Evidence map›Paper›PMID 38626934›Full record

ArticleOpen heart2024

Review of codelists used to define hypertension in electronic health records and development of a codelist for research.

Georgie May Massen, Philip W Stone, Harley H Y Kwok, Gisli Jenkins, Richard J Allen, Louise V Wain, Iain Stewart, Jennifer Kathleen Quint, DEMISTIFI Consortium

Abstract read
In one paragraph

Article in Open heart, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Georgie May MassenSchool of Public Health, Imperial College London, London, UK g.massen21@imperial.ac.uk.ORCID 0000-0003-4355-6546
Philip W StoneSchool of Public Health, Imperial College London, London, UK.
Harley H Y KwokSchool of Public Health, Imperial College London, London, UK.
Gisli JenkinsNational Heart and Lung Institute, Imperial College London, London, UK.
Richard J AllenDepartment of Population Health Sciences, University of Leicester, Leicester, UK.
Louise V WainDepartment of Population Health Sciences, University of Leicester, Leicester, UK.
Iain StewartNational Heart and Lung Institute, Imperial College London, London, UK.
Jennifer Kathleen QuintSchool of Public Health, Imperial College London, London, UK.ORCID 0000-0003-0149-4869
DEMISTIFI Consortium

Funding

Medical Research Council MR/W014491/1Wellcome Trust
6 · The paper itself

Abstract

BACKGROUND AND

aimsHypertension is a leading risk factor for cardiovascular disease. Electronic health records (EHRs) are routinely collected throughout a person's care, recording all aspects of health status, including current and past conditions, prescriptions and test results. EHRs can be used for epidemiological research. However, there are nuances in the way conditions are recorded using clinical coding; it is important to understand the methods which have been applied to define exposures, covariates and outcomes to enable interpretation of study findings. This study aimed to identify codelists used to define hypertension in studies that use EHRs and generate recommended codelists to support reproducibility and consistency. ELIGIBILITY CRITERIA: Studies included populations with hypertension defined within an EHR between January 2010 and August 2023 and were systematically identified using MEDLINE and Embase. A summary of the most frequently used sources and codes is described. Due to an absence of Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) codelists in the literature, a recommended SNOMED CT codelist was developed to aid consistency and standardisation of hypertension research using EHRs.

findings375 manuscripts met the study criteria and were eligible for inclusion, and 112 (29.9%) reported codelists. The International Classification of Diseases (ICD) was the most frequently used clinical terminology, 59 manuscripts provided ICD 9 codelists (53%) and 58 included ICD 10 codelists (52%). Informed by commonly used ICD and Read codes, usage recommendations were made. We derived SNOMED CT codelists informed by National Institute for Health and Care Excellence guidelines for hypertension management. It is recommended that these codelists be used to identify hypertension in EHRs using SNOMED CT codes.

conclusionsLess than one-third of hypertension studies using EHRs included their codelists. Transparent methodology for codelist creation is essential for replication and will aid interpretation of study findings. We created SNOMED CT codelists to support and standardise hypertension definitions in EHR studies.

Indexed as

Electronic Health RecordsHypertensionHumansInternational Classification of DiseasesReproducibility of ResultsSystematized Nomenclature of MedicineElectronic Health RecordsEpidemiologyHypertension

Identifiers

PMID38626934
PMCPMC11029375

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