e-Participate

Electronic health databases have been used widely in health research for years, consisting of data derived from routinely collected health records generated by daily clinical practice. Clinical Practice Research Datalink (CPRD) is one of the largest databases of longitudinal medical records from primary care in the world.  

CPRD is the Evolved GPRD

The original version of CPRD was GPRD (General Practice Research Database) established in 1987. It was renamed in 2012 to take account of both the increasing use of anonymised patient data for clinical trials and links being created with secondary datasets such as those from HES, Cancer, Diabetes, etc. CPRD is continuously collecting anonymised clinical records from millions of individuals and its total data archive currently represents almost 10% of the population of England.

Power and reach

 CPRD is an enormously powerful research tool, data from which have been used to produce close to 2,000 research reports, published in peer-reviewed journals, many of which have had a direct impact on public health.

How the data are used

For example, in 2004, CPRD data was used to ascertain whether or not the combined MMR injection was having a detrimental impact upon patients, as had been reported in the national press. The published report concluded that:

“…after adjustment for age at joining the database, the odds ratio for association between MMR and pervasive developmental disorder was 0.86 (95% CI 0.68–1.09). Findings suggest that MMR vaccination is not associated with an increased risk of pervasive developmental disorder…”

Lancet 2004, v364; p963-969.

More recently researchers identified a totally anonymised research frame of over 100k obese persons and of these

“…2167 patients without diabetes who had bariatric surgery were matched according to age, BMI, sex, index year, and HbA1c category with 2167 controls who did not have surgery…”.

The subsequent research concluded that

“…bariatric surgery used in the prevention of Type2 diabetes can reduce the incidence of clinical diabetes for up to 7 years after surgery in 80% of those who undergo the procedure”.

Incidence of type2 diabetes after bariatric surgery: population-based matched cohort study”, Lancet Diabetes & Endocrinology, v2, iss12, December 2014, p963–968.

The immediate future

These two examples of CPRD data being used to inform and offer the opportunity to influence public health practice and procedure, demonstrate how essential patient data is to the medium and long-term health and wellbeing of the nation. This said the time is right for a rethink in how CPRD aligns itself and coordinates research activity with CRN and the LCRNs, so that clear benefits for practices, patients and researchers can be achieved through sharing patient data for research purposes. This requires both a dialogue to identify a best-fit collaboration and a continued drive in recruiting practices to CPRD. At the end of the day, what’s important to remember is that it doesn’t matter how many or how few research platforms GP practices contribute patient data to, as long as practices continue to contribute data. 

If you would like further information on any aspect of CPRD organisation or sign-up, please contact Keith Hackett, Practice Recruitment Lead email: keith.hackett@mhra.gsi.gov.uk phone: 0203 080 6699