Presentation on theme: "Julia Hippisley-Cox University of Nottingham 19 th March 2010."— Presentation transcript:
Julia Hippisley-Cox University of Nottingham 19 th March 2010
Probably has many meanings Working definition here: ◦ Research where results can be directly applied into clinical care
Need a very clear research question What exactly do I hope to find out? Is it important? Is it original? Is it interesting? Is it answerable ? Is it timely?
Leads to ◦ Novel application of existing methods ◦ Development of new methods ◦ Better utilisation different data sources Leads to ◦ Lively academic debate! ◦ Changes in policy and guidance ◦ New utilities to implement research findings ◦ (hopefully) Better patient care
Who needs to know the answer? When do they need to know the answer and why? What will they do with it? How will it affect clinical practice? How will you communicate it? How will you implement it? Is a negative result worth knowing? What are the consequences of not doing the study?
Once question clear then early stats advice What is the study design? ◦ Cross sectional survey ◦ Cohort study ◦ Case control study ◦ Case series study ◦ Randomised controlled trial ◦ ? Other (specify) What are the outcome measures? What are the exposures? What are the confounders? Sample size calculation?
Once design is clear then Type of analysis needed? Handling of missing data? Hierarchical data? Accounting for bias and confounding? Whose skills & experience needed to prepare data and undertake analysis.
What type of data do I need? Purpose designed cohort or clinical trial Routinely collected NHS data Primary care? Secondary care? Other Anonymised or identifiable? Supplementary data needed? Data linkage require? questionnaires or blood tests
Clinical trialsObservational Data Single outcome Single intervention Precise measurements Powered for outcome Good estimation benefit Underpowered for ADR Selected populations Multiple outcomes Multiple interventions Imprecise measurements Better for unintended effects Good powers Representative populations
Three main UK databases ◦ QResearch ◦ THIN ◦ GPRD All very good All need application form, protocol, ethics Same answer for 90% of studies Some special features for each Different terms and conditions
Set up in 2002 Not-for-profit venture between EMIS & Nottingham University ◦ Management board ◦ National advisory board ◦ Scientific review board Practice feedback in 2010
QResearchTHINGPRD Year data started1988/9 coverageUK Size600 practices450 practices500 practices Basic contentV similar Quality etcfine Ethics requiredyes Yes Basic linkagesDeprivation & deaths Deprivation & deaths (soon) Deprivation & deaths Additional linkages Exploring options and risks MINAP Cancer HES
QResearchTHINGPRD OwnershipUoN & EMISEPIC companySecretary State (MHRA) Core FundingNone Yes TrainingNoneyes LicensingSpecific cuts data for specific projects Data cuts or entire database Pharma studiesNo (unless significant safety issue) Yes costCost per dataset 10K+VAT start up cost. Then bespoke. Academic = 190K+VAT over 4 years or per data cut Free under MRC license
QResearchTHINGPRD statusNot for profitCommercial Sample size calculations No unless funded yesNot sure Speed of access3 months+Check with THINCheck with GPRD Publication requirement Yes – everything must be published No Identification patients Not possibleYes Identification practices Noyes Free text dataNoYesyes
Did you have the original idea for this research project? To your knowledge is this work original and capable of publication as original research in a peer- reviewed journal? Are you free to undertake this study and publish its findings without needing to clear it with the funding source or any other organisation? Do you agree to acknowledge the source of QRESEARCH data in any publication, paper or report? Do you agree NOT to attempt to identify patient(s) or practice(s)? Do you undertake to provide a copy of the final report of the project and copies of any publications within one year of the project completion? Do you agree NOT to release the data to any third party including the funder, sponsor or other such body? Do you undertake to check the data you are given within a month of receipt and report back any problems within that time? Do you have a statistician on the project team who has contributed to the design of the study and will advise on the analysis? Do you have a clinician who will act as clinical guarantor for the data?
Two free online searchable databases ◦ Public health indicators ◦ Chest and allergy diseases Self register at For new funded research projects we will ◦ send you a login to researcher QWeb tools ◦ ask you to define the query you need ◦ You will need a clinician who understands GP data
Specify protocol Specify data required Complete application process Obtain funding On receipt of data, check it Data preparation Data analysis Preparation of paper dissemination
Good question Clear protocol Funding Data source appropriate to study Hardware/software IT skills -handling large dataset Statistics – advanced techniques Epidemiology Clinical academic Writing skills
What is the service? How will it be delivered? Who will deliver it? Who will use it? Which data sources? How will it be funded? What service levels? Criteria for prioritising applications? How evaluate it?