ArticlePharmacoepidemiology and drug safety2019
Exposure measurement error when assessing current glucocorticoid use using UK primary care electronic prescription data.
Article in Pharmacoepidemiology and drug safety, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- Prenatal medication exposure and epigenetic outcomes: a systematic literature review and recommendations for prenatal pharmacoepigenetic studies.Epigenetics · 2022Pooled it
- Agreement of Administrative Pharmacy Dispensing With Self-Reported Use of Oral Prednisone in US Veterans With Rheumatoid Arthritis.Arthritis care & research · 2025Article
- Treatment Persistence and Variations in Prescribing Oral, Injectable, and Inhaled Corticosteroids: A Population-Based Drug Utilisation Study.Pharmacoepidemiology and drug safety · 2025Article
- Accuracy of administrative claims prescription fill data to estimate glucocorticoid use and dose in patients with rheumatoid arthritis.Pharmacoepidemiology and drug safety · 2023Article
- Improving Outcomes of Pediatric Lupus Care Delivery With Provider Goal-Setting Activities and Multidisciplinary Care Models.Arthritis care & research · 2023Article
- Nondifferential Treatment Misclassification Biases Toward the Null? Not a Safe Bet for Active Comparator Studies.American journal of epidemiology · 2022Article
- Use of renin angiotensin aldosterone system inhibitors in children with lupus and time to glucocorticoid discontinuation.Kidney international · 2022Article
- Incidence of Cabergoline-Associated Valvulopathy in Primary Care Patients With Prolactinoma Using Hard Cardiac Endpoints.The Journal of clinical endocrinology and metabolism · 2021Article
- Exposure measurement error when assessing current glucocorticoid use using UK primary care electronic prescription data.Pharmacoepidemiology and drug safety · 2019Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 3 countries.
Funding
Abstract
purposeTo quantify misclassification in glucocorticoid (GC) exposure defined using UK primary care prescription data.
methodsA cross-sectional study including patients with rheumatoid arthritis prescribed oral GCs in the past 2 years. Glucocorticoid exposure based on electronic prescription records was compared with participant-reported GC use captured using a paper diary. Prescription data (containing information about prescriptions issued but no dispensing information) was provided by the Clinical Practice Research Datalink. The following variables were defined: current use and dose of oral GCs and if (and when) participants had received a GC injection. For oral GCs, self-reported use was taken to represent "true" exposure. A dataset representing a hypothetical population was generated to assess the impact of the misclassification found for current use.
resultsA total of 67 of 78 study participants (86%) were correctly classified as currently on/off oral GCs; 32/38 (84.2%) participants reporting current GC use and 35/40 (87.5%) participants not reporting current use were correctly classified. Estimated values of current dose were imprecise (correlation coefficient 0.46). Concordance between reported and prescribed GC injections was poor (kappa statistic 0.14). Misclassification bias was demonstrated in the hypothetical population: For "true" relative risks of 1.5, 4, and 9, the "observed" relative risks were 1.33, 2.48, and 3.58, respectively.
conclusionsMisclassification of current use of oral GCs was low but sufficient to lead to significant bias. Researchers should take care to assess the likely impact of exposure misclassification on their analyses.
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