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Cited by 89Medical Coding and Health InformationAcute Ischemic Stroke ManagementElectronic Health Records Systems

Validation of ischemic cerebrovascular diagnoses in the health improvement network (THIN)

Ruigómez, Ana, Martín‐Merino, Elisa, Rodríguez, Luis Alberto García·2010·Pharmacoepidemiology and Drug Safety
DOI 10.1002/pds.1919
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Abstract

Purpose: To evaluate the validity of recorded diagnoses of ischemic cerebrovascular events requiring hospitalization within The Health Improvement Network (THIN) UK primary care database. Methods: We identified 15 397 individuals aged 40–84 years with a first recorded ischemic event in 2000–2004. Of these, 4239 had a code suggestive of a hospitalization within 2 weeks of the event. A three‐step strategy was used to validate the records of these patients: manual review of computerized medical records excluding free‐text comments; manual review including free‐text comments (which include information gained from specialists, hospital discharge letters and results of diagnostic tests) of a random sample of possible cases (n = 300) and non‐cases (n = 100); and review of full medical records of this random sample and a questionnaire completed by their primary care physician. The positive predictive value (PPV) of each step was calculated. The confirmation rate was used to estimate incidence in the general population. Results: After step 1, 3447 individuals were classified as possible cases and 792 were excluded as non‐cases. After step 2, 82% of possible cases were still classified as such. Step 3 showed that inclusion of free‐text comments increased the PPV of a diagnosis from 76 to 86%. The weighted incidence of hospitalized ischemic cerebrovascular events was 1.73 per 1000 person‐years (95% CI:1.68–1.77). Conclusions: THIN demonstrates a high validity for the study of ischemic cerebrovascular events when reviewing computer records with additional free‐text comments. Accuracy of hospitalization status was not as well recorded. Copyright © 2010 John Wiley & Sons, Ltd.

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  • Since the turn of the millennium, strategies aimed at reducing the mortality gap between people with SMI and the general population have been implemented in the UK.

    “Since the turn of the millennium, a number of strategies aimed at reducing the mortality gap between people with SMI and the general population have been implemented in the UK.10–17”

    From Mortality gap for people with bipolar disorder and schizophrenia: UK-based cohort study 2000–2014 (2017) · cites this paper as [10]

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Authors
Ruigómez, A., Martín‐Merino, E., & Rodríguez, L. A. G.
Affiliations
Centro Español de Investigación Farmacoepidemiológica (ES)
Corresponding author
Ruigómez, Ana
ORCID
Venue
Pharmacoepidemiology and Drug Safety
Publisher
Wiley
Published
2010-02-03
Volume
19
Issue
6
Pages
579-585
ISSN
  • 1053-8569 (ISSN-L)
  • 1099-1557
DOI
10.1002/pds.1919
OpenAlex
W2024241244
Cited by
89
References
22
Citations by year
2025: 3 · 2024: 1 · 2023: 9 · 2022: 3 · 2021: 5 · 2020: 11 · 2019: 1 · 2018: 6 · 2017: 6 · 2016: 9 · 2015: 8 · 2014: 4 · 2013: 6 · 2012: 8
FWCI
13.71
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Pharmacoepidemiology and Drug Safety (publishedVersion)
  • PubMed (publishedVersion)
Funders
AstraZeneca
Topics
  • Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
  • Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
  • Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
Keywords
ischemic cerebrovascular disease, stroke, hospitalization, primary care records, Health Improvement Network, electronic health records, free-text comments, positive predictive value, incidence estimation
MeSH terms
Adult, Aged, Aged, 80 and over, Brain Ischemia, Epidemiologic Methods, United Kingdom, Hospitalization, Humans, Middle Aged, Predictive Value of Tests, Primary Health Care, Incidence, Databases, Factual, Medical Records Systems, Computerized

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