Generalisability of The Health Improvement Network (THIN) database:
demographics, chronic disease prevalence and mortality rates

Blak, Betina; Thompson, Mary Ann; Dattani, Hassy; Bourke, Alison

doi:10.14236/jhi.v19i4.820

Cited by 521 publications

(706 citation statements)

References 4 publications

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“…ColonFlag Ò was developed using data from Maccabi Healthcare Services (MHS) and the Israel National Cancer Register (INCR) [22]. This statistical detection model was validated using the UK's The Health Information Network (THIN) database-an anonymized UK primary care database derived from General Practitioners in the UK, which is broadly representative of the UK population in terms of sex, age, and major condition prevalence [23]. Individuals in the highest one percentile of ColonFlag Ò scores faced a 20-fold higher risk of being diagnosed with CRC in the subsequent 12-18 month period [20,21].…”

mentioning

confidence: 99%

Early Colorectal Cancer Detected by Machine Learning Model Using Gender, Age, and Complete Blood Count Data

Hornbrook

Goshen²,

Choman³

et al. 2017

Dig Dis Sci

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Background Machine learning tools identify patients with blood counts indicating greater likelihood of colorectal cancer and warranting colonoscopy referral. Aims To validate a machine learning colorectal cancer detection model on a US community-based insured adult population. Methods Eligible colorectal cancer cases (439 females, 461 males) with complete blood counts before diagnosis were identified from Kaiser Permanente Northwest Region's Tumor Registry. Control patients (n = 9108) were randomly selected from KPNW's population who had no cancers, received at C1 blood count, had continuous enrollment from 180 days prior to the blood count through 24 months after the count, and were aged 40-89. For each control, one blood count was randomly selected as the pseudo-colorectal cancer diagnosis date for matching to cases, and assigned a ''calendar year'' based on the count date. For each calendar year, 18 controls were randomly selected to match the general enrollment's 10-year age groups and lengths of continuous enrollment. Prediction performance was evaluated by area under the curve, specificity, and odds ratios. Results Area under the receiver operating characteristics curve for detecting colorectal cancer was 0.80 ± 0.01. At 99% specificity, the odds ratio for association of a high-risk detection score with colorectal cancer was 34.7 (95% CI 28.9-40.4). The detection model had the highest accuracy in identifying right-sided colorectal cancers. Conclusions ColonFlag Ò identifies individuals with tenfold higher risk of undiagnosed colorectal cancer at curable stages (0/I/II), flags colorectal tumors 180-360 days prior to usual clinical diagnosis, and is more accurate at identifying right-sided (compared to left-sided) colorectal cancers.

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mentioning

confidence: 99%

Early Colorectal Cancer Detected by Machine Learning Model Using Gender, Age, and Complete Blood Count Data

Hornbrook

Goshen²,

Choman³

et al. 2017

Dig Dis Sci

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“…However, the strict inclusion and exclusion criteria should have minimized the effect of inappropriate selection. In addition, the patient sample was more affluent overall than the general UK population, which suggests that men from less affluent areas are less likely to seek medical attention 20 , although it may just reflect the distribution of the patients in the database.…”

Section: Discussionmentioning

confidence: 99%

Drug treatment patterns for the management of men with lower urinary tract symptoms associated with benign prostatic hyperplasia who have both storage and voiding symptoms: a study using the health improvement network UK primary care data

Hakimi

Johnson

Nazir

et al. 2014

Current Medical Research and Opinion

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“…The patient data within THIN have been shown to be representative of the U.K. population in terms of demographics and disease distribution (24).…”

Section: Thin Databasementioning

confidence: 99%

“…The effect of CPAP treatment in OSA patients with T2D has been little studied in the real clinical practice setting, especially over periods as long as 5 years. Accordingly, the current study used The Health Improvement Network (THIN) database (a nationally representative database of patients registered with general practitioners [GPs] in the U.K.) (24) to examine the clinical outcomes and cost-effectiveness of using CPAP to manage OSA patients with T2D in clinical practice in the U.K. over 5 years from the perspective of the NHS.…”

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confidence: 99%

Clinical Outcomes and Cost-effectiveness of Continuous Positive Airway Pressure to Manage Obstructive Sleep Apnea in Patients With Type 2 Diabetes in the U.K.

et al. 2014

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OBJECTIVETo assess clinical outcomes and cost-effectiveness of using continuous positive airway pressure (CPAP) to manage obstructive sleep apnea (OSA) in patients with type 2 diabetes (T2D) from the perspective of the U.K.'s National Health Service (NHS). RESEARCH DESIGN AND METHODSUsing a case-control design, 150 CPAP-treated patients with OSA and T2D were randomly selected from The Health Improvement Network (THIN) database (a nationally representative database of patients registered with general practitioners in the U.K.) and matched with 150 OSA and T2D patients from the same database who were not treated with CPAP. The total NHS cost and outcomes of patient management in both groups over 5 years and the cost-effectiveness of CPAP compared with no CPAP treatment were estimated. RESULTSUsing CPAP was associated with significantly lower blood pressure at 5 years and increasingly lower HbA 1c levels over 5 consecutive years compared with untreated OSA patients. At 5 years, the HbA 1c level in the CPAP-treated group was 8.2% (66.0 mmol/mol) vs. 12.1% (108.4 mmol/mol) in the control group (P < 0.03). Use of CPAP significantly increased patients' health status by 0.27 quality-adjusted life years (QALYs) per patient over 5 years (P < 0.001) and NHS management costs by £4,141 per patient over 5 years; the cost per QALY gained with CPAP was £15,337. CONCLUSIONSInitiating treatment with CPAP in OSA patients with T2D leads to significantly lower blood pressure and better controlled diabetes and affords a cost-effective use of NHS resources. These observations have the potential for treatment modification if confirmed in a prospective study.

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Generalisability of The Health Improvement Network (THIN) database: demographics, chronic disease prevalence and mortality rates

Cited by 521 publications

References 4 publications

Early Colorectal Cancer Detected by Machine Learning Model Using Gender, Age, and Complete Blood Count Data

Early Colorectal Cancer Detected by Machine Learning Model Using Gender, Age, and Complete Blood Count Data

Drug treatment patterns for the management of men with lower urinary tract symptoms associated with benign prostatic hyperplasia who have both storage and voiding symptoms: a study using the health improvement network UK primary care data

Clinical Outcomes and Cost-effectiveness of Continuous Positive Airway Pressure to Manage Obstructive Sleep Apnea in Patients With Type 2 Diabetes in the U.K.

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