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Developing a large electronic primary care database (Doctors' Independent Network) for research.
Iain M Carey1, Derek G Cook, Stephen De Wilde
1Department of Community Health Sciences, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK. sgj450@sghms.ac.uk
International Journal of Medical Informatics
|June 3, 2004
Summary
The Doctors' Independent Network (DIN) database offers population-based clinical data comparable to the General Practice Research Database (GPRD). DIN uniquely includes socio-economic data, enabling analysis of health disparities in epidemiological research.
Area of Science:
- Epidemiology
- Health Services Research
- Population Health Data
Background:
- Primary care databases are vital for population health research.
- Historically, these databases lacked individual-level socio-economic data.
- The Doctors' Independent Network (DIN) database was developed to address this gap.
Purpose of the Study:
- To describe the development of the DIN database.
- To assess the validity and utility of DIN for epidemiological research.
- To evaluate the inclusion of an individual-level socio-economic marker (ACORN).
Main Methods:
- DIN database development and validation against the General Practice Research Database (GPRD).
- External validity assessed by comparing demographic structure and prevalence rates of ischemic heart disease (IHD) and hay fever.
- Socio-economic utility examined by analyzing IHD and hay fever prevalence trends by ACORN index.
Main Results:
- DIN includes 1,827,361 patients from 142 practices (1992-2001), with age-sex structure matching England & Wales and GPRD.
- Prevalence rates for treated IHD in DIN were highly comparable to GPRD.
- IHD prevalence showed a higher odds ratio in 'striving' compared to 'thriving' ACORN areas; hay fever prevalence was inversely associated with ACORN.
Conclusions:
- The DIN database provides reliable period prevalence rates for common conditions, comparable to GPRD.
- DIN's inclusion of a socio-economic index (ACORN) offers an advantage for health research.
- DIN has the potential to enhance epidemiological and health services research, possibly replacing national morbidity surveys.