An ontological approach to identifying cases of chronic kidney disease from routine primary care data: a cross-sectional study
Open Access
- 10 April 2018
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Nephrology
- Vol. 19 (1), 1-6
- https://doi.org/10.1186/s12882-018-0882-9
Abstract
Accurately identifying cases of chronic kidney disease (CKD) from primary care data facilitates the management of patients, and is vital for surveillance and research purposes. Ontologies provide a systematic and transparent basis for clinical case definition and can be used to identify clinical codes relevant to all aspects of CKD care and its diagnosis. We used routinely collected primary care data from the Royal College of General Practitioners Research and Surveillance Centre. A domain ontology was created and presented in Ontology Web Language (OWL). The identification and staging of CKD was then carried out using two parallel approaches: (1) clinical coding consistent with a diagnosis of CKD; (2) laboratory-confirmed CKD, based on estimated glomerular filtration rate (eGFR) or the presence of proteinuria. The study cohort comprised of 1.2 million individuals aged 18 years and over. 78,153 (6.4%) of the population had CKD on the basis of an eGFR of < 60 mL/min/1.73m2, and a further 7366 (0.6%) individuals were identified as having CKD due to proteinuria. 19,504 (1.6%) individuals without laboratory-confirmed CKD had a clinical code consistent with the diagnosis. In addition, a subset of codes allowed for 1348 (0.1%) individuals receiving renal replacement therapy to be identified. Finding cases of CKD from primary care data using an ontological approach may have greater sensitivity than less comprehensive methods, particularly for identifying those receiving renal replacement therapy or with CKD stages 1 or 2. However, the possibility of inaccurate coding may limit the specificity of this method.Keywords
This publication has 23 references indexed in Scilit:
- Evolving importance of kidney disease: from subspecialty to global health burdenThe Lancet, 2013
- Predicting the prevalence of chronic kidney disease in the English population: a cross-sectional studyBMC Nephrology, 2013
- Estimating the financial cost of chronic kidney disease to the NHS in EnglandNephrology Dialysis Transplantation, 2012
- The contribution of chronic kidney disease to the global burden of major noncommunicable diseasesKidney International, 2011
- BioPortal: enhanced functionality via new Web services from the National Center for Biomedical Ontology to access and use ontologies in software applicationsNucleic Acids Research, 2011
- Stratifying risk in chronic kidney disease: an observational study of UK guidelines for measuring total proteinuria and albuminuriaQJM: An International Journal of Medicine, 2011
- Creatinine Fluctuation Has a Greater Effect than the Formula to Estimate Glomerular Filtration Rate on the Prevalence of Chronic Kidney DiseaseNephron Clinical Practice, 2010
- Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysisThe Lancet, 2010
- Chronic kidney disease management in the United Kingdom: NEOERICA project resultsKidney International, 2007
- The validity of searching routinely collected general practice computer data to identify patients with chronic kidney disease (CKD): a manual review of 500 medical recordsNephrology Dialysis Transplantation, 2005