An analytical framework for increasing the efficiency and validity of research using primary care databases
- 1 January 2014 to 30 June 2015
- Project No: 211
- Funding round: FR 8
Randomised Controlled Trials (RCTs) are generally regarded as the ‘gold standard’ for research into patient health, however there are many research questions for which an RCT is not practical. For example, some patients are usually excluded from RCTs of new medications for ethical and other reasons, yet these groups will often be prescribed these medications when they become generally available.
A primary care database (PCD) is a centralised collection of information aboutindividual patient visits to GPs and nurses at the general practice they are registered with. Some of these databases contain information collected electronically from several hundred general practices and for many millions of patients, stretching back over two decades or more.The use made of PCDs for research is increasing rapidly: 41 scientific papers were published in 2000 based on data from one of the UK’s three major PCDs; in 2011 it was 147.
This proposal focuses around three problematic or under-developed aspects of database research:
1) Duplication of effort. We will create freely available computer software to automate a number of key commonly used and time-consuming data processes, thereby speeding up processing time and reducing project time-scales and costs.
2) Validity and replicability. In research using PCDs many key factors, such as the disease conditions a patient has and the treatments they are receiving,are defined using lists of relevant clinical codes, but very little detail about these lists is published and each research group develops their own lists. We aim to increase consistencyin the specification and use of clinical code listsacross the research community.
3) Data quality. PCD-based research is relatively new and there are a number of issues around incorrect and missing data that still need to be addressed.