Chronic obstructive pulmonary disease
Table of Contents
Metadata
| Name | Chronic obstructive pulmonary disease |
| Type | Disease or Syndrome |
| Group | Respiratory |
| Data Sources | UK Biobankprimary carehospital admissions datamortality data |
| Clinical Terminologies | Read, SNOMED CT, ICD-10 |
| Validation | cross-source, casenote, aetiology, prognosis |
| Valid Event Data Range | 01/01/2001 to 31/12/2019 |
| Sex | Female/Male |
| Authors | Eleanor L Axson, Jennifer K Quint |
| Agreement Date | 16 Dec 2019 |
| Modified Date | 16 Dec 2019 |
| Version | Revision 1 |
Definitions
UK Biobank
In Biobank, we utilised the self-report codes per the Definitions of Chronic Obstructive Pulmonary Disease for UK Biobank Phase 1 Outcomes Adjudication. For more information: http://biobank.ndph.ox.ac.uk/showcase/showcase/docs/alg_outcome_copd.pdf
| field_id | lookup_id | lookup_value |
|---|---|---|
| 20002 | 1112 | Chronic obstructive airways disease/COPD |
| 20002 | 1113 | Emphysema/chronic bronchitis |
| 20002 | 1472 | Emphysema |
Primary Care
| Read v2 Code | SNOMED CT Concept ID | SNOMED CT Description ID | Description | Quality and Outcomes Framework Read Codes 2017/18 | Validated Read Codes Quint et al. 2014 |
|---|---|---|---|---|---|
| Hyu3000 | 87433001 | 144964015 | [X]Other emphysema | Y | |
| Hyu3100 | 13645005 | 475431013 | [X]Other specified chronic obstructive pulmonary disease | Y | |
| H312200 | 195951007 | 301453013 | Acute exacerbation of chronic obstructive airways disease | ||
| H32y111 | 77690003 | 503646013 | Acute interstitial emphysema | ||
| H32y000 | 195963002 | 301470017 | Acute vesicular emphysema | Y | |
| 663K.00 | 170628003 | 1489743015 | Airways obstructn irreversible | Y | |
| H3B..00 | 10692761000119107 | 3046456013 | Asthma-chronic obstructive pulmonary disease overlap syndrome | Y | |
| 14OX.00 | 383611000000102 | 756761000000112 | At risk of chronic obstructive pulmonary diseas exacerbation | ||
| H32y100 | 266356006 | 396109014 | Atrophic (senile) emphysema | Y | |
| H312300 | 40100001 | 492443010 | Bronchiolitis obliterans | Y | |
| H320300 | 266355005 | 396108018 | Bullous emphysema with collapse | Y | |
| H322.00 | 68328006 | 113497011 | Centrilobular emphysema | Y | Y |
| H3y1.00 | 195951007 | 301453013 | Chron obstruct pulmonary dis wth acute exacerbation, unspec | ||
| H312000 | 195949008 | 301450011 | Chronic asthmatic bronchitis | Y | |
| H31..00 | 63480004 | 105519017 | Chronic bronchitis | Y | |
| H31z.00 | 63480004 | 105519017 | Chronic bronchitis NOS | Y | |
| H320.00 | 195957006 | 301460019 | Chronic bullous emphysema | Y | Y |
| H320z00 | 195957006 | 301460019 | Chronic bullous emphysema NOS | Y | Y |
| H310000 | 89549007 | 508562012 | Chronic catarrhal bronchitis | Y | |
| H464000 | 196026004 | 301572010 | Chronic emphysema due to chemical fumes | Y | |
| H3y0.00 | 196001008 | 301542016 | Chronic obstruct pulmonary dis with acute lower resp infectn | ||
| H3…11 | 13645005 | 475423015 | Chronic obstructive airways disease | Y | Y |
| H3z..00 | 13645005 | 475428012 | Chronic obstructive airways disease NOS | Y | Y |
| H3…00 | 13645005 | 475431013 | Chronic obstructive pulmonary disease | Y | Y |
| 66YM.00 | 394703002 | 1488424013 | Chronic obstructive pulmonary disease annual review | Y | |
| 8CMW500 | 848431000000106 | 2199261000000110 | Chronic obstructive pulmonary disease care pathway | ||
| 8CR1.00 | 736283006 | 3517019016 | Chronic obstructive pulmonary disease clini management plan | Y | |
| 1823851000006103 | 1823851000006119 | Chronic obstructive pulmonary disease confirmed | |||
| 6Yg.00 | 198401000000104 | 299001000000116 | Chronic obstructive pulmonary disease disturbs sleep | Y | |
| 66Yh.00 | 198411000000102 | 299031000000110 | Chronic obstructive pulmonary disease does not disturb sleep | Y | |
| 66YL.00 | 394702007 | 1488423019 | Chronic obstructive pulmonary disease follow-up | Y | |
| 9Oi4.00 | 716901000000101 | 1569451000000115 | Chronic obstructive pulmonary disease monitor phone invite | Y | |
| 66YB.00 | 390891009 | 1484924013 | Chronic obstructive pulmonary disease monitoring | Y | |
| 9Oi0.00 | 716241000000106 | 1568801000000112 | Chronic obstructive pulmonary disease monitoring 1st letter | Y | |
| 9Oi1.00 | 717021000000106 | 1569571000000113 | Chronic obstructive pulmonary disease monitoring 2nd letter | Y | |
| 9Oi2.00 | 717521000000104 | 1570061000000113 | Chronic obstructive pulmonary disease monitoring 3rd letter | Y | |
| 9Oi..00 | 713731000000102 | 1564971000000118 | Chronic obstructive pulmonary disease monitoring admin | Y | |
| 66YT.00 | 401185004 | 1780381012 | Chronic obstructive pulmonary disease monitoring by doctor | Y | |
| 66YS.00 | 401184000 | 1780380013 | Chronic obstructive pulmonary disease monitoring by nurse | Y | |
| 66YD.00 | 390941006 | 1484971019 | Chronic obstructive pulmonary disease monitoring due | Y | |
| 9Oi3.00 | 716281000000103 | 1568831000000118 | Chronic obstructive pulmonary disease monitoring verb invite | Y | |
| H3z..11 | 13645005 | 475431013 | Chronic obstructive pulmonary disease NOS | Y | Y |
| H31y100 | 52571006 | 87480013 | Chronic tracheobronchitis | Y | |
| H312011 | 195949008 | 301451010 | Chronic wheezy bronchitis | ||
| 66YL.11 | 394702007 | 1488423019 | COPD follow-up | Y | |
| H32..00 | 8743301 | 144964015 | Emphysema | Y | Y |
| H32z.00 | 8743301 | 144964015 | Emphysema NOS | Y | Y |
| H312100 | 185086009 | 285100019 | Emphysematous bronchitis | Y | Y |
| H3A..00 | 135836000 | 216596014 | End stage chronic obstructive airways disease | Y | |
| H583200 | 866901000000103 | 2240631000000119 | Eosinophilic bronchitis | Y | |
| H311100 | 84409004 | 506053014 | Fetid chronic bronchitis | Y | |
| H320200 | 16003001 | 27096010 | Giant bullous emphysema | Y | |
| 679V.00 | 741056003 | 3543021016 | Health education – chronic obstructive pulmonary disease | Y | |
| 14B3.12 | 270473001 | 1765681000000110 | History of chronic obstructive pulmonary disease | ||
| H32y200 | 45145000 | 1230190015 | MacLeod's unilateral emphysema | Y | |
| H36..00 | 313296004 | 457168017 | Mild chronic obstructive pulmonary disease | Y | Y |
| H313.00 | 195953005 | 301456017 | Mixed simple and mucopurulent chronic bronchitis | Y | |
| H37..00 | 313297008 | 457169013 | Moderate chronic obstructive pulmonary disease | Y | Y |
| H311.00 | 74417001 | 123588010 | Mucopurulent chronic bronchitis | Y | |
| H311z00 | 74417001 | 123588010 | Mucopurulent chronic bronchitis NOS | Y | |
| H464100 | 196027008 | 301573017 | Obliterative bronchiolitis due to chemical fumes | Y | |
| H312.00 | 185086009 | 285100019 | Obstructive chronic bronchitis | Y | |
| H312z00 | 185086009 | 285100019 | Obstructive chronic bronchitis NOS | Y | Y |
| 9NgP.00 | 826111000000109 | 2149041000000110 | On chronic obstructive pulmonary disease supportv cre pathway | ||
| 9NgP.11 | 826111000000109 | 2155811000000119 | On COPD (chr obstruc pulmonary disease) supportv cre pathway | ||
| H31y.00 | 63480004 | 105519017 | Other chronic bronchitis | Y | |
| H31yz00 | 63480004 | 105519017 | Other chronic bronchitis NOS | Y | |
| H32y.00 | 87433001 | 144964015 | Other emphysema | Y | |
| H32yz00 | 87433001 | 144964015 | Other emphysema NOS | Y | |
| H3y..00 | 13645005 | 475428012 | Other specified chronic obstructive airways disease | Y | Y |
| H3y..11 | 13645005 | 475431013 | Other specified chronic obstructive pulmonary disease | Y | |
| H321.00 | 4981000 | 9337016 | Panlobular emphysema | Y | |
| H311000 | 84409004 | 506053014 | Purulent chronic bronchitis | Y | |
| 9Nk7000 | 857661000000104 | 2219551000000113 | Seen in chronic obstructive pulmonary disease clinic | ||
| H320000 | 195958001 | 301463017 | Segmental bullous emphysema | Y | |
| H38..00 | 313299006 | 457171013 | Severe chronic obstructive pulmonary disease | Y | Y |
| H310.00 | 61937009 | 102938011 | Simple chronic bronchitis | Y | |
| H310z00 | 61937009 | 102938011 | Simple chronic bronchitis NOS | Y | |
| H39..00 | 293991000000106 | 516801000000112 | Very severe chronic obstructive pulmonary disease | Y | Y |
| H320100 | 195959009 | 301464011 | Zonal bullous emphysema | Y | |
Secondary Care
| ICD-10 code | ICD-10 term |
|---|---|
| J43 | Emphysema |
| J44 | Other chronic obstructive pulmonary disease |
Death
In the Office for National Statistics (ONS) mortality register, we used ICD-10 terms to identify where copd was recorded as the underlying cause of death.
| ICD-10 code | ICD-10 term |
|---|---|
| J43 | Emphysema |
| J44 | Other chronic obstructive pulmonary disease |
Implementation
These codes are not intended to be mandatory, but are to be used as a starting point for the identification of COPD in routine EHR. Each study may differ in the sensitivity and specificity of the coding required.
According to the National Institute for Health and Care Excellence (NICE) guidelines for the diagnosis of COPD, COPD should be suspected in patients over 35 years old who have a risk factor (typically smoking) and at least one symptom. It is therefore recommended that these codes are only utilised in an adult population at least 35 years old with a history of smoking.
https://www.nice.org.uk/guidance/ng115/chapter/Recommendations#diagnosing-copd
Validations
Quint et al. validated a set of Read codes for the identification of COPD in CPRD in 2014. Using diagnostic codes alone, the positive predictive value (PPV) was 86.5% (77.5–92.3%). Requiring a diagnostic code, spirometry measures, and specific medication increased PPV to 89.4% (80.7–94.5%) but reduced case numbers by 10%.
Publications
Publications in 2019 using validated Read codes from Quint et al. 2014
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D. Stolz, Kostikas, K., Loefroth, E., Fogel, R., Gutzwiller, F. S., Conti, V., Cao, H., and Clemens, A., “Differences in COPD exacerbation risk between women and men: analysis from the UK Clinical Practice Research Datalink data”, Chest, 2019.
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M. Pikoula, Quint, J. K., Nissen, F., Hemingway, H., Smeeth, L., and Denaxas, S., “Identifying clinically important COPD sub-types using data-driven approaches in primary care population based electronic health records”, BMC Med Inform Decis Mak, vol. 19, p. 86, 2019.
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H. R. Whittaker, Mullerova, H., Jarvis, D., Barnes, N. C., Jones, P. W., Compton, C. H., Kiddle, S. J., and Quint, J. K., “Inhaled corticosteroids, blood eosinophils, and FEV1 decline in patients with COPD in a large UK primary health care setting”, Int J Chron Obstruct Pulmon Dis, vol. 14, pp. 1063-1073, 2019.
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C. I. Bloom, Ricciardi, F., Smeeth, L., Stone, P., and Quint, J. K., “Predicting COPD 1-year mortality using prognostic predictors routinely measured in primary care”, BMC Med, vol. 17, p. 73, 2019.
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D. Dedman, Coton, S. J., Ghosh, R. E., Meeraus, W., Crim, C., Harvey, C., Amelio, J., and Landis, S. H., “Treatment Patterns of New Users of Fluticasone Furoate/Vilanterol in Asthma and COPD in UK Primary Care: Retrospective Cohort Study”, Pulmonary Therapy, vol. 5, pp. 81-95, 2019.
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J. D. Chalmers, Poole, C., Webster, S., Tebboth, A., Dickinson, S., and Gayle, A., “Assessing the healthcare resource use associated with inappropriate prescribing of inhaled corticosteroids for people with chronic obstructive pulmonary disease (COPD) in GOLD groups A or B: an observational study using the Clinical Practice Research Data”, Respir Res, vol. 19, p. 63, 2018.
Publications in 2019 using Read codes from QOF
- P. Rockenschaub, Jhass, A., Freemantle, N., Aryee, A., Rafiq, M., Hayward, A., and Shallcross, L., “Opportunities to reduce antibiotic prescribing for patients with COPD in primary care: a cohort study using electronic health records from the Clinical Practice Research Datalink (CPRD)”, J Antimicrob Chemother, 2019.