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Pharmacoepidemiol Drug Saf. 2010 Jun;19(6):579-85. doi: 10.1002/pds.1919.

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

Author information

1
Centro Español de Investigación Farmacoepidemiológica (CEIFE), Madrid, Spain. aruigomez@ceife.es

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.

PMID:
20131328
DOI:
10.1002/pds.1919
[Indexed for MEDLINE]

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