making progress professor martin gibson, director gm clrn

Making Progress

Professor Martin Gibson, Director GM CLRN

LOCAL HEALTH AND WELLNESS CHALLENGES

BUILDING LINKS AND SUCCESS

IMPROVE AND INNOVATE

Can data make us well?

• Need new tools to make sense of the quantity and quality of information available

• Unlocking important information from messy data

• Joining care across traditional boundaries, including academia, social care and health

Real-world Evidence Engine?

Research

Commissioning

Governance

Diabetes

CancerTSUNAMI of DATA

BLIZZARD ofMODELS/METHODS

and LITERATURE

Silo k…

DROUGHT of EXPERTISE

PROLIFERATION of PIPELINES

Looking Behind the CodesUK Diabetes Prevalence from Different Databases

From E. Kontopantelis & T. Doran

1999 2000 2001 2002 2003 2004 20050%

1%

2%

3%

4%

5%

GPRD - diagnostic codes GPRD - all codes THINQ-research QOF

Year

Estim

ated

UK

Prev

alen

ce o

f Dia

bete

s

Consider Vioxx MI risk detectable pre-2005 via text not coded data

Consider the GP annotation on a diabetes code “DM r/o”

Improved liver function (pooled) = 0.15 (se=0.009), p<1x10-59

Similar effect alone or with other drugs {G = 0.12; G+M = 0.16; G+S = 0.16; G+S+M = 0.15G = glitazone, M = metformin, S = sulponylurea}

First glitazone Rx

Mean log(ALT) beforeMean log(ALT) after

Fitted trends do not join evidence of glitazone effect on ALT

Raw NHS Data: Too Messy?

From M. Sperrin

Trends in liver function among patients with type 2 diabetes:messy real-world data; effect consistent with best evidence.

IMPROVE AND INNOVATE

Improving access to research

• Implementation of research knowledge • Fifteen years from recommendations to

complete uptake• Access to better treatments• More informed choice, enabling consent

SAFETY AND QUALITY

Benefits for everyone

Supporting patients - helping them know what they can do next and to contribute to their own care

Supporting clinicians – providing the information required to make safer, better decisions linked with other healthcare colleagues Supporting commissioners - Providing the evidence base for improvement and measurement of performance over time

Supporting research – supporting and evaluating new treatments and understanding the wider public health picture