{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T08:24:51Z","timestamp":1787041491829,"version":"build-2736575974"},"reference-count":10,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","award":["C16077\/A29186"],"award-info":[{"award-number":["C16077\/A29186"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004856","name":"Department of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004856","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Learning Health Systems"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The UK Biobank (UKB) study has linked hospital inpatient data collected from England, Scotland, and Wales, which use different clinical coding systems to record health outcomes. Scotland records up to 6 different diagnostic codes for one inpatient episode, compared with up to 20 in England and 14 in Wales. We assessed the relationship of the variations in diagnostic coding among countries on observed disease incidence rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We examined the number of diagnoses coded by each country, and then compared the incidence of three diseases between countries: Parkinson's disease (PD), type 2 diabetes (T2D), and dementia. We constructed Cox models for each disease, adjusting for \u201ccountry.\u201d<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with England, Scotland appears to have the lowest risk (hazard ratio, HR) for all three diseases: HR [95% CI]\u2009=\u20090.62 [0.54, 0.72] for PD, 0.49 [0.45, 0.54] for T2D, and 0.88 [0.78, 0.99] for dementia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The observed incidence of these diseases and the estimated effect of \u201ccountry\u201d in Cox models are likely influenced by the clinical coding variations among countries. Researchers need to be aware of this and account for these variations in their analyses.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lrh2.70083","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T14:40:26Z","timestamp":1777992026000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessing the Importance of Variation in Diagnostic Coding Among the Three Countries in the\n                    <scp>UK<\/scp>\n                    Biobank"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5595-8468","authenticated-orcid":false,"given":"Lei","family":"Clifton","sequence":"first","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenyu","family":"Liu","sequence":"additional","affiliation":[{"name":"Nuffield Department of Population Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer A.","family":"Collister","sequence":"additional","affiliation":[{"name":"Nuffield Department of Population Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J.","family":"Littlejohns","sequence":"additional","affiliation":[{"name":"Nuffield Department of Population Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael R.","family":"Goldacre","sequence":"additional","affiliation":[{"name":"Nuffield Department of Population Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Allen","sequence":"additional","affiliation":[{"name":"Nuffield Department of Population Health University of Oxford  Oxford UK"},{"name":"UK Biobank Ltd  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Hunter","sequence":"additional","affiliation":[{"name":"Nuffield Department of Population Health University of Oxford  Oxford UK"},{"name":"Department of Epidemiology Harvard TH Chan School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyx015"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001779"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0162388"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-023-01095-0"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1381146"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/database\/baad026"},{"key":"e_1_2_14_8_1","unstructured":"Parkinson's UK.\u201cPrevalence and Incidence of Parkinson's in the UK (Interactive Dashboard) \u201dParkinson's UK Public Tableau (2025) https:\/\/public.tableau.com\/app\/profile\/parkinsonsuk\/viz\/PrevalenceandIncidenceofParkinsonsintheUK\/PrevalenceandIncidence."},{"key":"e_1_2_14_9_1","unstructured":"The Health Foundation.\u201cQuality in Healthcare in England Wales Scotland and Northern Ireland: An Intra\u2010UK Chartbook (Diabetes Section) 49 \u201dThe Health Foundation (2009) https:\/\/www.health.org.uk\/sites\/default\/files\/QualityInHealthcareInEnglandWalesScotlandNorthernIreland_IntraUKChartbook.pdf."},{"key":"e_1_2_14_10_1","unstructured":"Alzheimer's Research UK.\u201cDementia Prevalence by UK Constituency: Interactive Map Interactive Visualisation \u201d(2024) https:\/\/visualisation.polimapper.co.uk\/?dataSetKey=dementia\u2010prevalence\u2010by\u2010uk\u2010constituency\u20102024&client=alzheimersresearch."},{"key":"e_1_2_14_11_1","unstructured":"Office for National Statistics (ONS).\u201cLife Expectancy for Local Areas of the UK: Between 2001 to 2003 and 2022 to 2024 Statistical Bulletin \u201dOffice for National Statistics (2025) https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/healthandsocialcare\/healthandlifeexpectancies\/bulletins\/lifeexpectancyforlocalareasoftheuk\/between2001to2003and2022to2024."}],"container-title":["Learning Health Systems"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lrh2.70083","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lrh2.70083","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lrh2.70083","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T07:34:42Z","timestamp":1787038482000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lrh2.70083"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,5]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/lrh2.70083"],"URL":"https:\/\/doi.org\/10.1002\/lrh2.70083","archive":["Portico"],"relation":{},"ISSN":["2379-6146","2379-6146"],"issn-type":[{"value":"2379-6146","type":"print"},{"value":"2379-6146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,5]]},"assertion":[{"value":"2025-07-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70083"}}