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Sean Hilton - One of the best experts on this subject based on the ideXlab platform.
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implications of the problem orientated medical record pomr for research using electronic gp Databases a comparison of the doctors independent Network Database din and the general practice research Database gprd
BMC Family Practice, 2003Co-Authors: Iain M Carey, Derek G Cook, Stephen De Wilde, Stephen Bremner, N Richards, Steve Caine, David P Strachan, Sean HiltonAbstract:Background The General Practice Research Database (GPRD) and Doctor's Independent Network Database (DIN), are large electronic primary care Databases compiled in the UK during the 1990s. They provide a valuable resource for epidemiological and health services research. GPRD (based on VAMP) presents notes as a series of discrete episodes, whereas DIN is based on a system (MEDITEL) that used a Problem Orientated Medical Record (POMR) which links prescriptions to diagnostic problems. We have examined the implications for research of these different underlying philosophies.
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implications of the problem orientated medical record pomr for research using electronic gp Databases a comparison of the doctors independent Network Database din and the general practice research Database gprd
BMC Family Practice, 2003Co-Authors: Iain M Carey, Derek G Cook, Stephen De Wilde, Stephen Bremner, N Richards, Steve Caine, David P Strachan, Sean HiltonAbstract:The General Practice Research Database (GPRD) and Doctor's Independent Network Database (DIN), are large electronic primary care Databases compiled in the UK during the 1990s. They provide a valuable resource for epidemiological and health services research. GPRD (based on VAMP) presents notes as a series of discrete episodes, whereas DIN is based on a system (MEDITEL) that used a Problem Orientated Medical Record (POMR) which links prescriptions to diagnostic problems. We have examined the implications for research of these different underlying philosophies. Records of 40,183 children from 141 practices in DIN and 76,310 from 464 practices in GRPD who were followed to age 5 were used to compare the volume of recording of prescribing and diagnostic codes in the two Databases. To assess the importance and additional value of the POMR within DIN, the appropriateness of diagnostic linking to skin emollient prescriptions was investigated. Variation between practices for both the number of days on which prescriptions were issued and diagnoses were recorded was marked in both Databases. Mean number of "prescription days" during the first 5 years of life was similar in DIN (19.5) and in GPRD (19.8), but the average number of "diagnostic days" was lower in DIN (15.8) than in GPRD (22.9). Adjustment for linkage increased the average "diagnostic days" to 23.1 in DIN. 32.7% of emollient prescriptions in GPRD appeared with an eczema diagnosis on the same day compared to only 19.4% in DIN; however, 86.4% of prescriptions in DIN were linked to an earlier eczema diagnosis. More specifically 83% of emollient prescriptions appeared under a problem heading of eczema in the 121 practices that were using problem headings satisfactorily. Prescribing records in DIN and GPRD are very similar, but the usage of diagnostic codes is more parsimonious in DIN because of its POMR structure. Period prevalence rates will be underestimated in DIN unless this structure is taken into account. The advantage of the POMR is that in 121 of 141 practices using problem headings as intended, most prescriptions can be linked to a problem heading providing a specific reason for their issue.
Iain M Carey - One of the best experts on this subject based on the ideXlab platform.
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implications of the problem orientated medical record pomr for research using electronic gp Databases a comparison of the doctors independent Network Database din and the general practice research Database gprd
BMC Family Practice, 2003Co-Authors: Iain M Carey, Derek G Cook, Stephen De Wilde, Stephen Bremner, N Richards, Steve Caine, David P Strachan, Sean HiltonAbstract:Background The General Practice Research Database (GPRD) and Doctor's Independent Network Database (DIN), are large electronic primary care Databases compiled in the UK during the 1990s. They provide a valuable resource for epidemiological and health services research. GPRD (based on VAMP) presents notes as a series of discrete episodes, whereas DIN is based on a system (MEDITEL) that used a Problem Orientated Medical Record (POMR) which links prescriptions to diagnostic problems. We have examined the implications for research of these different underlying philosophies.
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implications of the problem orientated medical record pomr for research using electronic gp Databases a comparison of the doctors independent Network Database din and the general practice research Database gprd
BMC Family Practice, 2003Co-Authors: Iain M Carey, Derek G Cook, Stephen De Wilde, Stephen Bremner, N Richards, Steve Caine, David P Strachan, Sean HiltonAbstract:The General Practice Research Database (GPRD) and Doctor's Independent Network Database (DIN), are large electronic primary care Databases compiled in the UK during the 1990s. They provide a valuable resource for epidemiological and health services research. GPRD (based on VAMP) presents notes as a series of discrete episodes, whereas DIN is based on a system (MEDITEL) that used a Problem Orientated Medical Record (POMR) which links prescriptions to diagnostic problems. We have examined the implications for research of these different underlying philosophies. Records of 40,183 children from 141 practices in DIN and 76,310 from 464 practices in GRPD who were followed to age 5 were used to compare the volume of recording of prescribing and diagnostic codes in the two Databases. To assess the importance and additional value of the POMR within DIN, the appropriateness of diagnostic linking to skin emollient prescriptions was investigated. Variation between practices for both the number of days on which prescriptions were issued and diagnoses were recorded was marked in both Databases. Mean number of "prescription days" during the first 5 years of life was similar in DIN (19.5) and in GPRD (19.8), but the average number of "diagnostic days" was lower in DIN (15.8) than in GPRD (22.9). Adjustment for linkage increased the average "diagnostic days" to 23.1 in DIN. 32.7% of emollient prescriptions in GPRD appeared with an eczema diagnosis on the same day compared to only 19.4% in DIN; however, 86.4% of prescriptions in DIN were linked to an earlier eczema diagnosis. More specifically 83% of emollient prescriptions appeared under a problem heading of eczema in the 121 practices that were using problem headings satisfactorily. Prescribing records in DIN and GPRD are very similar, but the usage of diagnostic codes is more parsimonious in DIN because of its POMR structure. Period prevalence rates will be underestimated in DIN unless this structure is taken into account. The advantage of the POMR is that in 121 of 141 practices using problem headings as intended, most prescriptions can be linked to a problem heading providing a specific reason for their issue.
Paul N Newton - One of the best experts on this subject based on the ideXlab platform.
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mind the gaps the epidemiology of poor quality anti malarials in the malarious world analysis of the worldwide antimalarial resistance Network Database
Malaria Journal, 2014Co-Authors: Patricia Tabernero, Facundo M Fernandez, Michael R Green, Philippe J Guerin, Paul N NewtonAbstract:Background: Poor quality medicines threaten the lives of millions of patients and are alarmingly common in many parts of the world. Nevertheless, the global extent of the problem remains unknown. Accurate estimates of the epidemiology of poor quality medicines are sparse and are influenced by sampling methodology and diverse chemical analysis techniques. In order to understand the existing data, the Antimalarial Quality Scientific Group at WWARN built a comprehensive, open-access, global Database and linked Antimalarial Quality Surveyor, an online visualization tool. Analysis of the Database is described here, the limitations of the studies and data reported, and their public health implications discussed. Methods: The Database collates customized summaries of 251 published anti-malarial quality reports in English, French and Spanish by time and location since 1946. It also includes information on assays to determine quality, sampling and medicine regulation. Results: No publicly available reports for 60.6% (63) of the 104 malaria-endemic countries were found. Out of 9,348 anti-malarials sampled, 30.1% (2,813) failed chemical/packaging quality tests with 39.3% classified as falsified, 2.3% as substandard and 58.3% as poor quality without evidence available to categorize them as either substandard or falsified. Only 32.3% of the reports explicitly described their definitions of medicine quality and just 9.1% (855) of the samples collected in 4.6% (six) surveys were conducted using random sampling techniques. Packaging analysis was only described in 21.5% of publications and up to twenty wrong active ingredients were found in falsified anti-malarials. Conclusions: There are severe neglected problems with anti-malarial quality but there are important caveats to accurately estimate the prevalence and distribution of poor quality anti-malarials. The lack of reports in many malaria-endemic areas, inadequate sampling techniques and inadequate chemical analytical methods and instrumental procedures emphasizes the need to interpret medicine quality results with caution. The available evidence demonstrates the need for more investment to improve both sampling and analytical methodology and to achieve consensus in defining different types of poor quality medicines.
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mind the gaps the epidemiology of poor quality anti malarials in the malarious world analysis of the worldwide antimalarial resistance Network Database
Malaria Journal, 2014Co-Authors: Patricia Tabernero, Facundo M Fernandez, Michael R Green, Philippe J Guerin, Paul N NewtonAbstract:Poor quality medicines threaten the lives of millions of patients and are alarmingly common in many parts of the world. Nevertheless, the global extent of the problem remains unknown. Accurate estimates of the epidemiology of poor quality medicines are sparse and are influenced by sampling methodology and diverse chemical analysis techniques. In order to understand the existing data, the Antimalarial Quality Scientific Group at WWARN built a comprehensive, open-access, global Database and linked Antimalarial Quality Surveyor, an online visualization tool. Analysis of the Database is described here, the limitations of the studies and data reported, and their public health implications discussed. The Database collates customized summaries of 251 published anti-malarial quality reports in English, French and Spanish by time and location since 1946. It also includes information on assays to determine quality, sampling and medicine regulation. No publicly available reports for 60.6% (63) of the 104 malaria-endemic countries were found. Out of 9,348 anti-malarials sampled, 30.1% (2,813) failed chemical/packaging quality tests with 39.3% classified as falsified, 2.3% as substandard and 58.3% as poor quality without evidence available to categorize them as either substandard or falsified. Only 32.3% of the reports explicitly described their definitions of medicine quality and just 9.1% (855) of the samples collected in 4.6% (six) surveys were conducted using random sampling techniques. Packaging analysis was only described in 21.5% of publications and up to twenty wrong active ingredients were found in falsified anti-malarials. There are severe neglected problems with anti-malarial quality but there are important caveats to accurately estimate the prevalence and distribution of poor quality anti-malarials. The lack of reports in many malaria-endemic areas, inadequate sampling techniques and inadequate chemical analytical methods and instrumental procedures emphasizes the need to interpret medicine quality results with caution. The available evidence demonstrates the need for more investment to improve both sampling and analytical methodology and to achieve consensus in defining different types of poor quality medicines.
David P Strachan - One of the best experts on this subject based on the ideXlab platform.
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implications of the problem orientated medical record pomr for research using electronic gp Databases a comparison of the doctors independent Network Database din and the general practice research Database gprd
BMC Family Practice, 2003Co-Authors: Iain M Carey, Derek G Cook, Stephen De Wilde, Stephen Bremner, N Richards, Steve Caine, David P Strachan, Sean HiltonAbstract:Background The General Practice Research Database (GPRD) and Doctor's Independent Network Database (DIN), are large electronic primary care Databases compiled in the UK during the 1990s. They provide a valuable resource for epidemiological and health services research. GPRD (based on VAMP) presents notes as a series of discrete episodes, whereas DIN is based on a system (MEDITEL) that used a Problem Orientated Medical Record (POMR) which links prescriptions to diagnostic problems. We have examined the implications for research of these different underlying philosophies.
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implications of the problem orientated medical record pomr for research using electronic gp Databases a comparison of the doctors independent Network Database din and the general practice research Database gprd
BMC Family Practice, 2003Co-Authors: Iain M Carey, Derek G Cook, Stephen De Wilde, Stephen Bremner, N Richards, Steve Caine, David P Strachan, Sean HiltonAbstract:The General Practice Research Database (GPRD) and Doctor's Independent Network Database (DIN), are large electronic primary care Databases compiled in the UK during the 1990s. They provide a valuable resource for epidemiological and health services research. GPRD (based on VAMP) presents notes as a series of discrete episodes, whereas DIN is based on a system (MEDITEL) that used a Problem Orientated Medical Record (POMR) which links prescriptions to diagnostic problems. We have examined the implications for research of these different underlying philosophies. Records of 40,183 children from 141 practices in DIN and 76,310 from 464 practices in GRPD who were followed to age 5 were used to compare the volume of recording of prescribing and diagnostic codes in the two Databases. To assess the importance and additional value of the POMR within DIN, the appropriateness of diagnostic linking to skin emollient prescriptions was investigated. Variation between practices for both the number of days on which prescriptions were issued and diagnoses were recorded was marked in both Databases. Mean number of "prescription days" during the first 5 years of life was similar in DIN (19.5) and in GPRD (19.8), but the average number of "diagnostic days" was lower in DIN (15.8) than in GPRD (22.9). Adjustment for linkage increased the average "diagnostic days" to 23.1 in DIN. 32.7% of emollient prescriptions in GPRD appeared with an eczema diagnosis on the same day compared to only 19.4% in DIN; however, 86.4% of prescriptions in DIN were linked to an earlier eczema diagnosis. More specifically 83% of emollient prescriptions appeared under a problem heading of eczema in the 121 practices that were using problem headings satisfactorily. Prescribing records in DIN and GPRD are very similar, but the usage of diagnostic codes is more parsimonious in DIN because of its POMR structure. Period prevalence rates will be underestimated in DIN unless this structure is taken into account. The advantage of the POMR is that in 121 of 141 practices using problem headings as intended, most prescriptions can be linked to a problem heading providing a specific reason for their issue.
Steve Caine - One of the best experts on this subject based on the ideXlab platform.
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implications of the problem orientated medical record pomr for research using electronic gp Databases a comparison of the doctors independent Network Database din and the general practice research Database gprd
BMC Family Practice, 2003Co-Authors: Iain M Carey, Derek G Cook, Stephen De Wilde, Stephen Bremner, N Richards, Steve Caine, David P Strachan, Sean HiltonAbstract:Background The General Practice Research Database (GPRD) and Doctor's Independent Network Database (DIN), are large electronic primary care Databases compiled in the UK during the 1990s. They provide a valuable resource for epidemiological and health services research. GPRD (based on VAMP) presents notes as a series of discrete episodes, whereas DIN is based on a system (MEDITEL) that used a Problem Orientated Medical Record (POMR) which links prescriptions to diagnostic problems. We have examined the implications for research of these different underlying philosophies.
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implications of the problem orientated medical record pomr for research using electronic gp Databases a comparison of the doctors independent Network Database din and the general practice research Database gprd
BMC Family Practice, 2003Co-Authors: Iain M Carey, Derek G Cook, Stephen De Wilde, Stephen Bremner, N Richards, Steve Caine, David P Strachan, Sean HiltonAbstract:The General Practice Research Database (GPRD) and Doctor's Independent Network Database (DIN), are large electronic primary care Databases compiled in the UK during the 1990s. They provide a valuable resource for epidemiological and health services research. GPRD (based on VAMP) presents notes as a series of discrete episodes, whereas DIN is based on a system (MEDITEL) that used a Problem Orientated Medical Record (POMR) which links prescriptions to diagnostic problems. We have examined the implications for research of these different underlying philosophies. Records of 40,183 children from 141 practices in DIN and 76,310 from 464 practices in GRPD who were followed to age 5 were used to compare the volume of recording of prescribing and diagnostic codes in the two Databases. To assess the importance and additional value of the POMR within DIN, the appropriateness of diagnostic linking to skin emollient prescriptions was investigated. Variation between practices for both the number of days on which prescriptions were issued and diagnoses were recorded was marked in both Databases. Mean number of "prescription days" during the first 5 years of life was similar in DIN (19.5) and in GPRD (19.8), but the average number of "diagnostic days" was lower in DIN (15.8) than in GPRD (22.9). Adjustment for linkage increased the average "diagnostic days" to 23.1 in DIN. 32.7% of emollient prescriptions in GPRD appeared with an eczema diagnosis on the same day compared to only 19.4% in DIN; however, 86.4% of prescriptions in DIN were linked to an earlier eczema diagnosis. More specifically 83% of emollient prescriptions appeared under a problem heading of eczema in the 121 practices that were using problem headings satisfactorily. Prescribing records in DIN and GPRD are very similar, but the usage of diagnostic codes is more parsimonious in DIN because of its POMR structure. Period prevalence rates will be underestimated in DIN unless this structure is taken into account. The advantage of the POMR is that in 121 of 141 practices using problem headings as intended, most prescriptions can be linked to a problem heading providing a specific reason for their issue.