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Predictive risk stratification - impact on care for people with or at risk of chronic conditions

PRISMATIC was a research study led by Swansea University to investigate the process and effects of introducing a new predictive risk model (Prism) into GP practices by comparing quality of patient care and resource use between GP practices with and without Prism (www.trustresearch.org.uk/en/prismatic.htm).

Prism is a web-based, predictive risk tool, commissioned by the Welsh Government, which stratifies people into four levels based on their individual risk of an emergency admission to hospital in the following 12 months. The Prism tool was developed and validated using 300,000 (10 per cent of the Welsh population) anonymised GP and hospital records, from which 37 variables with the highest predictive power were selected.

The PRISMATIC study took place across Wales, but focused on the Abertawe Bro Morgannwg University Health Board (ABM UHB) area in particular. It provided evidence regarding the effects on patient care and resources following Prism use across an entire health board. Crucially the study design included a controlled, randomised distribution of the Prism tool, allowing for comparisons within and between practices over a 20-month study period.

Prof Jeremy Dale (Principal Investigator at Warwick)

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