Developing a large electronic primary care database (Doctors' Independent Network) for research
Developing a large electronic primary care database (Doctors' Independent Network) for research
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DOI：
10.1016/j.ijmedinf.2004.02.002
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发表时间：
2004-06-15
影响因子：
4.9
通讯作者：
Hilton, SR
中科院分区：
文献类型：
--
作者：
Carey, IM;Cook, DG;Hilton, SR
背景和目标：初级保健数据库形成了一个独特的来源，以人口为基础的临床信息的患病率和管理的诊断疾病。从历史上看，这样的数据库缺乏个人层面的社会经济标志。我们描述了流行病学和卫生服务研究的医生独立网络（DIN）数据库的发展。DIN包括一个社会经济标志（ACORN），该标志基于个体患者水平的邮政编码联系。DIN的有效性根据全科医学研究数据库（GPRD）进行评估。研究方法：外部效度通过比较人口结构和患病率治疗缺血性心脏病（IHD）和治疗花粉热与那些从GPRD。我们评估的效用的社会经济措施（ACORN）的基础上，邮政编码的联系，在个别病人的水平，通过检查的趋势，流行率IHD和花粉症的ACORN指数。结果如下：选择了142个提供高质量数据的实践，1992年至2001年期间有1，827，361名完全注册的患者提供数据，代表了与英格兰和威尔士以及GPRD相同的年龄-性别结构。DIN中经区域调整的IHD治疗患病率（1998年，35岁以上男性和女性分别为7.29%和5.37%）与GPRD（7.27%和5.42%）高度相似。在DIN中，与“繁荣”地区相比，生活在“奋斗”地区的受试者中IHD的比值比为1.37（95%CI 1.30-1.44）。治疗花粉症患病率在数据库中相似，与DIN中的ACORN呈负相关（“繁荣”地区的患病率较高）。结论：DIN为两种常见疾病提供了与GPRD相当的时期患病率，社会趋势与预期一致。初级保健数据库，如这些有可能取代十年一次的全国发病率调查在英国的一般做法，DIN具有重要的优势，包括社会经济指数。(C)2004爱思唯尔爱尔兰有限公司保留所有权利。
Background and objectives: Primary care databases form a unique source of population-based clinical information on the prevalence and management of diagnosed disorders. Historically such databases have Lacked individual Level socioeconomic markers. We describe the development of the Doctors' Independent Network (DIN) database for epidemiological and health services research. DIN includes a socio-economic marker (ACORN) based on postcode linkage at individual patient Level. The validity of DIN is assessed against the General Practice Research Database (GPRD). Methods: External validity is assessed by comparing the demographic structure and prevalence rates for treated ischemic heart disease (IHD) and treated hay fever with those from the GPRD. We assess the utility of a socio-economic measure (ACORN) based on postcode-linkage at individual patient level by examining the trend in prevalence rates of IHD and hay fever by ACORN index. Results: 142 practices providing high quality data were selected, with 1,827,361 fully registered patients contributing data between 1992 and 2001, representing an identical age-sex structure to that for England Et Wales and GPRD. Regionally adjusted prevalence of treated IHD (7.29 and 5.37%, respectively for men and women aged 35+ in 1998) in DIN was highly comparable to GPRD (7.27 and 5.42%). In DIN, the odds ratio of IHD was 1.37 (95% CI 1.30-1.44) in subjects living in "striving" compared to "thriving" areas. The prevalence of treated hay fever prevalence was similar across databases, with inverse associations seen with ACORN in DIN (higher rates in "thriving" areas). Conclusions: DIN provides comparable period prevalence rates to GPRD for two common conditions, with social trends as expected. Primary care databases such as these have the potential to replace the decennial national morbidity surveys carried out in UK general practices, with DIN having the important advantage of including a socio-economic index. (C) 2004 Elsevier Ireland Ltd. All rights reserved.