e-Health initiative generates first published research
9 December 2009
The papers provide insight into the use of antibiotics to treat respiratory tract infections and the methodology of stroke research. They illustrate the potential of electronic patient databases to deliver key analyses that can help improve health care and public health, as well as analysing methodological questions facing researchers using large datasets from electronic records.
"These two papers illustrate the immense potential of electronic patient records to provide new information of public health importance across a range of different health problems," said Professor Martin Gulliford from the Division of Health and Social Care Research at King's College London and lead author on both papers.
In the first paper, researchers from King's College London, the University of Southampton and the Medicines and Healthcare products Regulatory Agency estimated trends in primary care consultations and the prescription of antibiotics to treat acute respiratory tract infections in the UK from 1997 to 2006.
Analysing data from 100 000 subjects registered with 78 family practices in the UK General Practice Research Database, the researchers found a decreasing frequency of consultation and antibiotic prescription for colds, rhinitis and upper respiratory tract infections. They say that this decrease continues to drive a reduction in the use of antibiotics.
In the second paper, researchers from the Division of Health and Social Care Research evaluated medical codes used by researchers to identify patients diagnosed with acute stroke and how these have changed over time.
Studying electronic patient records from primary care databases, they found substantial changes in the medical codes used between 1996 and 2006. The clinical and prognostic usefulness of different code sets varied, and the perceived relevance of different codes depended on the differing experience and interpretations of the epidemiologists and clinicians carrying out the research.
The authors of the paper call for greater transparency in the selection of codes used to identify conditions such as stroke, for increased use of sensitivity analyses using different code sets, as well as the sharing of code sets among researchers.
The e-Health Funding Initiative was launched in 2008 by the Wellcome Trust, the Economic and Social Research Council, the Engineering and Physical Sciences Research Council and the Medical Research Council. A total of £10.6 million was awarded to 17 projects with the Trust contributing £9.3 million.
Image: A family doctor referring to her computer to help a patient. Credit: Wellcome Library, London
References
Gulliford M et al. Selective decrease in consultations and antibiotic prescribing for acute respiratory tract infections in UK primary care up to 2006. J Public Health (Oxf). 2009 Dec;31(4):512-20.
Gulliford M et al. Selection of Medical Diagnostic Codes for Analysis of Electronic Patient Records. Application to Stroke in a Primary Care Database. PLoS One. 2009 Sep 24;4(9):e7168.
