlene M} and Tarek Hammad and Leufkens, {Hubert G M} and {de Vries}, Frank",

note = "{\textcopyright} Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.",

year = "2018",

month = may,

day = "26",

doi = "10.1136/bmjopen-2017-020827",

language = "English",

volume = "8",

journal = "BMJ Open",

issn = "2044-6055",

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Cancer recording in patients with and without type 2 diabetes in the Clinical Practice Research Datalink primary care data and linked hospital admission data: a cohort study. / Williams, Rachael; van Staa, Tjeerd-Pieter; Gallagher, Arlene M et al.
In: BMJ Open, Vol. 8, No. 5, 020827, 26.05.2018.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Cancer recording in patients with and without type 2 diabetes in the Clinical Practice Research Datalink primary care data and linked hospital admission data

T2 - a cohort study

AU - Williams, Rachael

AU - van Staa, Tjeerd-Pieter

AU - Gallagher, Arlene M

AU - Hammad, Tarek

AU - Leufkens, Hubert G M

AU - de Vries, Frank

PY - 2018/5/26

Y1 - 2018/5/26

N2 - OBJECTIVES AND SETTING: Conflicting results from studies using electronic health records to evaluate the associations between type 2 diabetes and cancer fuel concerns regarding potential biases. This study aimed to describe completeness of cancer recording in UK primary care data linked to hospital admissions records.DESIGN: Patients aged 40+ years with insulin or oral antidiabetic prescriptions in Clinical Practice Research Datalink (CPRD) primary care without type 1 diabetes were matched by age, sex and general practitioner practice to non-diabetics. Those eligible for linkage to Hospital Episode Statistics Admitted Patient Care (HES APC), and with follow-up during April 1997-December 2006 were included.PRIMARY AND SECONDARY OUTCOME MEASURES: Cancer recording and date of first record of cancer were compared. Characteristics of patients with cancer most likely to have the diagnosis recorded only in a single data source were assessed. Relative rates of cancer estimated from the two datasets were compared.PARTICIPANTS: 53 585 patients with type 2 diabetes matched to 47 435 patients without diabetes were included.RESULTS: Of all cancers (excluding non-melanoma skin cancer) recorded in CPRD, 83% were recorded in HES APC. 94% of cases in HES APC were recorded in CPRD. Concordance was lower when restricted to same-site cancer records, and was negatively associated with increasing age. Relative rates for cancer were similar in both datasets.CONCLUSIONS: Good concordance in cancer recording was found between CPRD and HES APC among type 2 diabetics and matched controls. Linked data may reduce misclassification and increase case ascertainment when analysis focuses on site-specific cancers.

AB - OBJECTIVES AND SETTING: Conflicting results from studies using electronic health records to evaluate the associations between type 2 diabetes and cancer fuel concerns regarding potential biases. This study aimed to describe completeness of cancer recording in UK primary care data linked to hospital admissions records.DESIGN: Patients aged 40+ years with insulin or oral antidiabetic prescriptions in Clinical Practice Research Datalink (CPRD) primary care without type 1 diabetes were matched by age, sex and general practitioner practice to non-diabetics. Those eligible for linkage to Hospital Episode Statistics Admitted Patient Care (HES APC), and with follow-up during April 1997-December 2006 were included.PRIMARY AND SECONDARY OUTCOME MEASURES: Cancer recording and date of first record of cancer were compared. Characteristics of patients with cancer most likely to have the diagnosis recorded only in a single data source were assessed. Relative rates of cancer estimated from the two datasets were compared.PARTICIPANTS: 53 585 patients with type 2 diabetes matched to 47 435 patients without diabetes were included.RESULTS: Of all cancers (excluding non-melanoma skin cancer) recorded in CPRD, 83% were recorded in HES APC. 94% of cases in HES APC were recorded in CPRD. Concordance was lower when restricted to same-site cancer records, and was negatively associated with increasing age. Relative rates for cancer were similar in both datasets.CONCLUSIONS: Good concordance in cancer recording was found between CPRD and HES APC among type 2 diabetics and matched controls. Linked data may reduce misclassification and increase case ascertainment when analysis focuses on site-specific cancers.

KW - VALIDITY

KW - VALIDATION

KW - DIAGNOSES

KW - REGISTRY

U2 - 10.1136/bmjopen-2017-020827

DO - 10.1136/bmjopen-2017-020827

M3 - Article

C2 - 29804063

SN - 2044-6055

VL - 8

JO - BMJ Open

JF - BMJ Open

IS - 5

M1 - 020827

ER -