[ { "phenotype_id": "PH4084", "phenotype_version_id": 9300, "name": "Eating disorder-related clinical events in linked ALSPAC primary and secondary care records", "definition": "This phenotype identifies eating disorder\\-related clinical events in linked primary and secondary care health records in the Avon Longitudinal Study of Parents and Children (ALSPAC). It includes clinical codes and dataset\\-specific ascertainment criteria used to identify linked eating disorder\\-related clinical events across primary care, Hospital Episode Statistics and Mental Health Services Data Set records.\n\nPrimary\\-care concepts are separated by coding system, including Read v2, CTV3/Read v3 and SNOMED CT. These codelists comprise clinically reviewed codes judged to be eating\\-disorder diagnostic codes, rather than codes for suspected eating disorders, symptoms, referrals or screening.\n\nThe Read v2 and CTV3/Read v3 concepts are ALSPAC\\-focused lists, restricted to eating disorder diagnostic codes identified in relation to ALSPAC linked primary\\-care data and cross\\-checked against ALSPAC/UKSeRP Read\\-code resources. External Read\\-code catalogues were used during code identification and review, but the submitted concepts should be interpreted as ALSPAC\\-focused implementation codelists rather than exhaustive Read v2 or CTV3 eating disorder codelists.\n\nThe ALSPAC primary\\-care SNOMED code catalogue available to researchers was searched for eating disorder\\-related codes, which were then reviewed and rated. This should be interpreted as an ALSPAC\\-specific SNOMED CT implementation list, not as an exhaustive current SNOMED CT UK Edition eating disorder codelist.\n\nICD\\-10 F50 codes were used in HES and MHSDS datasets to define eating disorder\\-related clinical events. F50\\.4, “Overeating associated with other psychological disturbances”, and F50\\.5, “Vomiting associated with other psychological disturbances”, were excluded.\n\nIn MHSDS\\-VARS, eating disorder\\-related events were also identified using dataset\\-specific service\\-context fields, including eating disorder main specialty and eating disorder/dietetics team type. These service\\-context criteria are implementation rules rather than standard clinical codelists.\n\nThis phenotype should therefore be interpreted as an ALSPAC\\-focused linked\\-record eating disorder clinical\\-event phenotype, rather than a comprehensive national eating disorder phenotype covering all possible contemporary clinical terminologies.\n", "implementation": "This phenotype can be used to identify eating disorder\\-related clinical events in primary and secondary care datasets linked to ALSPAC. In practice, each clinical concept should be applied separately within the relevant data source and coding system: Read v2, CTV3/Read v3 and SNOMED CT for primary care; ICD\\-10 F50 codes for HES and MHSDS diagnosis fields; and MHSDS\\-VARS service\\-context fields for eating disorder main specialty or eating disorder/dietetics team type.\n\nThe phenotype is intended to support both event\\-level and participant\\-level analyses. In the ALSPAC B3832 implementation, the phenotype was used to identify linked eating disorder\\-related clinical events between ages 13 and 24 years and to examine overlap with questionnaire\\-derived disordered eating and self\\-reported eating disorder diagnosis or treatment. Researchers applying this phenotype in other datasets should check which coding systems, data fields and code versions are available, and should interpret the SNOMED CT and Read\\-code components as ALSPAC\\-focused implementation lists rather than exhaustive contemporary UK clinical terminology codelists.\n\nWhere datasets contain multiple records per participant, the recommended implementation is to first identify all matching event\\-level records within each individual dataset, then derive dataset\\-specific participant\\-level flags and dates, before merging with an analysis backbone. This preserves the ability to analyse individual event records while also allowing reproducible participant\\-level ascertainment.\n", "publications": [], "validation": "The primary\\-care Read v2, CTV3/Read v3 and SNOMED CT concepts were restricted to eating disorder diagnostic codes to prioritise specificity. Referral codes, suspected eating disorder codes and broader eating disorder\\-related service\\-contact codes were not included as primary\\-care codes.\n\nCodes were identified and rated through clinical and epidemiological review by BG, TND, IC and HB who have research expertise in child and adolescent psychiatry, public health, eating disorder epidemiology and linked electronic health record research; BG, HB \\& TND have experience of working in psychiatric services (BG as a resident doctor in psychiatry; HB as a consultant child and adolescent psychiatrist; TND through previous roles as a resident doctor in psychiatry and specialist registrar child psychiatry and adolescent before entering public health); BG and HB also have experience of working as resident doctors in GP practices. Candidate codes were reviewed independently, and discrepancies were resolved through iterative discussion until agreement was reached.\n\nFor HES and MHSDS diagnosis fields, ICD\\-10 F50 codes were used to identify eating disorder diagnoses, excluding F50\\.4 and F50\\.5 because these were not considered sufficiently specific for a diagnosable eating disorder. In MHSDS\\-VARS, eating disorder\\-related clinical events were additionally identified using dataset\\-specific service\\-context fields: “Eating Disorders” main specialty and “Eating Disorders/Dietetics” team type.\n\nQuality control included manual review of event\\-level outputs and automated searches for eating disorder\\-related terms within each linked dataset using Stata. During this process, some primary\\-care events initially classified as eating disorder\\-related were found to have code descriptions not indicative of an eating disorder\\-related clinical event, due to some codes having multiple descriptions. These were reviewed with the project team and removed where inappropriate.\n", "citation_requirements": "If this phenotype is used in other work, please cite the HDR UK Phenotype Library entry and acknowledge the ALSPAC B3832 project codelist as follows:\n\nGeers B, Newlove\\-Delgado T, Costantini I, Solmi F, Bould H. Eating disorder\\-related clinical event phenotype for the ALSPAC B3832 linked health\\-record project. HDR UK Phenotype Library.\n\nWhere relevant, please also cite associated publication of ALSPAC project B3832\\.\n", "created": "2026-05-15T14:04:17.230488Z", "author": "Benjamin Geers, Tamsin Newlove-Delgado, Ilaria Costantini, Francesca Solmi, Helen Bould", "collections": null, "tags": null, "organisation": null, "world_access": 1, "updated": "2026-05-15T14:04:17.217616Z", "sex": [ { "name": "Neither", "value": "4" } ], "type": [ { "name": "Disease or syndrome", "value": "2" } ], "ontology": null, "phenoflowid": "", "data_sources": null, "coding_system": [ { "name": "SNOMED CT codes", "value": 9 }, { "name": "ICD10 codes", "value": 4 }, { "name": "Read codes v2", "value": 5 }, { "name": "Read codes v3", "value": 6 } ], "event_date_range": "", "concept_information": [ { "concept_id": 9512, "concept_version_id": 16997, "concept_name": "Primary care Read codes v2", "coding_system": { "id": 5, "name": "Read codes v2", "description": "Read codes v2" }, "phenotype_id": "PH4084", "phenotype_version_id": 9300, "phenotype_name": "Eating disorder-related clinical events in linked ALSPAC primary and secondary care records", "code_attribute_header": null, "codes": [ { "code": "E271.", "description": "Anorexia nervosa", "attributes": null }, { "code": "E275.", "description": "Other and unspecified non-organic eating disorders", "attributes": null }, { "code": "E2750", "description": "Unspecified non-organic eating disorder", "attributes": null }, { "code": "E2752", "description": "Pica", "attributes": null }, { "code": "E275z", "description": "Non-organic eating disorder NOS", "attributes": null }, { "code": "Eu500", "description": "[X]Anorexia nervosa", "attributes": null }, { "code": "Eu502", "description": "[X]Bulimia nervosa", "attributes": null }, { "code": "Eu503", "description": "[X]Atypical bulimia nervosa", "attributes": null }, { "code": "Eu50z", "description": "[X]Eating disorder, unspecified", "attributes": null } ] }, { "concept_id": 9513, "concept_version_id": 16998, "concept_name": "Primary care Read codes v3", "coding_system": { "id": 6, "name": "Read codes v3", "description": "Read codes v3" }, "phenotype_id": "PH4084", "phenotype_version_id": 9300, "phenotype_name": "Eating disorder-related clinical events in linked ALSPAC primary and secondary care records", "code_attribute_header": null, "codes": [ { "code": "E271.", "description": "Anorexia nervosa", "attributes": null }, { "code": "E275.", "description": "Other and unspecified non-organic eating disorders", "attributes": null }, { "code": "E2750", "description": "Unspecified non-organic eating disorder", "attributes": null }, { "code": "E2752", "description": "Pica", "attributes": null }, { "code": "E275z", "description": "Non-organic eating disorder NOS", "attributes": null }, { "code": "Eu50z", "description": "[X]Eating disorder, unspecified", "attributes": null } ] }, { "concept_id": 9514, "concept_version_id": 16999, "concept_name": "Primary care SNOMED CT codes", "coding_system": { "id": 9, "name": "SNOMED CT codes", "description": "SNOMED CT codes" }, "phenotype_id": "PH4084", "phenotype_version_id": 9300, "phenotype_name": "Eating disorder-related clinical events in linked ALSPAC primary and secondary care records", "code_attribute_header": null, "codes": [ { "code": "14077003", "description": "Pica", "attributes": null }, { "code": "1620911000006108", "description": "Eating disorders", "attributes": null }, { "code": "231523004", "description": "[X]Atypical bulimia nervosa", "attributes": null }, { "code": "413721000000105", "description": "[X]Eating disorders", "attributes": null }, { "code": "468041000000107", "description": "[X]Eating disorder, unspecified", "attributes": null }, { "code": "56882008", "description": "[X]Anorexia nervosa", "attributes": null }, { "code": "608241000000102", "description": "Eating disorder NOS - psychog.", "attributes": null }, { "code": "72366004", "description": "[X]Eating disorder, unspecified", "attributes": null }, { "code": "78004001", "description": "[X]Bulimia nervosa", "attributes": null } ] }, { "concept_id": 9515, "concept_version_id": 17000, "concept_name": "Secondary care ICD-10 codes", "coding_system": { "id": 4, "name": "ICD10 codes", "description": "ICD10 Codes" }, "phenotype_id": "PH4084", "phenotype_version_id": 9300, "phenotype_name": "Eating disorder-related clinical events in linked ALSPAC primary and secondary care records", "code_attribute_header": null, "codes": [ { "code": "F50", "description": "Eating disorders", "attributes": null }, { "code": "F50.0", "description": "Anorexia nervosa", "attributes": null }, { "code": "F50.1", "description": "Atypical anorexia nervosa", "attributes": null }, { "code": "F50.2", "description": "Bulimia nervosa", "attributes": null }, { "code": "F50.3", "description": "Atypical bulimia nervosa", "attributes": null }, { "code": "F50.8", "description": "Other eating disorders", "attributes": null }, { "code": "F50.9", "description": "Eating disorder, unspecified", "attributes": null } ] } ], "status": 1, "doi": "https://doi.org/10.48533/y3gf-9025", "is_deleted": false, "publish_status": 2, "owner": "Benjamin.Geers", "template": { "id": 1, "name": "Clinical-Coded Phenotype", "description": "Phenotype definitions that are based on lists of clinical codes, or algorithms using clinical codes.", "version_id": 1 }, "versions": [ { "version_id": 9300, "version_name": "Eating disorder-related clinical events in linked ALSPAC primary and secondary care records", "version_date": "2026-05-15T14:04:17.246990Z", "is_published": true, "is_latest": true } ] } ]