Evidence mapPaperPMID 33077509Full record

ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2020

Uncoded chronic kidney disease in primary care: a cross-sectional study of inequalities and cardiovascular disease risk management.

Mariam Molokhia, Grace N Okoli, Patrick Redmond, Elham Asgari, Catriona Shaw, Peter Schofield, Mark Ashworth, Stevo Durbaba, Dorothea Nitsch

Open access · bronzeAbstract read
In one paragraph

Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 2 pooled it
2.3field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Article
  6. Article
  7. Coded and uncoded chronic kidney disease: an explainer.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025
    Article
  8. Review
  9. Article
  10. Chronic kidney disease management in primary care: challenges and possible developments.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025
    Article
  11. Article
  12. Primary healthcare professionals' approach to clinical coding: a qualitative interview study in Wales.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025
    Article
  13. Article
  14. Article
  15. Article
  16. Review
  17. Care processes and outcomes of deprivation across the clinical course of kidney disease: findings from a high-income country with universal healthcare.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2023
    Article
  18. Article
  19. Inequalities in CKD management can be overcome.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021
    Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Mariam MolokhiaNational Institute for Health Research academic clinical lecturer.
Grace N OkoliInstitute of Population Health Sciences, Centre for Primary Care and Mental Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London.
Patrick RedmondNational Institute for Health Research academic clinical lecturer.
Elham AsgariRenal Department, Guy's and St Thomas' Hospital NHS Foundation Trust, London.
Catriona ShawRenal Department, King's College Hospital NHS Foundation Trust, London.
Peter SchofieldDepartment of Population Health Sciences, King's College London, London.
Mark AshworthDepartment of Population Health Sciences, King's College London, London.
Stevo DurbabaDepartment of Population Health Sciences, King's College London, London.
Dorothea NitschDepartment of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London.
King's College London · GBNational Institute for Health Research · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUncoded chronic kidney disease (CKD) is associated with poorer quality of care.

aimTo ascertain the proportion and determinants of CKD, which have not been formally recorded (Read coded), and identify differences in management and quality-of-care measures for patients with coded and uncoded CKD. DESIGN AND

settingCross-sectional survey undertaken in an ethnically diverse adult population using primary care electronic health records (EHRs) from GP clinics in Lambeth, South London, UK.

methodMultivariable logistic regression analysis examined the association of demographic factors, selected comorbidities, deprivation, and cardiovascular disease risk management in CKD, with coding status as outcome.

resultsIn total, the survey involved 286 162 adults, of whom 9325 (3.3%) were identified with CKD stage 3-5 (assigned as CKD based on estimated glomerular filtration rate [eGFR] values). Of those identified with CKD, 4239 (45.5%) were Read coded, and 5086 (54.5%) were uncoded. Of those identified with CKD stage 3-5, individuals aged ≥50 years were more likely to be coded for CKD, compared with those aged <50 years. Lower levels of coding were independently associated with deprivation and black Caribbean, black African, South Asian, and non-stated ethnicities, compared with white ethnicity. Prescribed statin and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker medications were associated with increased odds of coded CKD.

conclusionThis study found that >50% of CKD was uncoded and, for those patients, quality of care was lower compared with those with coded CKD. Future research and practices should focus on areas of greater deprivation and targeted initiatives for those aged <50 years and of black African, black Caribbean, South Asian, or non-stated ethnic groups. Possible areas for improvement include diagnostic coding support, automated CKD recording, and clinical decision support (based on adjusted eGFR results) in the GP clinical records.

Indexed as

Cardiovascular DiseasesRenal Insufficiency, ChronicAdultCross-Sectional StudiesGlomerular Filtration RateHumansLondonPrimary Health CareRisk Managementcardiovascular diseaseschronic kidney diseaseclinical codingethnic groups

Identifiers

PMID33077509
PMCPMC7575408
OpenAlexW3093027634

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.