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 the South 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 the South 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

UR - https://www.scopus.com/pages/publications/85044519897

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 -