The validity of selected mental health diagnoses in English Hospital Episode Statistics: Using data linkage to electronic patient records to assess the validity of selected mental health diagnoses in English Hospital Episode Statistics (HES)

TY - JOUR

T1 - The validity of selected mental health diagnoses in English Hospital Episode Statistics

T2 - Using data linkage to electronic patient records to assess the validity of selected mental health diagnoses in English Hospital Episode Statistics (HES)

AU - Davis, Katrina Alice Southworth

AU - Bashford, Oliver

AU - Jewell, Amelia

AU - Shetty, Hitesh

AU - Stewart, Robert J.

AU - Sudlow, Cathie L. M.

AU - Hotopf, Matthew Hugo

PY - 2018/3

Y1 - 2018/3

N2 - Background: Administrative data can be used to support research, such as in the UK Biobank. Hospital Episode Statistics (HES) are national data for England that include contain ICD-10 diagnoses for inpatient mental healthcare episodes, but the validity of these diagnoses for research purposes has not been assessed.Methods: 250 cases were selected based on a HES recorded inpatient stay at theSouth London and Maudsley NHS Foundation Trust with a diagnosis of schizophrenia, wider schizophrenia spectrum disorder, bipolar affective disorder or unipolar depression. A gold-standard research diagnosis was made using electronic patient records, pseudonymised and searched using Clinical Records Interactive Search, and the OPCRIT+ algorithm.Results: Positive predictive value at the level of lifetime psychiatric disorder was 100%, and at the level of lifetime diagnosis in the four categories of schizophrenia, wider schizophrenia spectrum, bipolar or unipolar depression was 73% (68-79). Agreement varied by diagnosis, with schizophrenia having the highest PPV at 90% (80-96). Each person had five HES records with psychiatric diagnoses on average. An algorithm that looked at the last recorded psychiatric diagnosis led to greatest overall agreement with the research diagnosis.Discussion: For people who have a HES record from a psychiatric admission with a diagnosis of schizophrenia spectrum disorder, bipolar affective disorder or unipolar depression, HES records appear to be a good indicator of a mental disorder, and can provide a diagnostic category with reasonable certainty. For these diagnoses, HES records can be an effective way of ascertaining psychiatric diagnosis

AB - Background: Administrative data can be used to support research, such as in the UK Biobank. Hospital Episode Statistics (HES) are national data for England that include contain ICD-10 diagnoses for inpatient mental healthcare episodes, but the validity of these diagnoses for research purposes has not been assessed.Methods: 250 cases were selected based on a HES recorded inpatient stay at theSouth London and Maudsley NHS Foundation Trust with a diagnosis of schizophrenia, wider schizophrenia spectrum disorder, bipolar affective disorder or unipolar depression. A gold-standard research diagnosis was made using electronic patient records, pseudonymised and searched using Clinical Records Interactive Search, and the OPCRIT+ algorithm.Results: Positive predictive value at the level of lifetime psychiatric disorder was 100%, and at the level of lifetime diagnosis in the four categories of schizophrenia, wider schizophrenia spectrum, bipolar or unipolar depression was 73% (68-79). Agreement varied by diagnosis, with schizophrenia having the highest PPV at 90% (80-96). Each person had five HES records with psychiatric diagnoses on average. An algorithm that looked at the last recorded psychiatric diagnosis led to greatest overall agreement with the research diagnosis.Discussion: For people who have a HES record from a psychiatric admission with a diagnosis of schizophrenia spectrum disorder, bipolar affective disorder or unipolar depression, HES records appear to be a good indicator of a mental disorder, and can provide a diagnostic category with reasonable certainty. For these diagnoses, HES records can be an effective way of ascertaining psychiatric diagnosis

U2 - 10.1371/journal.pone.0195002

DO - 10.1371/journal.pone.0195002

M3 - Article

SN - 1932-6203

VL - 13

JO - PLOS One

JF - PLOS One

IS - 3

ER -