Eleven key measures for monitoring general practice clinical activity during COVID-19 using federated analytics on 48 million adults' primary care records through OpenSAFELY
Eleven key measures for monitoring general practice clinical activity during COVID-19 using federated analytics on 48 million adults' primary care records through OpenSAFELY
复制标题
通过 OpenSAFELY 对 4800 万成人初级保健记录进行联合分析，监测 COVID-19 期间全科临床活动的 11 项关键措施
DOI：
10.1101/2022.10.17.22281058
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Fisher L
中科院分区：
文献类型：
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作者：
Fisher L
背景 COVID-19 大流行对 NHS 护理的提供产生了重大影响。我们开发了 OpenSAFELY 服务恢复观测站 (SRO) 来描述这种对初级保健活动的影响并监测其恢复情况。目标制定初级保健活动的关键衡量标准，并描述整个 COVID-19 大流行期间这些衡量标准的趋势。方法经英国 NHS 批准，我们开发了一个用于数据管理和分析的开源软件框架，以描述 4800 万成年人初级保健电子健康记录 (EHR) 数据中临床活动的趋势和变化。我们为由专家临床咨询小组选择的初级保健临床活动的关键指标，并进行了一项基于人群队列的研究，以描述这些指标在2019年1月至2021年12月期间的趋势和变化，并使用中位实践水平率的百分比变化，务实地将其一年内的恢复水平分类为大流行。结果我们制定了11项反映一般实践中临床活动的指标。在 COVID-19 大流行开始时，所有措施的活动均大幅下降。到2021年4月，六项措施的中位率已恢复至2019年4月中位率的15%以内。其余指标持续下降，从药物审查减少 18.5% 到血压监测减少 42.0%。到 2021 年 12 月，三项指标继续呈现持续下降。 结论 在我们制定的指标中，COVID-19 大流行与初级保健活动的重大变化有关，大多数指标都出现了复苏。我们提供了一个开源软件框架，用于描述前所未有规模的初级保健数据中临床活动的趋势和变化。我们将继续扩大使用我们公开的 NHS OpenSAFELY SRO 仪表板和近实时数据进行日常监控的关键措施集。
BackgroundThe COVID-19 pandemic has had a significant impact on delivery of NHS care. We have developed the OpenSAFELY Service Restoration Observatory (SRO) to describe this impact on primary care activity and monitor its recovery.ObjectivesTo develop key measures of primary care activity and describe the trends in these measures throughout the COVID-19 pandemic.MethodsWith the approval of NHS England we developed an open source software framework for data management and analysis to describe trends and variation in clinical activity across primary care electronic health record (EHR) data on 48 million adults.We developed SNOMED-CT codelists for key measures of primary care clinical activity selected by a expert clinical advisory group and conducted a population cohort-based study to describe trends and variation in these measures January 2019-December 2021, and pragmatically classified their level of recovery one year into the pandemic using the percentage change in the median practice level rate.ResultsWe produced 11 measures reflective of clinical activity in general practice. A substantial drop in activity was observed in all measures at the outset of the COVID-19 pandemic. By April 2021, the median rate had recovered to within 15% of the median rate in April 2019 in six measures. The remaining measures showed a sustained drop, ranging from a 18.5% reduction in medication reviews to a 42.0% reduction in blood pressure monitoring. Three measures continued to show a sustained drop by December 2021.ConclusionsThe COVID-19 pandemic was associated with a substantial change in primary care activity across the measures we developed, with recovery in most measures. We delivered an open source software framework to describe trends and variation in clinical activity across an unprecedented scale of primary care data. We will continue to expand the set of key measures to be routinely monitored using our publicly available NHS OpenSAFELY SRO dashboards with near real-time data.
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全科医疗的预约
DOI：
10.2307/3007211
发表时间：
1964
期刊：
A Quarterly Journal of Operations Research
影响因子：
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作者：
J. Fry
通讯作者：
J. Fry
OpenSAFELY NHS 服务恢复观察站 2：COVID-19 大流行期间六个临床领域初级保健活动的变化
DOI：
10.1101/2022.06.01.22275674
发表时间：
2022
期刊：
The British Journal of General Practice
影响因子：
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作者：
H. Curtis;B. Mackenna;Milan Wiedemann;Louis Fisher;R. Croker;C. Morton;P. Inglesby;A. Walker;J. Morley;A. Mehrkar;S. Bacon;G. Hickman;D. Evans;T. Ward;S. Davy;W. Hulme;O. Macdonald;Robin Conibere;T. Lewis;M. Myers;Shamila Wanninayake;Kiren Collison;C. Drury;Miriam Samuel;H. Sood;Andrea Cipriani;S. Fazel;Manuj Sharma;W. Baqir;C. Bates;John Parry;B. Goldacre
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DOI：
10.1101/2022.05.05.22273234
发表时间：
2022
期刊：
The British Journal of General Practice
影响因子：
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作者：
Louis Fisher;L. Hopcroft;S. Rodgers;James Barrett;Kerry Oliver;Anthony J Avery;David Evans;Helen J. Curtis;R. Croker;O. Macdonald;Jessica Morley;A. Mehrkar;S. Bacon;S. Davy;I. Dillingham;David Evans;G. Hickman;P. Inglesby;C. Morton;Becky Smith;Tom Ward;W. Hulme;A. Green;J. Massey;Alex J. Walker;Chris Bates;J. Cockburn;John Parry;F. Hester;Sam Harper;S. O’Hanlon;A. Eavis;R. Jarvis;D. Avramov;P. Griffiths;A. Fowles;N. Parkes;B. Goldacre;B. Mackenna
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B. Mackenna
影响因子：
2.9
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Moynihan R;Sanders S;Michaleff ZA;Scott AM;Clark J;To EJ;Jones M;Kitchener E;Fox M;Johansson M;Lang E;Duggan A;Scott I;Albarqouni L
通讯作者：
Albarqouni L
影响因子：
15.1
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