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a Department of Public
Health Sciences, St George's Hospital Medical School, Cranmer Terrace,
London SW17 0RE, UK, b General Practice Research Database,
Office for National Statistics, Room B6/04, 1 Drummond Gate, London
SW1V 2QQ, UK
Correspondence to: Dr A Hansell.
Received 7 September 1998; Returned to authors 26 October 1998; Revised version received 9 December 1998; Accepted for publication 5 January 1999
BACKGROUND
The General
Practice Research Database (GPRD) covers over 6% of the population of
England and Wales and holds data on diagnoses and prescribing from 1987 onwards. Most previous studies using the GPRD have concentrated on drug
use and safety. A study was undertaken to assess the validity of using
the GPRD for epidemiological research into respiratory diseases.
METHODSAge-specific
and sex-specific rates derived from the GPRD for 11 respiratory
conditions were compared with patient consultation rates from the 4th
Morbidity Survey in General Practice (MSGP4). Within the GPRD
comparisons were made between patient diagnosis rates, patient
prescription rates, and patient "prescription plus relevant
diagnosis" rates for selected treatments.
RESULTSThere was good
agreement between consultation rates in the MSGP4 and diagnosis or
"prescription plus diagnosis" from the GPRD in terms of pattern and
magnitude, except for "acute bronchitis or bronchiolitis" where the
best comparison was the combination category of "chest infection"
and/or "acute bronchitis or bronchiolitis". Within the GPRD,
patient prescription rates for inhalers, tuberculosis or hayfever
therapy showed little similarity with diagnosis only rates but a
similarity was seen with the combination of "prescription plus
diagnosis" which may be a better reflection of morbidity than
diagnosis alone.
CONCLUSIONSThe GPRD
appears to be valid for primary care epidemiological studies by
comparison with MSGP4 and offers advantages in terms of large size, a
longer time period covered, and ability to link prescriptions with
diagnoses. However, careful interpretation is needed because not all
consultations are recorded and the coding system used contains terms
which do not directly map to ICD codes.
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