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Published in: BMC Health Services Research 1/2021

Open Access 01-12-2021 | Bronchial Asthma | Research

Validity of algorithms for identifying five chronic conditions in MedicineInsight, an Australian national general practice database

Authors: Alys Havard, Jo-Anne Manski-Nankervis, Jill Thistlethwaite, Benjamin Daniels, Rimma Myton, Karen Tu, Kendal Chidwick

Published in: BMC Health Services Research | Issue 1/2021

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Abstract

Background

MedicineInsight is a database containing de-identified electronic health records (EHRs) from over 700 Australian general practices. It is one of the largest and most widely used primary health care EHR databases in Australia. This study examined the validity of algorithms that use information from various fields in the MedicineInsight data to indicate whether patients have specific health conditions. This study examined the validity of MedicineInsight algorithms for five common chronic conditions: anxiety, asthma, depression, osteoporosis and type 2 diabetes.

Methods

Patients’ disease status according to MedicineInsight algorithms was benchmarked against the recording of diagnoses in the original EHRs. Fifty general practices contributing data to MedicineInsight met the eligibility criteria regarding patient load and location. Five were randomly selected and four agreed to participate. Within each practice, 250 patients aged ≥ 40 years were randomly selected from the MedicineInsight database. Trained staff reviewed the original EHR for as many of the selected patients as possible within the time available for data collection in each practice.

Results

A total of 475 patients were included in the analysis. All the evaluated MedicineInsight algorithms had excellent specificity, positive predictive value, and negative predictive value (above 0.9) when benchmarked against the recording of diagnoses in the original EHR. The asthma and osteoporosis algorithms also had excellent sensitivity, while the algorithms for anxiety, depression and type 2 diabetes yielded sensitivities of 0.85, 0.89 and 0.89 respectively.

Conclusions

The MedicineInsight algorithms for asthma and osteoporosis have excellent accuracy and the algorithms for anxiety, depression and type 2 diabetes have good accuracy. This study provides support for the use of these algorithms when using MedicineInsight data for primary health care quality improvement activities, research and health system policymaking and planning.
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Literature
1.
go back to reference Youens D, Moorin R, Harrison A, Varhold R, Robinson S, Brooks C, et al. Using general practice clinical information system data for research: the case in Australia. Int J Popul Data Sci. 2020;5(1):01.CrossRef Youens D, Moorin R, Harrison A, Varhold R, Robinson S, Brooks C, et al. Using general practice clinical information system data for research: the case in Australia. Int J Popul Data Sci. 2020;5(1):01.CrossRef
2.
go back to reference Herrett E, Gallagher A, Bhaskaran K, Forbes H, Mathur R, van Staa T, et al. Data Resource Profile: Clinical Practice Research Datalink (CPRD). Int J Epidemiol. 2015;44(3):827–36.CrossRef Herrett E, Gallagher A, Bhaskaran K, Forbes H, Mathur R, van Staa T, et al. Data Resource Profile: Clinical Practice Research Datalink (CPRD). Int J Epidemiol. 2015;44(3):827–36.CrossRef
3.
go back to reference Blak B, Thompson M, Dattani H, Bourke A. Generalisability of The Health Improvement Network (THIN) database: demographics, chronic disease prevalence and mortality rates. Inform Prim Care. 2011;19:215–5. Blak B, Thompson M, Dattani H, Bourke A. Generalisability of The Health Improvement Network (THIN) database: demographics, chronic disease prevalence and mortality rates. Inform Prim Care. 2011;19:215–5.
4.
go back to reference Williamson T, Green M, Birtwhistle R, Khan S, Garies S, Wong S, et al. Validating the 8 CPCSSN case definitions for chronic disease surveillance in a primary care database of electronic health records. Ann Fam Med. 2014;12(4):367–72.CrossRef Williamson T, Green M, Birtwhistle R, Khan S, Garies S, Wong S, et al. Validating the 8 CPCSSN case definitions for chronic disease surveillance in a primary care database of electronic health records. Ann Fam Med. 2014;12(4):367–72.CrossRef
5.
go back to reference Greiver M, Drummond N, Birtwhistle R, Queenan J, Lambert-Lanning A, Jackson D. Using EMRs to fuel quality improvement. Can Fam Physician. 2015;61(1):92.PubMedPubMedCentral Greiver M, Drummond N, Birtwhistle R, Queenan J, Lambert-Lanning A, Jackson D. Using EMRs to fuel quality improvement. Can Fam Physician. 2015;61(1):92.PubMedPubMedCentral
6.
go back to reference Mannan F, Chaudhry Z, Gibson-White A, Syed U, Ahmed S, Kousoulis A, et al. Outputs and growth of primary care databases in the United Kingdom: bibliometric analysis. J Innov Health Inform. 2017;24(3):284–90.CrossRef Mannan F, Chaudhry Z, Gibson-White A, Syed U, Ahmed S, Kousoulis A, et al. Outputs and growth of primary care databases in the United Kingdom: bibliometric analysis. J Innov Health Inform. 2017;24(3):284–90.CrossRef
8.
go back to reference Canaway R, Boyle D, Manski-Nankervis J, Bell J, Hocking J, Clarke K, et al. Gathering data for decisions: best practice use of primary care electronic records for research. Med J Aust. 2019;210(6):S12-S6. Canaway R, Boyle D, Manski-Nankervis J, Bell J, Hocking J, Clarke K, et al. Gathering data for decisions: best practice use of primary care electronic records for research. Med J Aust. 2019;210(6):S12-S6.
9.
go back to reference Busingye D, Gianacas C, Pollak A, Chidwick K, Merrifield A, Norman S, et al. Data Resource Profile: MedicineInsight, an Australian national primary health care database. Int J Epidemiol. 2019;48(6):1741-h. Busingye D, Gianacas C, Pollak A, Chidwick K, Merrifield A, Norman S, et al. Data Resource Profile: MedicineInsight, an Australian national primary health care database. Int J Epidemiol. 2019;48(6):1741-h.
11.
go back to reference Benchimol E, Manuel D, To T, Griffiths A, Rabeneck L, Guttmann A. Development and use of reporting guidelines for assessing the quality of validation studies of health administrative data. J Clin Epidemiol. 2011;64:821–9.CrossRef Benchimol E, Manuel D, To T, Griffiths A, Rabeneck L, Guttmann A. Development and use of reporting guidelines for assessing the quality of validation studies of health administrative data. J Clin Epidemiol. 2011;64:821–9.CrossRef
12.
go back to reference Ehrenstein V, Petersen I, Smeeth L, Jick S, Benchimol E, Ludvigsson J, et al. Helping everyone do better: a call for validation studies of routinely recorded health data. Clinical Epidemiology. 2016;8:49–51.CrossRef Ehrenstein V, Petersen I, Smeeth L, Jick S, Benchimol E, Ludvigsson J, et al. Helping everyone do better: a call for validation studies of routinely recorded health data. Clinical Epidemiology. 2016;8:49–51.CrossRef
13.
go back to reference Heron J, Norman S, Yoo J, Lembke K, O’Connor C, Weston C, et al. The prevalence and risk of non-infectious comorbidities in HIV-infected and non-HIV infected men attending general practice in Australia. PLoS One. 2019;14(10):e0223224.CrossRef Heron J, Norman S, Yoo J, Lembke K, O’Connor C, Weston C, et al. The prevalence and risk of non-infectious comorbidities in HIV-infected and non-HIV infected men attending general practice in Australia. PLoS One. 2019;14(10):e0223224.CrossRef
14.
go back to reference NPS MedicineWise. General Practice Insights Report July 2018-June 2019. Sydney: NPS MedicineWise; 2020. NPS MedicineWise. General Practice Insights Report July 2018-June 2019. Sydney: NPS MedicineWise; 2020.
15.
go back to reference Gonzalez-Chica D, Vanlint S, Hoon E, Stocks N. Epidemiology of arthritis, chronic back pain, gout, osteoporosis, spondyloarthropathies and rheumatoid arthritis among 1.5 million patients in Australian general practice: NPS MedicineWise MedicineInsight dataset. BMC Musculoskelet Disord. 2018;19(1):20.CrossRef Gonzalez-Chica D, Vanlint S, Hoon E, Stocks N. Epidemiology of arthritis, chronic back pain, gout, osteoporosis, spondyloarthropathies and rheumatoid arthritis among 1.5 million patients in Australian general practice: NPS MedicineWise MedicineInsight dataset. BMC Musculoskelet Disord. 2018;19(1):20.CrossRef
16.
go back to reference McBrien K, Souri S, Symonds N, Rouhi A, Lethebe B, Williamson T, et al. Identification of validated case definitions for medical conditions used in primary care electronic medical record databases: a systematic review. J Am Med Inform Assoc. 2018;25(11):1567–78.CrossRef McBrien K, Souri S, Symonds N, Rouhi A, Lethebe B, Williamson T, et al. Identification of validated case definitions for medical conditions used in primary care electronic medical record databases: a systematic review. J Am Med Inform Assoc. 2018;25(11):1567–78.CrossRef
17.
go back to reference The Royal Australian College of General Practitioners. General practice management of type 2 diabetes: 2016–2018. East Melbourne, VIC: RACGP; 2016. The Royal Australian College of General Practitioners. General practice management of type 2 diabetes: 2016–2018. East Melbourne, VIC: RACGP; 2016.
18.
go back to reference R Core Team. R: A Language and Environment for Statistical Computing Vienna, Austria: R Foundation for Statistical Computing; 2019 [cited 10 June 2020]. Available from: https://www.R-project.org. R Core Team. R: A Language and Environment for Statistical Computing Vienna, Austria: R Foundation for Statistical Computing; 2019 [cited 10 June 2020]. Available from: https://​www.​R-project.​org.
19.
go back to reference Chubak J, Pocobelli G, Weiss N. Trade-offs between accuracy measures for electronic healthcare data algorithms. J Clin Epidemiol. 2012;65(3):343–9.CrossRef Chubak J, Pocobelli G, Weiss N. Trade-offs between accuracy measures for electronic healthcare data algorithms. J Clin Epidemiol. 2012;65(3):343–9.CrossRef
20.
go back to reference Kadhim-Saleh A, Green M. Validation of the diagnostic algorithms for 5 chronic conditions in the Canadian Primary Care Sentinel Surveillance Network (CPCSSN): A Kingston Practice-based Research Network (PBRN) Report. J Am Board Fam Med. 2013;26:159–67.CrossRef Kadhim-Saleh A, Green M. Validation of the diagnostic algorithms for 5 chronic conditions in the Canadian Primary Care Sentinel Surveillance Network (CPCSSN): A Kingston Practice-based Research Network (PBRN) Report. J Am Board Fam Med. 2013;26:159–67.CrossRef
21.
go back to reference Madden J, Lakoma M, Rusinak D, Lu C, Soumerai S. Missing clinical and behavioural health data in a large electronic health record (EHR) system. J Am Med Inform Assoc. 2016;23:1143–9.CrossRef Madden J, Lakoma M, Rusinak D, Lu C, Soumerai S. Missing clinical and behavioural health data in a large electronic health record (EHR) system. J Am Med Inform Assoc. 2016;23:1143–9.CrossRef
22.
go back to reference Herrett E, Thomas S, Schoonen W, Smeeth L, Hall A. Validation and validity of diagnoses in the General Practice Research Database: a systematic review. Br J Clin Pharmacol. 2009;69(1):4–14.CrossRef Herrett E, Thomas S, Schoonen W, Smeeth L, Hall A. Validation and validity of diagnoses in the General Practice Research Database: a systematic review. Br J Clin Pharmacol. 2009;69(1):4–14.CrossRef
23.
go back to reference Dregan A, Moller H, Murray-Thomas T, Gulliford M. Validity of cancer diagnosis in a primary care database compared with linked cancer registrations in England: Population-based cohort study. Cancer Epidemiol. 2012;36(5):425–9.CrossRef Dregan A, Moller H, Murray-Thomas T, Gulliford M. Validity of cancer diagnosis in a primary care database compared with linked cancer registrations in England: Population-based cohort study. Cancer Epidemiol. 2012;36(5):425–9.CrossRef
24.
go back to reference Thomas K, Davies N, Metcalfe C, Windmeijer F, Martin R, Gunnell D. Validation of suicide and self-harm records in the Clinical Practice Research Datalink. Br J Clin Pharmacol. 2012;76(1):145–57.CrossRef Thomas K, Davies N, Metcalfe C, Windmeijer F, Martin R, Gunnell D. Validation of suicide and self-harm records in the Clinical Practice Research Datalink. Br J Clin Pharmacol. 2012;76(1):145–57.CrossRef
Metadata
Title
Validity of algorithms for identifying five chronic conditions in MedicineInsight, an Australian national general practice database
Authors
Alys Havard
Jo-Anne Manski-Nankervis
Jill Thistlethwaite
Benjamin Daniels
Rimma Myton
Karen Tu
Kendal Chidwick
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2021
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-021-06593-z

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