Validation study of bullous pemphigoid and pemphigus vulgaris recording in routinely collected electronic primary healthcare records in England

Persson, Monica S.M.; Harman, Karen E.; Vinogradova, Yana; Langan, Sinead M; Hippisley-Cox, Julia; Thomas, Kim S; Gran, Sonia

Abstract

Objectives: The validity of bullous pemphigoid and pemphigus vulgaris recording in routinely collected healthcare data in the UK is unknown. We assessed the positive predictive value (PPV) for bullous pemphigoid and pemphigus vulgaris primary care Read codes in the Clinical Practice Research Datalink (CPRD) using linked inpatient data (Hospital Episode Statistics; HES) as the diagnostic benchmark.

Setting: Adult participants with bullous pemphigoid or pemphigus vulgaris registered with HES-linked general practices in England between January 1998 to December 2017. Code-based algorithms were used to identify patients from the CPRD and extract their benchmark blistering disease diagnosis from HES.

Primary outcome measure: The PPVs of Read codes for bullous pemphigoid and pemphigus vulgaris.

Results: Of 2,468 incident cases of bullous pemphigoid and 431 of pemphigus vulgaris, 797 (32.3%) and 85 (19.7%) patients, respectively, had a hospitalisation record for a blistering disease. The PPV for bullous pemphigoid Read codes was 93.2% (95%CI 91.3 to 94.8). Of the bullous pemphigoid cases, 3.0% had a HES diagnosis of pemphigus vulgaris and 3.8% of another blistering disease. The PPV for pemphigus vulgaris Read codes was 58.5% (95%CI 48.0 to 68.9%). Of the pemphigus vulgaris cases, 24.7% had a HES diagnosis of bullous pemphigoid and 16.5% of another blistering disease.

Conclusions: The CPRD can be used to study bullous pemphigoid, but recording of pemphigus vulgaris needs to improve in primary care.

Citation

Persson, M. S., Harman, K. E., Vinogradova, Y., Langan, S. M., Hippisley-Cox, J., Thomas, K. S., & Gran, S. (2020). Validation study of bullous pemphigoid and pemphigus vulgaris recording in routinely collected electronic primary healthcare records in England. BMJ Open, 10(7), e035934. https://doi.org/10.1136/bmjopen-2019-035934

• Journal Article Type: Article
• Acceptance Date: Jun 3, 2020
• Online Publication Date: Jul 14, 2020
• Publication Date: Jul 14, 2020
• Deposit Date: Jun 23, 2020
• Publicly Available Date: Jul 14, 2020
• Journal: BMJ Open
• Electronic ISSN: 2044-6055
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 10
• Issue: 7
• Pages: e035934
• DOI: https://doi.org/10.1136/bmjopen-2019-035934
• Keywords: Bullous pemphigoid, Pemphigus vulgaris, Validation, Read code, Electronic healthcare records
• Public URL: https://nottingham-repository.worktribe.com/output/4660558
• Publisher URL: https://bmjopen.bmj.com/content/10/7/e035934