Eleven key measures for monitoring general practice clinical activity during COVID-19: A retrospective cohort study using 48 million adults' primary care records in England through OpenSAFELY.
Eleven key measures for monitoring general practice clinical activity during COVID-19: A retrospective cohort study using 48 million adults' primary care records in England through OpenSAFELY.
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DOI：
10.7554/elife.84673
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发表时间：
2023-07-27
期刊：
影响因子：
7.7
通讯作者：
Goldacre B
中科院分区：
文献类型：
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作者：
Fisher L;Curtis HJ;Croker R;Wiedemann M;Speed V;Wood C;Brown A;Hopcroft LEM;Higgins R;Massey J;Inglesby P;Morton CE;Walker AJ;Morley J;Mehrkar A;Bacon S;Hickman G;Macdonald O;Lewis T;Wood M;Myers M;Samuel M;Conibere R;Baqir W;Sood H;Drury C;Collison K;Bates C;Evans D;Dillingham I;Ward T;Davy S;Smith RM;Hulme W;Green A;Parry J;Hester F;Harper S;Cockburn J;O'Hanlon S;Eavis A;Jarvis R;Avramov D;Griffiths P;Fowles A;Parkes N;MacKenna B;Goldacre B
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服务恢复观察站（SRO），以制定初级保健活动的关键措施，并描述COVID-19大流行期间这些措施的趋势。在英国NHS的批准下，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4800万成年人的初级保健电子健康记录（EHR）数据中临床活动的趋势和变化。我们为初级保健临床活动的关键指标（如血压监测和哮喘审查）开发了SNOMED-CT代码表，由专家临床咨询小组选择，并进行了一项基于人群队列的研究，以描述2019年1月至2021年12月这些指标的趋势和变化，并使用执业水平比率中位数的百分比变化，务实地将其一年的恢复水平归类为大流行。我们提出了11项措施，反映临床活动的一般做法。COVID-19疫情爆发初期，所有指标均录得活动大幅下降。截至2021年4月，六项指标的中位率已恢复至2019年4月的中位率15%以内。其余指标显示持续下降，从药物审查减少18.5%到血压监测减少42.0%。截至2021年12月，三项指标继续显示持续下降。2019冠状病毒病大流行与我们制定的各项措施中的基层医疗活动发生重大变化有关，大部分措施均已恢复。我们提供了一个开源软件框架，以描述前所未有的初级保健数据规模中临床活动的趋势和变化。我们将继续扩大一套关键措施，使用我们公开的NHS OpenSAFELY SRO仪表板进行常规监测，并提供近实时数据。这项研究使用了作为数据和连接国家核心研究的一部分提供的数据资产，该研究由英国健康数据研究与国家统计局合作领导，并由英国研究与创新资助。OpenSAFELY平台由Wellcome Trust的赠款支持。（222097/Z/20/Z）; MRC（MR/V015757/1，MC_PC-20059，MR/W 016729/1）; NIHR（NIHR 135559，COV-LT 2 -0073）和英国健康数据研究（HDRUK2021.000，2021.0157）。
The COVID-19 pandemic has had a significant impact on delivery of NHS care. We have developed the OpenSAFELY Service Restoration Observatory (SRO) to develop key measures of primary care activity and describe the trends in these measures throughout the COVID-19 pandemic. With 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 such as blood pressure monitoring and asthma reviews, selected by an 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. We 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. The 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. This research used data assets made available as part of the Data and Connectivity National Core Study, led by Health Data Research UK in partnership with the Office for National Statistics and funded by UK Research and Innovation (grant ref MC_PC_20058).The OpenSAFELY Platform is supported by grants from the Wellcome Trust (222097/Z/20/Z); MRC (MR/V015757/1, MC_PC-20059, MR/W016729/1); NIHR (NIHR135559, COV-LT2-0073), and Health Data Research UK (HDRUK2021.000, 2021.0157).
影响因子：
2.9
作者：
通讯作者：
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