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What was required for our research, and which did not exist, was a straight-forward classification in a simple hierarchy organised according to surgical disciplines, but which facilitated effective coding of conditions encountered in primary care environments.
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We confined our analysis to QOF conditions which standardised the GP coding of these conditions.
Using drug-disease knowledge bases to infer pathological conditions from medications is a feasible and useful technique to complete the coding of pathological conditions.
These changes were made to facilitate the coding of the conditions during the data extraction process since definitions do not generally include etiological distinctions in incidence/prevalence studies of maternal conditions.
It is known that diagnostic coding of acute conditions is not always accurate [ 33].
Similarly, the coding of IRD conditions may have inaccuracies and be biased towards only coding the most severe cases.
Improvements to the coding of psychiatric conditions in ICD-11 will assist in the standardization of this approach.
However, the standards require coding of certain conditions whenever they are present; some communicable diseases (e.g. HIV, viral hepatitis), diabetes and pregnancy [ 19].
Given the complexity of factors likely to influence administrative coding of these conditions, we did not hypothesize which of the administrative codes may have the highest levels of sensitivity or specificity for data recorded in charts.
However, incomplete diagnostic coding of obstetric conditions could have inflated the number of elective CS performed between 35th and 39th weeks and so have led to the proportion of elective CS performed after 39 weeks being underestimated.
These results highlight an important finding for researchers that the routine coding of acute conditions such as ILI within general practice may be substantially lower than the actual presentation.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com