Validating self-reported strokes in a longitudinal UK cohort study (Whitehall II): Extracting information from hospital medical records versus the Hospital Episode Statistics database

BMC Medical Research Methodology

Eric J Brunner¹  Ajay Bhalla²  Charles DA Wolfe²  Anthony Rudd²  Martin Shipley¹  Adelaida Sanchez-Galvez¹  Therese Butler¹  Beverly Milne¹  Annie Britton¹ 

[1] Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK;Division of Health and Social Care Research, King’s College London, 7th Floor Capital House, 42 Weston Street, London, SE1 3QD, UK

关键词: NHS HES database;    Medical records;    Validation;    Self-report;    Cohort studies;    Stroke;   

Others  :  1136604
DOI  :  10.1186/1471-2288-12-83

 received in 2012-02-27, accepted in 2012-06-21,  发布年份 2012

【 摘 要 】

Background

Valuable information on the determinants of non-fatal stroke can be obtained from longitudinal observational cohort studies. Such studies often rely on self-reported stroke events, which are best validated with external medical evidence. The aim of this paper is to compare the information on incident non-fatal stroke events arising from different sources.

Methods

We carried out a validation of self-reported stoke events among participants in the Whitehall II Study, a large UK based cohort study (baseline sample size 10,308 men and women).

Results

106 stroke events were self-reported in three self-administered questionnaires between 2002 and 2009. Eight (7.5%) of these events were discarded as false positives after medical review, 66 were validated by information from the NHS Hospital Episode Statistics (HES) database in England, 16 by manual searches of hospital records alone, and 12 by letters from general practitioners alone. HES provided information on an additional (i.e. not self-reported) 47 events coded as stroke during the period 2002 to 2009 in hospitals in England among the original baseline participants. Of these, 43 participants were no longer active in the study and 4 had completed questionnaires but not reported a stroke event.

Conclusions

Validating self-reported strokes in cohort studies with information from the NHS HES database was efficient and provided information on probable non-fatal stroke events among cohort members no longer in active follow-up. Manual extraction from hospital notes can provide supplementary information beyond that available in the HES discharge summary and was used to sub-type some strokes. However, the process was labour intensive. Multiple sources are needed to capture maximum information on stroke events but increasingly with hospitalisation in the acute phase of stroke, HES has an important role. Further development of HES is required to assure validity and coverage.

【 授权许可】

   
2012 Britton et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Walker Mk, Whincup PH, Shaper GS, Lennon LT, Thomson AG: Validation of patient recall of doctor-diagnosed heart attack and stroke: A postal questionnaire and record review comparison. Am J Epidemiol 1998, 148:355-361.
• [2]Tretli S, Lund-Larsen PG, Foss OP: Reliability of questionnaire information on cardiovascular disease and diabetes; cardiovascular disease study in Finnmark County. J Epidemiol Community Health 1982, 36:269-273.
• [3]Colditz GA, Martin P, Stampfer MJ, Willett WC, Sampson L, Rosner B, Hennekens CH, Speizer FE: Validation of questionnaire information on risk factors and disease outcomes in a prospective cohort study of women. Am J Epidemiol 1986, 123:894-900.
• [4]O’Mahony PG, Dobson R, Rodgers H, James OF, Thomson RG: Validation of a population screening questionnaire to assess prevalence of stroke. Stroke 1995, 26:1334-1337.
• [5]Berger K, Hense HW, Rothdach A, Weltermann B, Keil U: A single question about prior stroke versus a stroke questionnaire to assess stroke prevalence in populations. Neuroepidemiology 2000, 19:245-257.
• [6]Marmot M, Smith GD, Stansfeld S, Patel C, North F, Head J, White I, Brunner E, Feeney A: Health inequalities among British civil servants: the Whitehall II study. Lancet 1991, 337:1387-1393.
• [7]Marmot M, Brunner E: Cohort Profile: the Whitehall II study. Int J Epidemiol 2005, 34:251-256.
• [8]Sinha S, Myint PK, Luben RN, Khaw K-T: Accuracy of death certification and hospital record linkage for identification of incident stroke. BMC Med Res Methodol 2008, 8:74. BioMed Central Full Text
• [9]Dixon J, Sanderson C, Elliot P, Walls P, Jones J, Petticrew M: Assessment of the reproducibility of clinical coding in routinely collected hospital activity data: a study in two hospitals. J Public Health Med 1998, 20:63-69.
• [10]Campbell SE, Campbell MK, Grimshaw JM, Walker AE: A systematic review of discharge coding accuracy. J Public Health Med 2001, 23:205-211.
• [11]Burns EM, Rigby E, Mamidanna R, Bottle A, Aylin P, Ziprin P, Faiz OD: Systematic review of discharge coding accuracy. J Public Health 2011, 34:138-148.
• [12]Kirkman MA, Mahattanakul W, Gregson BA, Mendelow AD: The accuracy of hospital discharge coding for hemorrhagic stroke. Acta Neurol Belg 2009, 109:114-119.