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Validation of suicide and self-harm records in the Clinical Practice Research Datalink

Research output: Contribution to journalArticle

Original languageEnglish
Pages (from-to)145-157
Number of pages13
JournalBritish Journal of Clinical Pharmacology
Volume76
Issue number1
DOIs
DatePublished - Jul 2013

Abstract

AIMS: The UK Clinical Practice Research Datalink (CPRD) is increasingly being used to investigate suicide-related adverse drug reactions. No studies have comprehensively validated the recording of suicide and nonfatal self-harm in the CPRD. We validated general practitioners' recording of these outcomes using linked Office for National Statistics (ONS) mortality and Hospital Episode Statistics (HES) admission data.

METHODS: We identified cases of suicide and self-harm recorded using appropriate Read codes in the CPRD between 1998 and 2010 in patients aged ≥15 years. Suicides were defined as patients with Read codes for suicide recorded within 95 days of their death. International Classification of Diseases codes were used to identify suicides/hospital admissions for self-harm in the linked ONS and HES data sets. We compared CPRD-derived cases/incidence of suicide and self-harm with those identified from linked ONS mortality and HES data, national suicide incidence rates and published self-harm incidence data.

RESULTS: Only 26.1% (n = 590) of the 'true' (ONS-confirmed) suicides were identified using Read codes. Furthermore, only 55.5% of Read code-identified suicides were confirmed as suicide by the ONS data. Of the HES-identified cases of self-harm, 68.4% were identified in the CPRD using Read codes. The CPRD self-harm rates based on Read codes had similar age and sex distributions to rates observed in self-harm hospital registers, although rates were underestimated in all age groups.

CONCLUSIONS: The CPRD recording of suicide using Read codes is unreliable, with significant inaccuracy (over- and under-reporting). Future CPRD suicide studies should use linked ONS mortality data. The under-reporting of self-harm appears to be less marked.

Additional information

© 2012 The Authors. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society.

    Research areas

  • Adolescent, Adult, Age Distribution, Aged, Clinical Coding, Databases, Factual, Drug-Related Side Effects and Adverse Reactions, Female, General Practitioners, Great Britain, Humans, Incidence, International Classification of Diseases, Male, Middle Aged, Self-Injurious Behavior, Sex Distribution, Suicide, Young Adult

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