ArticlePharmacoepidemiology and drug safety2011
Temporal and within practice variability in the health improvement network.
Article in Pharmacoepidemiology and drug safety, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Factors influencing the development of primary care data collection projects from electronic health records: a systematic review of the literature.BMC medical informatics and decision making · 2017Pooled it
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- Annual consultation incidence of osteoarthritis estimated from population-based health care data in England.Rheumatology (Oxford, England) · 2015Article
- Risk of major cardiovascular events in patients with psoriatic arthritis, psoriasis and rheumatoid arthritis: a population-based cohort study.Annals of the rheumatic diseases · 2015Article
- Antihyperglycaemic treatment patterns, observed glycaemic control and determinants of treatment change among patients with type 2 diabetes in the United Kingdom primary care: a retrospective cohort study.BMC endocrine disorders · 2014Article
- Five-year malignancy incidence in patients with chronic pruritus: a population-based cohort study aimed at limiting unnecessary screening practices.Journal of the American Academy of Dermatology · 2014Article
- Risk of mortality in patients with psoriatic arthritis, rheumatoid arthritis and psoriasis: a longitudinal cohort study.Annals of the rheumatic diseases · 2014Article
- Methods and dimensions of electronic health record data quality assessment: enabling reuse for clinical research.Journal of the American Medical Informatics Association : JAMIA · 2013Review
- Risk of myocardial infarction associated with chronic hepatitis C virus infection: a population-based cohort study.Journal of viral hepatitis · 2012Article
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5 authors.
Funding
Abstract
backgroundThe Health Improvement Network (THIN) database is a primary care electronic medical record database in the UK designed for pharmacoepidemiologic research. Matching on practice and calendar year often is used to account for secular trends in time and differences across practices. However, little is known about the consistency within practices across observation years and among practices within a given year, in THIN or other large medical record databases.
methodsWe analyzed mortality rates, cancer incidence rates, prescribing rates, and encounter rates across 415 practices from 2000 to 2007 using a practice-year as the unit of observation in separate random and fixed effects longitudinal Poisson regression models. Adjusted models accounted for aggregate practice-level characteristics (smoking, obesity, age, and Vision software experience).
resultsIn adjusted models, subsequent calendar years were associated with lower reported mortality rates, increasing cancer reporting rates, increasing prescriptions per patient, and decreasing encounters per patient, with a corresponding linear trend (p < 0.001 for all analyses). For calendar year 2007, the ratio of the 75th percentile to the 25th percentile for crude rate of cancer, mortality, prescriptions, and encounters was 1.63, 1.63, 1.45, and 1.42, respectively. Adjusting for practice characteristics reduced the among-practice variation by approximately 40%.
conclusionsTHIN data are characterized by secular trends and among-practice variation, both of which should be considered in the design of pharmacoepidemiology studies. Whether these are trends in data quality or true secular trends could not be definitively differentiated.
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