{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T23:11:11Z","timestamp":1791673871716,"version":"4.3.4"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T00:00:00Z","timestamp":1705363200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T00:00:00Z","timestamp":1705363200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"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"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Epidemiol"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The UK Biobank has made general practitioner (GP) data (censoring date 2016\u20132017) available for approximately 45% of the cohort, whilst hospital inpatient and death registry (referred to as \u201cHES\/Death\u201d) data are available cohort-wide through 2018\u20132022 depending on whether the data comes from England, Wales or Scotland. We assessed the importance of case ascertainment via different data sources in UKB for three diseases that are usually first diagnosed in primary care: Parkinson\u2019s disease (PD), type 2 diabetes (T2D), and all-cause dementia. Including GP data at least doubled the number of incident cases in the subset of the cohort with primary care data (e.g. from 619 to 1390 for dementia). Among the 786 dementia cases that were only captured in the GP data before the GP censoring date, only 421 (54%) were subsequently recorded in HES. Therefore, estimates of the absolute incidence or risk-stratified incidence are misleadingly low when based only on the HES\/Death data. For incident cases present in both HES\/Death and GP data during the full follow-up period (i.e. until the HES censoring date), the median time difference between an incident diagnosis of dementia being recorded in GP and HES\/Death was 2.25 years (i.e. recorded 2.25 years earlier in the GP records). Similar lag periods were also observed for PD (median 2.31 years earlier) and T2D (median 2.82 years earlier). For participants with an incident GP diagnosis, only 65.6% of dementia cases, 69.0% of PD cases, and 58.5% of T2D cases had their diagnosis recorded in HES\/Death within 7 years since GP diagnosis. The effect estimates (hazard ratios, HR) of established risk factors for the three health outcomes mostly remain in the same direction and with a similar strength of association when cases are ascertained either using HES only or further adding GP data. The confidence intervals of the HR became narrower when adding GP data, due to the increased statistical power from the additional cases. In conclusion, it is desirable to extend both the coverage and follow-up period of GP data to allow researchers to maximise case ascertainment of chronic health conditions in the UK.<\/jats:p>","DOI":"10.1007\/s10654-023-01095-0","type":"journal-article","created":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T03:01:52Z","timestamp":1705374112000},"page":"219-229","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Assessing the importance of primary care diagnoses in the UK Biobank"],"prefix":"10.1007","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5595-8468","authenticated-orcid":false,"given":"Lei","family":"Clifton","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaonan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer A","family":"Collister","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J","family":"Littlejohns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi","family":"Allen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J","family":"Hunter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,1,16]]},"reference":[{"key":"1095_CR1","doi-asserted-by":"crossref","unstructured":"Sudlow C et al. Mar., UK Biobank: An Open Access Resource for Identifying the Causes of a Wide Range of Complex Diseases of Middle and Old Age, PLoS Med, 2015;12(3).","DOI":"10.1371\/journal.pmed.1001779"},{"key":"1095_CR2","doi-asserted-by":"crossref","unstructured":"Livingston G. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission, Lancet, 2020;396(10248):413\u2013446.","DOI":"10.1016\/S0140-6736(20)30367-6"},{"issue":"10291","key":"1095_CR3","doi-asserted-by":"publisher","first-page":"2284","DOI":"10.1016\/S0140-6736(21)00218-X","volume":"397","author":"BR Bloem","year":"2021","unstructured":"Bloem BR, Okun MS, Klein C. Parkinson\u2019s Disease. The Lancet. 2021;397(10291):2284\u2013303.","journal-title":"The Lancet"},{"key":"1095_CR4","doi-asserted-by":"crossref","unstructured":"Jacobs BM et al. Oct., Parkinson\u2019s disease determinants, prediction and gene\u2013environment interactions in the UK Biobank, J. Neurol. Neurosurg. Psychiatry, 2020;91(10):1046\u20131054.","DOI":"10.1136\/jnnp-2020-323646"},{"key":"1095_CR5","doi-asserted-by":"crossref","unstructured":"Xu C, Hou Y, Fang X, Yang H, Cao Z. The role of type 2 diabetes in the association between habitual glucosamine use and dementia: a prospective cohort study, Alzheimer\u2019s Res. Ther, 2022;14(1):1\u201310.","DOI":"10.1186\/s13195-022-01137-x"},{"key":"1095_CR6","unstructured":"NICE, Diabetes -. Type 2 - Background information, Clinical Knowledge Summaries (CKS), 2023. [Online]. Available: https:\/\/cks.nice.org.uk\/topics\/diabetes-type-2\/background-information\/risk-factors\/. [Accessed: 01-Jun-2023]."},{"issue":"1","key":"1095_CR7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12916-022-02354-9","volume":"20","author":"F Bragg","year":"2022","unstructured":"Bragg F, Trichia E, Aguilar-Ramirez D, Be\u0161evi\u0107 J, Lewington S, Emberson J. Predictive value of circulating NMR metabolic biomarkers for type 2 Diabetes risk in the UK Biobank study. BMC Med. 2022;20(1):1\u201312.","journal-title":"BMC Med"},{"key":"1095_CR8","doi-asserted-by":"crossref","unstructured":"Liu X, Collister JA, Clifton L, Hunter DJ, Littlejohns TJ. Polygenic risk of Prediabetes, undiagnosed Diabetes, and Incident Type 2 Diabetes stratified by Diabetes risk factors. J Endocr Soc. Feb. 2023;7(4):1\u20137.","DOI":"10.1210\/jendso\/bvad020"},{"key":"1095_CR9","doi-asserted-by":"crossref","unstructured":"Eastwood SV et al. Sep., Algorithms for the Capture and Adjudication of Prevalent and Incident Diabetes in UK Biobank, PLoS One, 2016;11(9).","DOI":"10.1371\/journal.pone.0162388"},{"key":"1095_CR10","unstructured":"Biobank UK. Hospital inpatient data: Data_providers_and_dates, 2023. [Online]. Available: https:\/\/biobank.ctsu.ox.ac.uk\/showcase\/exinfo.cgi?src=Data_providers_and_dates. [Accessed: 18-Apr-2023]."},{"issue":"14","key":"1095_CR11","doi-asserted-by":"publisher","first-page":"2252","DOI":"10.1002\/sim.7654","volume":"37","author":"M Schomaker","year":"2018","unstructured":"Schomaker M, Heumann C. Bootstrap inference when using multiple imputation. Stat Med. 2018;37(14):2252\u201366.","journal-title":"Stat Med"},{"key":"1095_CR12","doi-asserted-by":"crossref","unstructured":"Stamatakis E, Owen KB, Shepherd L, Drayton B, Hamer M, Bauman AE. Is Cohort Representativeness Pass\u00e9 ? Poststratified Associations of Lifestyle Risk Factors with Mortality in the UK Biobank, Epidemiology, 2021;32(2):179\u2013188.","DOI":"10.1097\/EDE.0000000000001316"},{"key":"1095_CR13","doi-asserted-by":"crossref","unstructured":"Clifton L, Collister JA, Liu X, Littlejohns TJ, Hunter DJ. Assessing agreement between different polygenic risk scores in the UK Biobank. Sci Rep 2022. 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Jan. 2020;94(2):e123\u201332.","DOI":"10.1212\/WNL.0000000000008779"}],"container-title":["European Journal of Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10654-023-01095-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10654-023-01095-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10654-023-01095-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T18:25:29Z","timestamp":1709231129000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10654-023-01095-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,16]]},"references-count":16,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["1095"],"URL":"https:\/\/doi.org\/10.1007\/s10654-023-01095-0","relation":{},"ISSN":["0393-2990","1573-7284"],"issn-type":[{"value":"0393-2990","type":"print"},{"value":"1573-7284","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,16]]},"assertion":[{"value":"7 July 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 December 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 January 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The UK Biobank study received ethical approval from the North West Multi-centre Research Ethics Committee (REC reference: 11\/NW\/03820). All participants gave written informed consent before enrolment in the study, which was conducted in accordance with the principles of the Declaration of Helsinki. This study has been conducted using the UK Biobank Resource under Application Number 33952.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The lead author affirms that this manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned have been explained.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Transparency statement"}},{"value":"The analyses presented here are based on existing data from the UK Biobank cohort study, and the authors were not involved in participant recruitment. To the best of our knowledge, no patients were explicitly engaged in the design or implementation of the UK Biobank study. No patients were asked to advise on interpretation or writing these results. Results from UK Biobank are routinely disseminated to study participants via the study website and social media outlets.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Patient and community involvement"}},{"value":"Yes.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors declare no support from any organization for the submitted work, no financial relationship with any organization that might have an interest in the submitted work in the previous three years; no other relationship or activities that could appear to have influenced the submitted work.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}