Evidence map›Paper›PMID 39444499›Full record

ArticleLearning health systems2024

Creating a learning health system to include environmental determinants of health: The GroundsWell experience.

Sarah E Rodgers, Rebecca S Geary, Roberto Villegas-Diaz, Iain E Buchan, Hannah Burnett, Tom Clemens, Rebecca Crook, Helen Duckworth, Mark Alan Green, Elly King and 2 more

Abstract read
In one paragraph

Article in Learning health systems, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
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

12 authors.

Sarah E RodgersPublic Health, Policy & Systems University of Liverpool Liverpool UK.ORCID https://orcid.org/0000-0002-4483-0845
Rebecca S GearyPublic Health, Policy & Systems University of Liverpool Liverpool UK.ORCID https://orcid.org/0000-0003-1417-1057
Roberto Villegas-DiazPublic Health, Policy & Systems University of Liverpool Liverpool UK.ORCID https://orcid.org/0000-0001-5036-8661
Iain E BuchanPublic Health, Policy & Systems University of Liverpool Liverpool UK.ORCID https://orcid.org/0000-0003-3392-1650
Hannah BurnettPublic Health, Policy & Systems University of Liverpool Liverpool UK.ORCID https://orcid.org/0000-0001-5710-3180
Tom ClemensSchool of Geosciences, Institute of Geography University of Edinburgh Edinburgh UK.
Rebecca CrookPublic Health, Policy & Systems University of Liverpool Liverpool UK.ORCID https://orcid.org/0000-0002-3557-5731
Helen DuckworthNHS Arden & Great East Midlands Commissioning Support Unit Leicester UK.
Mark Alan GreenGeography & Planning, Roxby Building University of Liverpool Liverpool UK.ORCID https://orcid.org/0000-0002-0942-6628
Elly KingPublic Health, Policy & Systems University of Liverpool Liverpool UK.
Wenjing ZhangGeography & Planning, Roxby Building University of Liverpool Liverpool UK.
Oliver ButtersPublic Health, Policy & Systems University of Liverpool Liverpool UK.ORCID https://orcid.org/0000-0003-0354-8461

Funding

Wellcome Trust
6 · The paper itself

Abstract

Introduction: Policies aiming to prevent ill health and reduce health inequalities need to consider the full complexity of health systems, including environmental determinants. A learning health system that incorporates environmental factors needs healthcare, social care and non-health data linkage at individual and small-area levels. Our objective was to establish privacy-preserving household record linkage for England to ensure person-level data remain secure and private when linked with data from households or the wider environment. Methods: A stakeholder workshop with participants from our regional health board, together with the regional data processor, and the national data provider. The workshop discussed the risks and benefits of household linkages. This group then co-designed actionable dataflows between national and local data controllers and processors. Results: A process was defined whereby the Personal Demographics Service, which includes the addresses of all patients of the National Health Service (NHS) in England, was used to match patients to a home identifier, for the time they are recorded as living at that address. Discussions with NHS England resulted in secure and quality-assured data linkages and a plan to flow these pseudonymised data onwards into regional health boards. Methods were established, including the generation of matching algorithms, transfer processes and information governance approvals. Our collaboration accelerated the development of a new data governance application, facilitating future public health intervention evaluations. Conclusion: These activities have established a secure method for protecting the privacy of NHS patients in England, while allowing linkage of wider environmental data. This enables local health systems to learn from their data and improve health by optimizing non-health factors. Proportionate governance of health and linked non-health data is practical in England for incorporating key environmental factors into a learning health system.

Indexed as

data privacyhousehold record linkagepublic health learning systempublic health researchrecord linkage complex systems

Identifiers

PMID39444499
PMCPMC11493545

What OpenQuestion holds

Textmetadata
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.