Abstract:IntroductionHealth Data Research UK designated seven UK-based Hubs to facilitate health data use for research. PIONEER is the Hub in Acute Care. PIONEER delivered workshops where patients/public citizens agreed key principles to guide access to unconsented, anonymised, routinely collected health data. These were used to inform the protocol.MethodsThis paper describes the PIONEER infrastructure and data access processes. PIONEER is a research database and analytical environment that links routinely collected he… Show more
“…This data study was supported by PIONEER, 21 a Health Data Research Hub in Acute Care, with ethical approval provided by the East Midlands – Derby REC (reference: 20/EM/0158) and the requirement of informed consent waived. The findings are reported as per the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.…”
“…This data study was supported by PIONEER, 21 a Health Data Research Hub in Acute Care, with ethical approval provided by the East Midlands – Derby REC (reference: 20/EM/0158) and the requirement of informed consent waived. The findings are reported as per the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.…”
“…The research question and topic were agreed following patient/public discussion groups about NHSE discharge policies. Patients/public reviewed the data fields included in the study, with the PIONEER Data Trust Committee providing support for the project (a group of patient/public members who review studies using health data 9 ). A patient/public group has reviewed the results and has written a lay summary for study dissemination to patient groups.…”
ObjectivesNHS England (NHSE) advocates ‘reason to reside’ (R2R) criteria to support discharge planning. The proportion of patients without R2R and their rate of discharge are reported daily by acute hospitals in England. R2R has no interoperable standardised data model (SDM), and its performance has not been validated. We aimed to understand the degree of intercentre and intracentre variation in R2R-related metrics reported to NHSE, define an SDM implemented within a single centre Electronic Health Record to generate an electronic R2R (eR2R) and evaluate its performance in predicting subsequent discharge.DesignRetrospective observational cohort study using routinely collected health data.Setting122 NHS Trusts in England for national reporting and an acute hospital in England for local reporting.Participants6 602 706 patient-days were analysed using 3-month national data and 1 039 592 patient-days, using 3-year single centre data.Main outcome measuresVariability in R2R-related metrics reported to NHSE. Performance of eR2R in predicting discharge within 24 hours.ResultsThere were high levels of intracentre and intercentre variability in R2R-related metrics (p<0.0001) but not in eR2R. Informedness of eR2R for discharge within 24 hours was low (J-statistic 0.09–0.12 across three consecutive years). In those remaining in hospital without eR2R, 61.2% met eR2R criteria on subsequent days (76% within 24 hours), most commonly due to increased NEWS2 (21.9%) or intravenous therapy administration (32.8%).ConclusionsReported R2R metrics are highly variable between and within acute Trusts in England. Although case-mix or community care provision may account for some variability, the absence of a SDM prevents standardised reporting. Following the development of a SDM in one acute Trust, the variability reduced. However, the performance of eR2R was poor, prone to change even when negative and unable to meaningfully contribute to discharge planning.
“…The profile of NHS users is therefore highly representative of the whole, diverse UK population. Second, alongside other similar initiatives in the UK [22 ▪ ], it is based on routinely collected healthcare data and is approved to be undertaken on an ‘opt out’ basis. Numerous studies have shown that the majority of the UK population supports the use of their health data for research [23,24 ▪▪ ], with fewer than 6% of the UK population having opted out after considerable media coverage of the issue and public awareness [25].…”
Purpose of reviewIn this review, we consider the challenges of creating a trusted resource for real-world data in ophthalmology, based on our experience of establishing INSIGHT, the
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