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

• Published in: PloS one 2018-03, Vol.13 (3), p.e0195002-e0195002
• Main Authors: Davis, Katrina Alice Southworth, Bashford, Oliver, Jewell, Amelia, Shetty, Hitesh, Stewart, Robert J, Sudlow, Cathie L M, Hotopf, Matthew Hugo
• Format: Article
• Language: English
• Subjects: Accuracy; Aged; Algorithms; Archives & records; Biomedical research; Bipolar Disorder - diagnosis; Datasets; Depressive Disorder - diagnosis; Diagnosis; Diagnostic systems; Electronic Health Records; England; Epidemiology; Evaluation; Female; Health care; Health informatics; Hospitals; Humans; Identification and classification; Information Storage and Retrieval; Male; Medical diagnosis; Medical record linkage; Medical research; Medical statistics; Medicine; Medicine and Health Sciences; Mental depression; Mental disorders; Mental health; Middle Aged; Neurosciences; Predictive Value of Tests; Psychiatric diagnosis; Psychiatry; Psychology; Psychopathology; Registries; Research and Analysis Methods; Researchers; Schizophrenia; Schizophrenia - diagnosis; Statistics; Systematic review; Validity
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0195002

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. 250 peoples' HES records were selected based on a HES recorded inpatient stay at the South London and Maudsley NHS Foundation Trust with a diagnosis of schizophrenia, a wider schizophrenia spectrum disorder, bipolar affective disorder or unipolar depression. A gold-standard research diagnosis was made using Clinical Records Interactive Search pseudonymised electronic patient records using, and the OPCRIT+ algorithm. 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 an average of five psychiatric HES records. An algorithm that looked at the last recorded psychiatric diagnosis led to greatest overall agreement with the research diagnosis. 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.