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Some new data too

Introduction to UK GO data GPRD: General Practice Research Database THIN: Health Improvement Network. Some new data too. Records from GP routine records GPRD=THIN (almost) >6% of the UK population >350 GP practices >6½ million individual people. Data sources.

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Some new data too

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  1. Introduction to UK GO dataGPRD: General Practice Research DatabaseTHIN: Health Improvement Network Some new data too

  2. Records from GP routine records • GPRD=THIN (almost) • >6% of the UK population • >350 GP practices • >6½ million individual people Data sources

  3. Largest UK employer―4th largest employer in world • 1.7 million employees • 40,000 GPs • 10,000 GP practices • GPs see 140 patients per week UK NHS―National Health Service

  4. Diagnoses: GP and some hospital • Biochemistry: HbA1c etc • Risk factors: weight, smoking etc • Family history (some) • Drugs (all prescribed drugs) • Outpatient contacts • Free text • GPRD only….linked data: • Cancer registry data • Hospital inpatient data Data content

  5. Quality: representativeness

  6. Quality: completeness

  7. Quality: completeness

  8. Size―over 5% UK population • Nationally representative • Fast―information already collected • Frequent collections • All prescribable drugs • Population based • Study design flexibility • ‘Real Life’ data―collected during normal GP visit • Link to GP and patient for additional information Strengths

  9. £cost! • No direct link to secondary care data (THIN) • No direct link of prescriptions to diagnoses - temporal implied link • Limited information on OTC medications • Limited data on lifestyles, diet etc • Not dispensed prescriptions • Limited information on hospital prescribing • Some medications only administered by specialists Weaknesses

  10. Details of the cancer diagnosis variable • No systematic cancer staging data • Metastatic cancer: have to infer • Hospital cancer treatments not known Weaknesses re Ca.

  11. New data! Survival after incident cancer: diabetes vs. non-diabetes

  12. Incident cancers by cancer site

  13. Incident cancers by DM treatment

  14. Mean survival by Ca. site (years)

  15. Δ mean survival by Ca. site (years)

  16. Cumulative mortality (crude) DM Non-DM

  17. Cumulative mortality (adjusted) DM Non-DM Adjusted: age, sex, smoking, morbidity

  18. HR DM vs-N-DM (Cox)

  19. adjHR: DM vs N-DM (=1) by treatment

  20. Cum-mortality: ± metformin (adjusted) Met- Met- Met+ Met+ Exposed in first 3 months Exposed anytime aft Ca. diag HR=0.72; 0.68-0.76; p<0.00001 HR=0.83; 0.78-0.89; p<0.00001

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