Making Progress

Professor Martin Gibson, Director GM CLRN

LOCAL HEALTH AND WELLNESS CHALLENGES

BUILDING LINKS AND SUCCESS

IMPROVE AND INNOVATE

Can data make us well?

• Need new tools to make sense of the quantity and quality of information available

• Unlocking important information from messy data

• Joining care across traditional boundaries, including academia, social care and health

Real-world Evidence Engine?

Research

Commissioning

Governance

Diabetes

CancerTSUNAMI of DATA

BLIZZARD ofMODELS/METHODS

and LITERATURE

Silo k…

DROUGHT of EXPERTISE

PROLIFERATION of PIPELINES

Looking Behind the CodesUK Diabetes Prevalence from Different Databases

From E. Kontopantelis & T. Doran

1999 2000 2001 2002 2003 2004 20050%

1%

2%

3%

4%

5%

GPRD - diagnostic codes GPRD - all codes THINQ-research QOF

Year

Estim

ated

UK

Prev

alen

ce o

f Dia

bete

s

Consider Vioxx MI risk detectable pre-2005 via text not coded data

Consider the GP annotation on a diabetes code “DM r/o”

Improved liver function (pooled) = 0.15 (se=0.009), p<1x10-59

Similar effect alone or with other drugs {G = 0.12; G+M = 0.16; G+S = 0.16; G+S+M = 0.15G = glitazone, M = metformin, S = sulponylurea}

First glitazone Rx

Mean log(ALT) beforeMean log(ALT) after

Fitted trends do not join evidence of glitazone effect on ALT

Raw NHS Data: Too Messy?

From M. Sperrin

Trends in liver function among patients with type 2 diabetes:messy real-world data; effect consistent with best evidence.

IMPROVE AND INNOVATE

Improving access to research

• Implementation of research knowledge • Fifteen years from recommendations to

complete uptake• Access to better treatments• More informed choice, enabling consent

SAFETY AND QUALITY

Benefits for everyone

Supporting patients - helping them know what they can do next and to contribute to their own care

Supporting clinicians – providing the information required to make safer, better decisions linked with other healthcare colleagues Supporting commissioners - Providing the evidence base for improvement and measurement of performance over time

Supporting research – supporting and evaluating new treatments and understanding the wider public health picture