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Primary data sources

Primary data sources. John Langley Adapted from work by Helen Cooke (SWPHO) 2008. Primary data sources. Differences between record-level and aggregate data Some examples of primary data (births, deaths, HES) Simple sources of pre-calculated data (VS, Compendium, LHO basket, NeSS)

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Primary data sources

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  1. Primary data sources John Langley Adapted from work by Helen Cooke (SWPHO) 2008

  2. Primary data sources • Differences between record-level and aggregate data • Some examples of primary data (births, deaths, HES) • Simple sources of pre-calculated data (VS, Compendium, LHO basket, NeSS) • confidentiality • Codes and lookups • Specialist data sources (reference and links) • Geodemographics (segmentation)

  3. Some data sources for public health Data types • person-based • Aggregate • More complex tools • Health Profiles, HPI, etc, • Codes and lookups

  4. 1 Person-based • only available under confidentiality agreements to appropriate organisations • Individual records eg • Births • Mortality • HES • A&E attendances • May be anonymised • Record linkage increasingly difficult • May or may not have NHS number • Confidentiality issues

  5. Common characteristics • Each line is one patient/episode of care • Dates eg birth, death, admission • Geographical data eg postcode, LA • Appropriate details of COD, Underlying cause of death, place of death, diagnosis, procedure • Some socioeconomic data may be inferred Essential for non-standard analyses

  6. Communal Age Units Establish- Underlying Years OfAge Postcode ment Code COD Sex COD1 COD2 COD3 COD4 COD5 COD6 COD7 COD8 PCT 0 4 TR9 00976 1 T818 Y839 Q243 Q210 Q211 Q253 Q251 Q234 5KT 0 2 PL5 19289 2 S061 W650 W650 5F1 0 2 BA1 00976 1 S099 Y339 Y339 5FL 30 1 BH8 E 1 T07 X815 X815 5CE 0 3 BH12 04500 1 P363 P239 O469 O60 5KV 76 1 BA1 34979 1 I219 I219 5FL 0 3 BS10 00976 1 P543 P780 E841 P073 5JF 90 1 BS21 H 2 R54 C509 C509 5M8 74 1 TQ6 H 2 C80 C80 C80 5CV 80 1 TQ6 05868 2 J189 N19 J189 5CV 71 1 SN10 H 1 C160 C160 5K4 75 1 BS48 00982 1 T814 J852 N151 T821 Y831 I259 Y442 I259 5M8 74 1 BS23 25188 1 N179 N189 N139 I749 D469 D469 5M8 98 1 BH19 06319 2 J180 J449 S720 Y839 X599 J440 5FN Extract from ONS mortality file

  7. hesid age sexcat admidate disdate epidur admimeth dismeth admisorc disdest mainspef diag_1 diag_2 13256319 87 2 01-Apr-05 17-Jun-05 77 13 1 51 86 430 S7210 R13X 863234 88 2 01-Apr-05 08-Apr-05 7 21 1 19 19 110 S7200 W199 8369811 77 2 01-Apr-05 12-Apr-05 11 21 1 19 51 110 S7200 W199 22041799 80 2 01-Apr-05 11-Apr-05 10 21 1 19 51 110 S720 R634 22078557 75 2 01-Apr-05 07-Apr-05 6 21 1 19 19 110 S7200 W010 23713513 87 2 01-Apr-05 04-May-05 33 21 1 19 51 110 S7200 W199 32466323 96 2 01-Apr-05 13-Apr-05 12 21 1 19 19 110 S7210 W190 43693194 78 2 01-Apr-05 12-Apr-05 11 21 8 19 98 110 S7200 W190 46821454 90 2 01-Apr-05 04-Apr-05 3 21 1 19 51 110 S7200 W010 50118762 83 2 01-Apr-05 04-Apr-05 3 21 8 19 98 100 S7200 W199 Extract from HES

  8. 2 Aggregate data • Vital Statistics • CD or ONS website • Compendium • LHO Basket of Indicators • NeSS • No individual data • Rates already calculated • Quick for standard queries

  9. Vital Statistics • Accessible to all • A convenient summary of major statistics • resident population, births, maternities, deaths, mortality and migration • local administrative areas and health areas throughout the United Kingdom • explanatory material and illustrative maps • http://www.statistics.gov.uk/StatBase/Product.asp?vlnk=539&Pos=2&ColRank=1&Rank=272 • Available at ward level on CD-ROM

  10. Compendiumof clinical and health indicators National Centre for Health Outcomes Development • primitive – hundreds of Excel spreadsheets • You can now download all the indicators for your authority via the workbench on front page • Best collection of data on health and disease – less comprehensive on determinants

  11. Compendiumof clinical and health indicators • Mortality, but increasingly lifestyle and outcomes • Risk factors from Health Survey for England (trend data at SHA level) • CD or NCHOD website • nww.nchod.nhs.uk complete and historic data sets • www.nchod.nhs.uk public website with small numbers suppressed

  12. Basket of indicators produced by London Health Observatory • A wide variety of indicators of the wider determinants of health • http://www.lho.org.uk/Health_Inequalities/BasketOfIndicators/BasketData.htm

  13. Browsing sources (1) • Have a look at the NCHOD website: nww.nchod.nhs.uk (or www version if nww • access not available) • Browse the tables, maps, graphs section to • see what data is available. • 2. Look at data relating to teenage pregnancy – • what could you use it for, what are its • limitations?

  14. Browsing sources (2) Look at the ONS website www.statistics.gov.uk • Select theme – ‘health and care’ and see what is available • To find census data by ward or PCT select ‘Neighbourhood’ at top of screen, then ‘Topics’ part way down screen, then ‘2001 Census’, then ‘Key statistics’ • Look to see what data are available in the census • Look at the data for socio-economic classifications, economic activity, educational attainment. • Choose a ward in your local area by selecting (1) the data you want to look at, then (2) administrative area, and then (3) geographical area - England, East Midlands, your local authority and then a ward. See how the ward compares with the local authority as a whole for manual (semi-routine and routine) classifications, unemployment, no qualifications. (These are factors associated with higher smoking uptake.)

  15. Confidentiality • No statistics may be published which will reveal personal information • In practice this means no numbers under 5 • Avoid indirect disclosure (disclosure by differencing) eg subtracting males from a total will reveal that the count for females us under 5

  16. Screengrab of NeSS site

  17. Codes and lookups • Gridlink (NHS Postcode Directory) • IMD • ICD-10 • OPCS 4 • Ward History Database • SNAC (Standard Names and Codes)

  18. Extract from gridlink postcode file

  19. Index of Multiple Deprivation 2007 • Distinct dimensions of deprivation which can be recognised and measured separately. • These are experienced by individuals living in an area. • People may be counted in one or more of the domains, depending on the number of types of deprivation that they experience.

  20. Domains of Index of Multiple Deprivation 2007

  21. Extract from IMD http://www.communities.gov.uk/communities/neighbourhoodrenewal/deprivation/deprivation07/

  22. IMD 2007 • For every indicator: • Rank 1 is the most deprived SOA in England • Rank 32,482 the least • Ward scores and ranks are calculated (unofficially) • Local Authority summaries calculated (officially)

  23. International Classification of DiseasesICD-10 chapters

  24. OPCS 4 – CLASSIFICATION OF SURGICAL OPERATIONS AND PROCEDURES A Nervous System B Endocrine System and Breast C Eye D Ear E Respiratory Tract F Mouth G Upper Digestive Tract H Lower Digestive Tract J Other Abdominal Organs - principally Digestive K Heart L Arteries and Veins M Urinary N Male Genital Organs P Lower Female Genital Tract Q Upper Female Genital Tract R Female Genital Tract associated with Pregnancy Childbirth and Puerperium S Skin T Soft Tissue U Bones and Joints of Skull and Spine W Other Bones and Joints X Miscellaneous Operations Y Subsidiary Classification of Methods of Operation Z Subsidiary Classification of Sites of Operation

  25. EXTRACT FROM OPCS 4

  26. Other disease classifications • Read (primary care) • SNOMED (Systematic Nomenclature of Medicine) • ICF (International Classification of Functioning, Disability and Health) http://www.healthknowledge.org.uk/Health%20Information/HK%203b3.htm

  27. Elementary record linkage • If you have a common field in two sets of records you can link records • eg NHS number (link HES and mortality records) • Postcode (link mortality to Gridlink to IMD for SuperOutput Area (LSOA))

  28. Many sources of special data (which we can’t cover here) including: Infectious diseases (hpa.org.uk) Cancer Prescribing http://www.healthknowledge.org.uk/Health%20Information/HK%203b6&7.htm Sexual health (hpa.org.uk and http://www.everychildmatters.gov.uk/teenagepregnancy/) Lifestyle Specialist data sources

  29. Geodemographics • Segmentation

  30. What you have learned • Differences between record-level and aggregate data • Some examples of primary data (births, deaths, HES) • Simple sources of pre-calculated data (VS, Compendium, LHO basket, NeSS) • confidentiality • Codes and lookups • Specialist data sources (reference and links) • What geodemographics and segmentation are

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