title: The communication of a secondary care diagnosis of autoimmune hepatitis to primary care practitioners: a population-based study.
abstract: BACKGROUND
  Autoimmune Hepatitis is a chronic liver disease which affects young people and can result in liver failure leading to death or transplantation yet there is a lack of information on the incidence and prevalence of this disease and its natural history in the UK. A means of obtaining this information is via the use of clinical databases formed of electronic primary care records. How reliably the diagnosis is coded in such records is however unknown. The aim of this study therefore was to assess the proportion of consultant hepatologist diagnoses of Autoimmune Hepatitis which were accurately recorded in General Practice computerised records.
  
  
  METHODS
  Our study population were patients with Autoimmune Hepatitis diagnosed by consultant hepatologists in the Queens Medical Centre, Nottingham University Hospitals (UK) between 2004 and 2009. We wrote to the general practitioners of these patients to obtain the percentage of patients who had a valid READ code specific for Autoimmune Hepatitis.
  
  
  RESULTS
  We examined the electronic records of 51 patients who had biopsy evidence and a possible diagnosis of Autoimmune Hepatitis. Forty two of these patients had a confirmed clinical diagnosis of Autoimmune Hepatitis by a consultant hepatologist: we contacted the General Practitioners of these patients obtaining a response rate of 90.5% (39/42 GPs). 37/39 of these GPs responded with coding information and 89% of these patients (33/37) used Read code J638.00 (Autoimmune Hepatitis) to record a diagnosis.
  
  
  CONCLUSIONS
  The diagnosis of Autoimmune Hepatitis made by a Consultant Hepatologist is accurately communicated to and electronically recorded by primary care in the UK. As a large proportion of cases of Autoimmune Hepatitis are recorded in primary care, this minimises the risk of introducing selection bias and therefore selecting cases using these data will be a valid method of conducting population based studies on Autoimmune Hepatitis.
authors: Department of Gastroenterology, Queens Medical Centre, Nottingham University Hospital NHS Trust, Derby Road, Nottingham, NG7 2UH, United Kingdom. fumi_varyani@hotmail.com
authors: Fumi
authors: F
authors: Varyani
authors: Timothy
authors: T
authors: Card
authors: Philip
authors: P
authors: Kaye
authors: Guru P
authors: GP
authors: Aithal
authors: Joe
authors: J
authors: West
mesh_terms: D003142:Communication; D019693:Hepatitis, Autoimmune / Q000175:diagnosis*; D006801:Humans; D010817:Physician-Patient Relations; D058007:Physicians, Primary Care; D011159:Population Surveillance
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