Exploring practical approaches to maximising data quality in electronic healthcare records in the primary care setting and associated benefits

Exploiting the information contained within electronic healthcare records (EHR) data will be key to addressing major challenges to public health both nationally and globally, ultimately offering a means of maximising efficiency and equality in care. There are, however, significant challenges in using EHRs effectively and particularly in ensuring the quality of data recorded. Incorrect or missing data could render records as useless or indeed misleading such that conclusions drawn from the data could have a negative impact. Amongst other difficulties, recording data can be time consuming to the extent of conflicting with the GP’s primary focus of patient consultation in an already time-constrained environment. Understanding the requirements of and the demands upon GPs must be central to addressing the issue of data quality (DQ) within EHRs. As part of on-going work into DQ at the Clinical Practice Research Datalink (CPRD) and in collaboration with the University of Sussex (UoS), a workshop session was held at the SAPC (Society for Academic Primary Care) conference in 2014 with the aim of exploring issues of DQ in primary care EHRs from the perspective of different users of GP data and with particular focus on how and why data is recorded in the first instance. The intended outcome was a furthered understanding of both the challenges and the direct benefits to GPs of ensuring high quality data with a view to establishing a workable approach to recording data and maximising benefits to all users of EHRs

SDSSJ14584479+3720215: A Benchmark JHK Blazar Light Curve from the 2MASS Calibration Scans

Active galactic nuclei (AGNs) are well-known to exhibit flux variability across a wide range of wavelength regimes, but the precise origin of the variability at different wavelengths remains unclear. To investigate the relatively unexplored near-IR variability of the most luminous AGNs, we conduct a search for variability using well sampled JHKs-band light curves from the 2MASS survey calibration fields. Our sample includes 27 known quasars with an average of 924 epochs of observation over three years, as well as one spectroscopically confirmed blazar (SDSSJ14584479+3720215) with 1972 epochs of data. This is the best-sampled NIR photometric blazar light curve to date, and it exhibits correlated, stochastic variability that we characterize with continuous auto-regressive moving average (CARMA) models. None of the other 26 known quasars had detectable variability in the 2MASS bands above the photometric uncertainty. A blind search of the 2MASS calibration field light curves for AGN candidates based on fitting CARMA(1,0) models (damped-random walk) uncovered only 7 candidates. All 7 were young stellar objects within the {\rho} Ophiuchus star forming region, five with previous X-ray detections. A significant {\gamma}-ray detection (5{\sigma}) for the known blazar using 4.5 years of Fermi photon data is also found. We suggest that strong NIR variability of blazars, such as seen for SDSSJ14584479+3720215, can be used as an efficient method of identifying previously-unidentified {\gamma}-ray blazars, with low contamination from other AGN.Comment: 6 pages, 3 figures, ApJ Accepte

Stocking Rate Theory and Profit Drivers in North Australian Rangeland Grazing Enterprises

Setting correct stock numbers is a key decision for successful pastoralism. In marginal environments, typified by northern Australia, this involves careful cattle herd management across landscapes and seasons characterised by heterogeneous land condition and extreme climatic uncertainty. Stocking rate theory which links animal production to stocking rates concentrates only on liveweight gain of sale animals and ignores complex herd (e.g. reproduction, mortality) and pasture dynamics (e.g. land condition) and costs of maintaining stock numbers (e.g. supplementary feeding). Related economic models are generally naïve and incomplete, being based on liveweight gain, meat prices and variable husbandry costs (e.g. Workman, 1986). Modelling approaches, which simulate whole herds (including breeding animals) with dynamic links between animal numbers, pasture availability, management effort and profits are more realistic. This paper explores the economic implications of changing stocking rates, animal production and management effort in the form of supplementary feeding

Young people's views about consenting to data linkage:findings from the PEARL qualitative study

Abstract Background Electronic administrative data exist in several domains which, if linked, are potentially useful for research. However, benefits from data linkage should be considered alongside risks such as the threat to privacy. Avon Longitudinal Study of Parents and Children (ALSPAC) is a birth cohort study. The Project to Enhance ALSPAC through Record Linkage (PEARL) was established to enrich the ALSPAC resource through linkage between ALSPAC participants and routine sources of health and social data. Qualitative research was incorporated in the PEARL study to examine participants’ views about data linkage and inform approaches to information sharing. This paper focusses on issues of consent. Methods Digitally recorded interviews were conducted with 55 participants aged 17–19 years. Terms and processes relating to consent, anonymization and data linkage were explained to interviewees. Scenarios were used to prompt consideration of linking different sources of data, and whether consent should be requested. Interview recordings were fully transcribed. Thematic analysis was undertaken using the Framework approach. Results Participant views on data linkage appeared to be most influenced by: considerations around the social sensitivity of the research question, and; the possibility of tangible health benefits in the public interest. Some participants appeared unsure about the effectiveness of anonymization, or did not always view effective anonymization as making consent unnecessary. This was related to notions of ownership of personal information and etiquette around asking permission for secondary use. Despite different consent procedures being explained, participants tended to equate consent with ‘opt-in’ consent through which participants are ‘asked’ if their data can be used for a specific study. Participants raising similar concerns came to differing conclusions about whether consent was needed. Views changed when presented with different scenarios, and were sometimes inconsistent. Conclusions Findings from this study question the validity of ‘informed consent’ as a cornerstone of good governance, and the extent to which potential research participants understand different types of consent and what they are consenting, or not consenting, to. Pragmatic, imaginative and flexible approaches are needed if research using data linkage is to successfully realise its potential for public good without undermining public trust in the research process