Determining patient characteristics for decision analysis support systems using anonymized electronic patient records

Area of Science:

• Health Services Research
• Decision Science
• General Practice

Background:

• Decision analysis holds promise for enhancing treatment decisions, but its progress is limited by the availability of patient-specific data.
• The General Practice Research Database (GPRD) offers a potential solution for generating the necessary patient data.
• Effective data utilization is crucial for evidence-based practice in general practice.

Purpose of the Study:

• To demonstrate the feasibility of generating patient-specific data for decision analysis using the GPRD.
• To develop a decision analysis model for recurrent stroke risk and aspirin treatment using GPRD data.
• To explore how decision analysis can integrate evidence-based information into primary care consultations.

Main Methods:

• Systematic application of eight criteria to identify suitable patients from a large West Midlands GPRD cohort (664,241 patients).
• Utilizing survival analysis to estimate recurrent stroke risk, generating multivariate hazard ratios for 960 distinct patient profiles.
• Populating a decision analysis model with the derived risk estimates and treatment effect data.

Main Results:

• Successfully identified a cohort of patients suitable for decision analysis from the GPRD.
• Quantified the risk of recurrent stroke and the associated risks and benefits of aspirin treatment for various patient profiles.
• Demonstrated the transformation of raw data into actionable information for clinical decision-making.

Conclusions:

• Decision analysis, supported by robust data from sources like the GPRD, can effectively introduce evidence-based information into clinical consultations.
• This approach can clarify prescribing risks and benefits, enhance General Practitioner-patient dialogue, and foster shared decision-making.
• The study underscores the value of transforming complex data into practical insights for modern general practice.