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Assessing the Importance of Variation in Diagnostic Coding Among the Three Countries in the UK Biobank.

Assessing the Importance of Variation in Diagnostic Coding Among the Three Countries in the UK Biobank.

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GB · Possible study site · country only

BACKGROUND: The UK Biobank (UKB) study has linked hospital inpatient data collected from England, Scotland, and Wales, which use different clinical coding systems to record health outcomes.
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Oxford, GB · Author affiliation

Nuffield Department of Primary Care Health Sciences University of Oxford Oxford UK.
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GB · Author affiliation · country only

UK Biobank Ltd UK.
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Boston, US · Author affiliation

Department of Epidemiology Harvard TH Chan School of Public Health Boston Massachusetts USA.
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Original abstract

BACKGROUND: The UK Biobank (UKB) study has linked hospital inpatient data collected from England, Scotland, and Wales, which use different clinical coding systems to record health outcomes. Scotland records up to 6 different diagnostic codes for one inpatient episode, compared with up to 20 in England and 14 in Wales. We assessed the relationship of the variations in diagnostic coding among countries on observed disease incidence rates. METHODS: We examined the number of diagnoses coded by each country, and then compared the incidence of three diseases between countries: Parkinson's disease (PD), type 2 diabetes (T2D), and dementia. We constructed Cox models for each disease, adjusting for "country." RESULTS: Compared with England, Scotland appears to have the lowest risk (hazard ratio, HR) for all three diseases: HR [95% CI] = 0.62 [0.54, 0.72] for PD, 0.49 [0.45, 0.54] for T2D, and 0.88 [0.78, 0.99] for dementia. CONCLUSIONS: The observed incidence of these diseases and the estimated effect of "country" in Cox models are likely influenced by the clinical coding variations among countries. Researchers need to be aware of this and account for these variations in their analyses.

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