Evidence map›Paper›PMID 37498081›Full record

ArticleeLife2023

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.

Louis Fisher, Helen J Curtis, Richard Croker, Milan Wiedemann, Victoria Speed, Christopher Wood, Andrew Brown, Lisa E M Hopcroft, Rose Higgins, Jon Massey and 38 more

Abstract read
In one paragraph

Article in eLife, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

48 authors.

Louis FisherThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.ORCID 0000-0002-0295-3812
Helen J CurtisThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
Richard CrokerThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
Milan WiedemannThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
Victoria SpeedThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
Christopher WoodThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.ORCID 0000-0001-5184-0606
Andrew BrownThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
Lisa E M HopcroftThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
Rose HigginsThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.ORCID 0000-0002-5295-4370
Jon MasseyThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.ORCID 0000-0002-2497-4040
Peter InglesbyThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
Caroline E MortonThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
Alex J WalkerThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
Jessica MorleyThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
Amir MehrkarThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
Seb BaconThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
George HickmanThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.ORCID 0000-0002-6691-4046
Orla MacdonaldOxford Health Foundation Trust, Warneford Hospital, Oxford, United Kingdom.
Tom LewisRoyal Devon University Healthcare NHS Foundation Trust, Barnstaple, United Kingdom.
Marion WoodNHS England, London, United Kingdom.
Martin MyersLancashire Teaching Hospitals NHS Foundation Trust, Chorley, United Kingdom.
Miriam SamuelQueen Mary University of London, London, United Kingdom.
Robin ConibereBeacon Medical Group, Plymouth, United Kingdom.
Wasim BaqirNHS England, London, United Kingdom.
Harpreet SoodSternhall Lane Surgery, London, United Kingdom.
Charles DruryHerefordshire and Worcestershire Health and Care NHS Trust, Worcester, United Kingdom.
Kiren CollisonNHS England, London, United Kingdom.
Chris BatesTPP, Leeds, United Kingdom.
David EvansThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
Iain DillinghamThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
Tom WardThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
Simon DavyThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
Rebecca M SmithThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
William HulmeThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.ORCID 0000-0002-9162-4999
Amelia GreenThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.ORCID 0000-0002-7246-2074
John ParryTPP, Leeds, United Kingdom.
Frank HesterTPP, Leeds, United Kingdom.
Sam HarperTPP, Leeds, United Kingdom.
Jonathan CockburnTPP, Leeds, United Kingdom.
Shaun O'HanlonEMIS, Leeds, United Kingdom.
Alex EavisEMIS, Leeds, United Kingdom.
Richard JarvisEMIS, Leeds, United Kingdom.
Dima AvramovEMIS, Leeds, United Kingdom.
Paul GriffithsEMIS, Leeds, United Kingdom.
Aaron FowlesEMIS, Leeds, United Kingdom.
Nasreen ParkesEMIS, Leeds, United Kingdom.
Brian MacKennaThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.ORCID 0000-0002-3786-9063
Ben GoldacreThe Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.

Funding

Department of Health COV-LT2-0073Department of Health NIHR135559Medical Research Council MC_PC-20059Medical Research Council MR/V015757/1Medical Research Council MR/W016729/1Wellcome TrustWellcome Trust 222097/Z/20/Z
6 · The paper itself

Abstract

Background: 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. Methods: 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. Results: 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. Conclusions: 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. Funding: 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).

Indexed as

COVID-19General PracticeAdultEnglandHumansPandemicsPrimary Health CareRetrospective Studiesepidemiologyglobal healthhealth informaticshumanprimary carepublic health

Identifiers

PMID37498081
PMCPMC10374277

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.