Linked electronic health records for research on a nationwide cohort of more than 54 million people in England: data resource. (7th April 2021)

• Record Type: Journal Article
• Authors: Wood, Angela; Denholm, Rachel; Hollings, Sam; Cooper, Jennifer; Ip, Samantha; Walker, Venexia; Denaxas, Spiros; Akbari, Ashley; Banerjee, Amitava; Whiteley, William; Lai, Alvina; Sterne, Jonathan; Sudlow, Cathie
• Other Names: author non-byline.; Douiri Abdel author non-byline.; Akinoso-Imran Abdul Qadr author non-byline.; Jonas Adrian author non-byline.; Shah Ajay author non-byline.; Handy Alex author non-byline.; Davies Alun author non-byline.; Kurdi Amanj author non-byline.; Hansell Anna author non-byline.; Docherty Annemarie author non-byline.; Pherwani Arun author non-byline.; Dashtban Ashkan author non-byline.; Bray Ben author non-byline.; Cairns Ben author non-byline.; Goldacre Ben author non-byline.; Humberstone Ben author non-byline.; Mateen Bilal author non-byline.; Doble Brett author non-byline.; Roberts Brian author non-byline.; Morris Carole author non-byline.; Dale Caroline author non-byline.; Rogers Caroline author non-byline.; Wolfe Charles author non-byline.; Tomlinson Christopher author non-byline.; Lawson Claire author non-byline.; du Toit Clea author non-byline.; Berry Colin author non-byline.; Smith Craig author non-byline.; O'Connell Dan author non-byline.; Harris Daniel author non-byline.; Brind David author non-byline.; Cromwell David author non-byline.; Hughes David author non-byline.; Martos David Moreno author non-byline.; Ringham Debbie author non-byline.; Lawler Deborah author non-byline.; Lowe Deborah author non-byline.; Nikiphorou Elena author non-byline.; Withnell Eloise author non-byline.; Di Angelantonio Emanuele author non-byline.; Morris Eva author non-byline.; Birney Ewan author non-byline.; Falck Fabian author non-byline.; Torabi Fatemeh author non-byline.; Greaves Felix author non-byline.; Falter Florian author non-byline.; Zaccardi Francesco author non-byline.; Kee Frank author non-byline.; Davies Gareth author non-byline.; Nicholson George author non-byline.; Curry Gwenetta author non-byline.; Zhang Haoting author non-byline.; Hemingway Harry author non-byline.; Wilde Harry author non-byline.; Abbasizanjani Hoda author non-byline.; Wu Honghan author non-byline.; Tang Howard author non-byline.; Wang Huan author non-byline.; Mordi Ify author non-byline.; MacArthur Jackie author non-byline.; Lyons Jane author non-byline.; Beveridge Jennifer author non-byline.; Barrett Jessica author non-byline.; Wu Jianhua author non-byline.; Thygesen Johan author non-byline.; Danesh John author non-byline.; Dennis John author non-byline.; Boyle Jon author non-byline.; Halcox Julian author non-byline.; Khunti Kamlesh author non-byline.; Cheema Kate author non-byline.; Brown Katherine author non-byline.; Li Ken author non-byline.; Kavanagh Kim author non-byline.; North Laura author non-byline.; Pasea Laura author non-byline.; Ellins Libby author non-byline.; Pierotti Livia author non-byline.; Wright Lucy author non-byline.; Martin Lydia author non-byline.; Morrice Lynn author non-byline.; Mamas Mamas author non-byline.; Bennie Marion author non-byline.; Barber Mark author non-byline.; Macleod Mary Joan author non-byline.; Caputo Massimo author non-byline.; Buch Maya author non-byline.; Mizani Mehrdad author non-byline.; Katsoulis Michalis author non-byline.; Gravenor Mike author non-byline.; Inouye Mike author non-byline.; Skrypak Mirek author non-byline.; Gerstung Moritz author non-byline.; Pirmohamed Munir author non-byline.; Glickman Myer author non-byline.; Herz Naomi author non-byline.; Davies Neil author non-byline.; Hall Nick author non-byline.; Samani Nilesh author non-byline.; Seminog Olena author non-byline.; Lorgelly Paula author non-byline.; Machado Pedro author non-byline.; Li Qiuju author non-byline.; Denholm Rachel author non-byline.; Goldacre Raph author non-byline.; Carragher Raymond author non-byline.; Sofat Reecha author non-byline.; Takhar Rohan author non-byline.; Lyons Ronan author non-byline.; Priedon Rouven author non-byline.; Griffiths Rowena author non-byline.; Payne Rupert author non-byline.; Kolamunnage-Dona Ruwanthi author non-byline.; Salim Safa author non-byline.; Padmanabhan Sandosh author non-byline.; Onida Sarah author non-byline.; Kent Seamus author non-byline.; Bacon Seb author non-byline.; Manohar Sinduja author non-byline.; Babu-Narayan Sonya author non-byline.; Keene Spencer author non-byline.; Varma Susheel author non-byline.; Lawrence Thomas author non-byline.; Wang Tianxiao author non-byline.; Wilkinson Tim author non-byline.; Norris Tom author non-byline.; Palmer Tom author non-byline.; Nafilyan Vahé author non-byline.;
• Is Part Of: BMJ. Volume 373(2021)
• Publication Date: 2021-04-07
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Periodicals; 610
• DOI: 10.1136/bmj.n826
• Languages: English
• ISSNs: 0007-1447

Abstract

Abstract: Objective: To describe a novel England-wide electronic health record (EHR) resource enabling whole population research on covid-19 and cardiovascular disease while ensuring data security and privacy and maintaining public trust. Design: Data resource comprising linked person level records from national healthcare settings for the English population, accessible within NHS Digital's new trusted research environment. Setting: EHRs from primary care, hospital episodes, death registry, covid-19 laboratory test results, and community dispensing data, with further enrichment planned from specialist intensive care, cardiovascular, and covid-19 vaccination data. Participants: 54.4 million people alive on 1 January 2020 and registered with an NHS general practitioner in England. Main measures of interest: Confirmed and suspected covid-19 diagnoses, exemplar cardiovascular conditions (incident stroke or transient ischaemic attack and incident myocardial infarction) and all cause mortality between 1 January and 31 October 2020. Results: The linked cohort includes more than 96% of the English population. By combining person level data across national healthcare settings, data on age, sex, and ethnicity are complete for around 95% of the population. Among 53.3 million people with no previous diagnosis of stroke or transient ischaemic attack, 98 721 had a first ever incident stroke or transient ischaemic attack between 1 January and 31 October 2020, of which 30% were recorded only in primary care and 4% only in death registry records. Among 53.2 million people with no previous diagnosis of myocardial infarction, 62 966 had an incident myocardial infarction during follow-up, of which 8% were recorded only in primary care and 12% only in death registry records. A total of 959 470 people had a confirmed or suspected covid-19 diagnosis (714 162 in primary care data, 126 349 in hospital admission records, 776 503 in covid-19 laboratory test data, and 50 504 in death registry records). Although 58% of these were recorded in both primary care and covid-19 laboratory test data, 15% and 18%, respectively, were recorded in only one. Conclusions: This population-wide resource shows the importance of linking person level data across health settings to maximise completeness of key characteristics and to ascertain cardiovascular events and covid-19 diagnoses. Although this resource was initially established to support research on covid-19 and cardiovascular disease to benefit clinical care and public health and to inform healthcare policy, it can broaden further to enable a wide range of research.