| Title: | Identifying dementia outcomes in UK Biobank: a validation study of primary care, hospital admissions and mortality data |
| Journal: | European Journal of Epidemiology |
| Published: | 26 Feb 2019 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/30806901/ |
| DOI: | https://doi.org/10.1007/s10654-019-00499-1 |
| URL: | https://link.springer.com/content/pdf/10.1007/s10654-019-00499-1.pdf |
Publication 8696
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Abstract
Prospective, population-based studies that recruit participants in mid-life are valuable resources for dementia research. Follow-up in these studies is often through linkage to routinely-collected healthcare datasets. We investigated the accuracy of these datasets for dementia case ascertainment in a validation study using data from UK Biobank - an open access, population-based study of > 500,000 adults aged 40-69 years at recruitment in 2006-2010. From 17,198 UK Biobank participants recruited in Edinburgh, we identified those with ≥ 1 dementia code in their linked primary care, hospital admissions or mortality data and compared their coded diagnoses to clinical expert adjudication of their full-text medical record. We calculated the positive predictive value (PPV, the proportion of cases identified that were true positives) for all-cause dementia, Alzheimer's disease and vascular dementia for each dataset alone and in combination, and explored algorithmic code combinations to improve PPV. Among 120 participants, PPVs for all-cause dementia were 86.8%, 87.3% and 80.0% for primary care, hospital admissions and mortality data respectively and 82.5% across all datasets. We identified three algorithms that balanced a high PPV with reasonable case ascertainment. For Alzheimer's disease, PPVs were 74.1% for primary care, 68.2% for hospital admissions, 50.0% for mortality data and 71.4% in combination. PPV for vascular dementia was 43.8% across all sources. UK routinely-collected healthcare data can be used to identify all-cause dementia in prospective studies. PPVs for Alzheimer's disease and vascular dementia are lower. Further research is required to explore the geographic generalisability of these findings.</p>
13 Authors
- Tim Wilkinson
- Christian Schnier
- Kathryn Bush
- Kristiina Rannikmäe
- David E. Henshall
- Chris Lerpiniere
- Naomi E. Allen
- Robin Flaig
- Tom C. Russ
- Deborah Bathgate
- Suvankar Pal
- John T. O'Brien
- Cathie L. M. Sudlow
Enabling scientific discoveries that improve human health