ArticleBMC health services research2012
Defining upper gastrointestinal bleeding from linked primary and secondary care data and the effect on occurrence and 28 day mortality.
Article in BMC health services research, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Characterization of bleeding in thrombotic thrombocytopenic purpura in the precaplacizumab era: a retrospective nationwide analysis.Research and practice in thrombosis and haemostasis · 2025Article
- Concomitant Use of Selective Serotonin Reuptake Inhibitors With Oral Anticoagulants and Risk of Major Bleeding.JAMA network open · 2024Article
- The global epidemiology of upper and lower gastrointestinal bleeding in general population: A systematic review.World journal of gastrointestinal surgery · 2023Article
- Time trends in the incidence rates of venous thromboembolism following colorectal resection by indication and operative technique.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2022Article
- Article
- Bleeding in cardiac patients prescribed antithrombotic drugs: electronic health record phenotyping algorithms, incidence, trends and prognosis.BMC medicine · 2019Article
- Approach to record linkage of primary care data from Clinical Practice Research Datalink to other health-related patient data: overview and implications.European journal of epidemiology · 2019Article
- Gastrointestinal bleeding risk of selective serotonin reuptake inhibitors by level of kidney function: A population-based cohort study.British journal of clinical pharmacology · 2018Article
- Under-recording of hospital bleeding events in UK primary care: a linked Clinical Practice Research Datalink and Hospital Episode Statistics study.Clinical epidemiology · 2018Article
- Incidence of First Stroke in Pregnant and Nonpregnant Women of Childbearing Age: A Population-Based Cohort Study From England.Journal of the American Heart Association · 2017Article
- Assessing recording delays in general practice records to inform near real-time vaccine safety surveillance using the Clinical Practice Research Datalink (CPRD).Pharmacoepidemiology and drug safety · 2017Article
- Improved incidence estimates from linked vs. stand-alone electronic health records.Journal of clinical epidemiology · 2016Article
- Article
- Recording of hospitalizations for acute exacerbations of COPD in UK electronic health care records.Clinical epidemiology · 2016Article
- Article
- Comorbidities affect risk of nonvariceal upper gastrointestinal bleeding.Gastroenterology · 2013Article
- Excess long-term mortality following non-variceal upper gastrointestinal bleeding: a population-based cohort study.PLoS medicine · 2013Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundPrimary care records from the UK have frequently been used to identify episodes of upper gastrointestinal bleeding in studies of drug toxicity because of their comprehensive population coverage and longitudinal recording of prescriptions and diagnoses. Recent linkage within England of primary and secondary care data has augmented this data but the timing and coding of concurrent events, and how the definition of events in linked data effects occurrence and 28 day mortality is not known.
methodsWe used the recently linked English Hospital Episodes Statistics and General Practice Research Database, 1997-2010, to define events by; a specific upper gastrointestinal bleed code in either dataset, a specific bleed code in both datasets, or a less specific but plausible code from the linked dataset.
resultsThis approach resulted in 81% of secondary care defined bleeds having a corresponding plausible code within 2 months in primary care. However only 62% of primary care defined bleeds had a corresponding plausible HES admission within 2 months. The more restrictive and specific case definitions excluded severe events and almost halved the 28 day case fatality when compared to broader and more sensitive definitions.
conclusionsRestrictive definitions of gastrointestinal bleeding in linked datasets fail to capture the full heterogeneity in coding possible following complex clinical events. Conversely too broad a definition in primary care introduces events not severe enough to warrant hospital admission. Ignoring these issues may unwittingly introduce selection bias into a study's results.
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