The Earl of Munsterasked Her Majesty's Government:
Further to the Answer given by Baroness Jay of Paddington on 7 July (WA 62), whether the Department of Health will undertake to ascertain by collection of new data the frequency and cost of osteoporotic fractures secondary to steroid use, especially in patients with asthma, inflammatory connective tissue diseases, inflammatory bowel diseases and transplant patients.
§ Baroness Jay of PaddingtonWe are not convinced that the considerable cost and burden data collection would impose upon the National Health Service is likely to justify the benefits of having the information requested. It will often not be possible to infer a direct relationship between primary and secondary diagnoses, or between the diagnoses and any cause of accident or injury.
Data Collection
1. In 1994–95 there were six (6) recorded episodes with a primary diagnosis of fracture (ICD9 code range 800–829) and a secondary diagnosis of osteoporosis (ICD9 code 733.0) and containing a code indicating the adverse effect of therapeutic use of hormones and synthetic substitutes (ICD9 code E932).
2. Presence of code E932 on a HES record in such cases would normally depend on relevant information being supplied by the patient, and also on the care taken in recording such details when preparing the HES record. As such, the data could be corrupted by inaccuracies in the information provided by patients and by incomplete recording of details when preparing the HES record.
3. The Hospital Episode Statistics (HES) database contains 10 million records per year detailing individual episodes of in-patient care within NHS hospitals in England. Each record contains a primary diagnosis code (the primary diagnosis is currently defined as the main condition treated or investigated). There are also six further fields that may be used to record additional details about the patients condition (the 'secondary diagnoses' or a code relating to the cause of an accident or an accident of poisoning).
4. Although there will often be a direct relationship between the primary and any secondary diagnosis (for example cataract as a primary and diabetes as a secondary—the diabetes having caused the cataract), this cannot automatically be inferred (e.g. if the primary is broken leg and the secondary is diabetes, it is clearly wrong to assume a relationship—the patient with the broken leg just happens to be diabetic).