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Gastroenterology and hepatology
Research
Coding of Barrett’s oesophagus with high-grade dysplasia in national administrative databases: a population-based cohort study
  1. Georgina Chadwick1,
  2. Mira Varagunam1,
  3. Christian Brand1,2,
  4. Stuart A Riley3,
  5. Nick Maynard4,
  6. Tom Crosby5,
  7. Julie Michalowski6,
  8. David A Cromwell1,2
  1. 1Clinical Effectiveness Unit, The Royal College of Surgeons of England, London, UK
  2. 2Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
  3. 3Department of Gastroenterology, Northern General Hospital, Sheffield, UK
  4. 4Oxford Health NHS Trust, Department of Oesophago-Gastric Surgery, Oxford, UK
  5. 5Department of Radiotherapy, Velindre Cancer Centre, Cardiff, UK
  6. 6Health and Social Care Information Centre, Leeds, UK
  1. Correspondence to Professor David A Cromwell; dcromwell{at}rcseng.ac.uk

Abstract

Objectives The International Classification of Diseases 10th Revision (ICD-10) system used in the English hospital administrative database (Hospital Episode Statistics (HES)) does not contain a specific code for oesophageal high-grade dysplasia (HGD). The aim of this paper was to examine how patients with HGD were coded in HES and whether it was done consistently.

Setting National population-based cohort study of patients with newly diagnosed with HGD in England. The study used data collected prospectively as part of the National Oesophago-Gastric Cancer Audit (NOGCA). These records were linked to HES to investigate the pattern of ICD-10 codes recorded for these patients at the time of diagnosis.

Participants All patients with a new diagnosis of HGD between 1 April 2013 and 31 March 2014 in England, who had data submitted to the NOGCA.

Outcomes measured The main outcome assessed was the pattern of primary and secondary ICD-10 diagnostic codes recorded in the HES records at endoscopy at the time of diagnosis of HGD.

Results Among 452 patients with a new diagnosis of HGD between 1 April 2013 and 31 March 2014, Barrett’s oesophagus was the only condition coded in 200 (44.2%) HES records. Records for 59 patients (13.1%) contained no oesophageal conditions. The remaining 193 patients had various diagnostic codes recorded, 93 included a diagnosis of Barrett’s oesophagus and 57 included a diagnosis of oesophageal/gastric cardia cancer.

Conclusions HES is not suitable to support national studies looking at the management of HGD. This is one reason for the UK to adopt an extended ICD system (akin to ICD-10-CM).

  • Adult gastroenterology
  • Endoscopy
  • Gastrointestinal tumours
  • Oesophageal disease

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-014281

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    Footnotes

    • Contributors GC and MV: Conception and design, analysis and interpretation of data, critical revision of the article and final approval of article. CB, SAR, NM and TC: Conception and design, interpretation of data, critical revision of the article and final approval of article. JM: Conception and design, critical revision of the article and final approval of article. DAC: Conception and design, analysis and interpretation of data, critical revision of the article and final approval of article.

    • Disclaimer This publication is based on data collected by or on behalf of the Healthcare Quality Improvement Partnership, who have no responsibility or liability for the accuracy, currency, reliability and/or correctness of this publication.

    • Competing interests None declared.

    • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional unpublished data available from the study.