49 results on '"M. McGilchrist"'
Search Results
2. Sensitive Data Exchange Protocol Suite for Healthcare.
- Author
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Thibaud Ecarot, Benoît Fraikin, Francis Ouellet, Luc Lavoie, Mark M. McGilchrist, and Jean-François Ethier
- Published
- 2020
- Full Text
- View/download PDF
3. eSource for clinical trials: Implementation and evaluation of a standards-based approach in a real world trial.
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Jean-François Ethier, Vasa Curcin, Mark M. McGilchrist, Sarah N. Lim Choi Keung, Lei Zhao, Anna Andreasson, Piotr Bródka, Radoslaw Michalski, Theodoros N. Arvanitis, Nikolaos Mastellos, Anita Burgun, and Brendan C. Delaney
- Published
- 2017
- Full Text
- View/download PDF
4. Transform: Implementing a Learning Healthcare System in Europe through Embedding Clinical Research into Clinical Practice.
- Author
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Sarah N. Lim Choi Keung, Lei Zhao, Vasa Curcin, Jean-François Ethier, Anita Burgun, Mark M. McGilchrist, Piotr Bródka, Wodzimierz Tuligowicz, Brendan C. Delaney, Theodoros N. Arvanitis, and Anna Andreasson
- Published
- 2015
- Full Text
- View/download PDF
5. A Sensitive Data Access Model in Support of Learning Health Systems.
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Thibaud Ecarot, Benoît Fraikin, Luc Lavoie, Mark M. McGilchrist, and Jean-François Ethier
- Published
- 2021
- Full Text
- View/download PDF
6. An Approach for Utilizing Clinical Statements in HL7 RIM to Evaluate Eligibility Criteria.
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Richard Bache, Christel Daniel, Julie James, Sajjad Hussain, Mark M. McGilchrist, Brendan Delaney, and Adel Taweel
- Published
- 2014
- Full Text
- View/download PDF
7. Cross Border Semantic Interoperability for Clinical Research: the EHR4CR Semantic Resources and Services.
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Christel Daniel, David Ouagne, Eric Sadou, Kerstin Forsberg, Mark M. McGilchrist, Eric Zapletal, Nicolas Paris, Sajjad Hussain, Marie-Christine Jaulent, and Dipak Kalra
- Published
- 2016
8. Data Integration in eHealth: A Domain/Disease Specific Roadmap.
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Jenny Ure, Rob Procter, Maryann E. Martone, David Porteous, Sharon Lloyd, Stephen M. Lawrie, Dominic Job, Richard A. Baldock, Alistair Philp, Dave Liewald, Frank Rakebrandt, Alan Blaikie, Clare McKay, Stuart Anderson, John D. Ainsworth, Jano I. van Hemert, Ignacio Blanquer, Richard O. Sinnott, Christian Barillot, Bernard Gibaud, Alan R. Williams, Mark Hartswood, Paul Watson 0001, Leslie Smith, Albert Burger, Jessie B. Kennedy, Horacio González-Vélez, Robert Stevens 0001, óscar Corcho, Robin Morton, Pamela Linksted, Mylene Deschenes, Mark M. McGilchrist, Paul Johnson, Alex Voss, Renate Gertz, and Joanna M. Wardlaw
- Published
- 2007
9. A unified structural/terminological interoperability framework based on LexEVS: application to TRANSFoRm.
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Jean-François Ethier, Olivier Dameron, Vasa Curcin, Mark M. McGilchrist, Robert A. Verheij, Theodoros N. Arvanitis, Adel Taweel, Brendan Delaney, and Anita Burgun
- Published
- 2013
- Full Text
- View/download PDF
10. Slower Decline in C-Reactive Protein after an Inflammatory Insult Is Associated with Longer Survival in Older Hospitalised Patients.
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Maryam Barma, James A Goodbrand, Peter T Donnan, Mark M McGilchrist, Helen Frost, Marion E T McMurdo, and Miles D Witham
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Medicine ,Science - Abstract
Enhancing biological resilience may offer a novel way to prevent and ameliorate disease in older patients. We investigated whether changes in C-reactive protein (CRP), as a dynamic marker of the acute inflammatory response to diverse stressors, may provide a way to operationalize the concept of resilience in older adults. We tested this hypothesis by examining whether such changes could predict prognosis by identifying which individuals are at greater risk of 6-month mortality.Analysis of prospective, routinely collected datasets containing data on hospitalization, clinical chemistry and rehabilitation outcomes for rehabilitation inpatients between 1999 and 2011. Maximum CRP response during acute illness and CRP recovery indices (time and slope of CRP decay to half maximum, and to
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- 2016
- Full Text
- View/download PDF
11. Possible Sources of Bias in Primary Care Electronic Health Record Data Use and Reuse
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Robert A, Verheij, Vasa, Curcin, Brendan C, Delaney, and Mark M, McGilchrist
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Bias ,Primary Health Care ,Data Collection ,Electronic Health Records ,Humans ,Health Services Research ,Medical Informatics - Abstract
Enormous amounts of data are recorded routinely in health care as part of the care process, primarily for managing individual patient care. There are significant opportunities to use these data for other purposes, many of which would contribute to establishing a learning health system. This is particularly true for data recorded in primary care settings, as in many countries, these are the first place patients turn to for most health problems.In this paper, we discuss whether data that are recorded routinely as part of the health care process in primary care are actually fit to use for other purposes such as research and quality of health care indicators, how the original purpose may affect the extent to which the data are fit for another purpose, and the mechanisms behind these effects. In doing so, we want to identify possible sources of bias that are relevant for the use and reuse of these type of data.This paper is based on the authors' experience as users of electronic health records data, as general practitioners, health informatics experts, and health services researchers. It is a product of the discussions they had during the Translational Research and Patient Safety in Europe (TRANSFoRm) project, which was funded by the European Commission and sought to develop, pilot, and evaluate a core information architecture for the learning health system in Europe, based on primary care electronic health records.We first describe the different stages in the processing of electronic health record data, as well as the different purposes for which these data are used. Given the different data processing steps and purposes, we then discuss the possible mechanisms for each individual data processing step that can generate biased outcomes. We identified 13 possible sources of bias. Four of them are related to the organization of a health care system, whereas some are of a more technical nature.There are a substantial number of possible sources of bias; very little is known about the size and direction of their impact. However, anyone that uses or reuses data that were recorded as part of the health care process (such as researchers and clinicians) should be aware of the associated data collection process and environmental influences that can affect the quality of the data. Our stepwise, actor- and purpose-oriented approach may help to identify these possible sources of bias. Unless data quality issues are better understood and unless adequate controls are embedded throughout the data lifecycle, data-driven health care will not live up to its expectations. We need a data quality research agenda to devise the appropriate instruments needed to assess the magnitude of each of the possible sources of bias, and then start measuring their impact. The possible sources of bias described in this paper serve as a starting point for this research agenda.
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- 2017
12. Towards safer methods of electronic surveillance
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Mark M. McGilchrist
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Electronic surveillance ,SAFER ,medicine ,Business ,Medical emergency ,medicine.disease - Published
- 2014
13. Data Integration in eHealth: A Domain/Disease Specific Roadmap
- Author
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Ure J, Procter R, Martone M, Porteous D, Lloyd S, Lawrie S, Job D, Baldock R, Philp A, Liewald D, Rakebrandt F, Blaikie A, McKay C, Anderson S, Ainsworth J, Van Hemert J, Blanquer I, Sinnott R, Barillot C, Gibaud B, Williams A, Hartswood M, Watson P, Smith L, Burger A, Kennedy J, Gonzalez velez H, Stevens R, Corcho O., Morton R, Linksted P, Deschenes M, Mcgilchrist M, Johnson P, Voss A, Gertz R, Wardlaw J
- Published
- 2007
14. Drug exposure risk windows and unexposed comparator groups for cohort studies in pharmacoepidemiology
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A D, McMahon, J M, Evans, M M, McGilchrist, D G, McDevitt, and T M, MacDonald
- Abstract
To determine the appropriate size of risk windows in both exposed and unexposed sub-cohorts.Data was taken from a previous study of upper gastrointestinal haemorrhage and perforation. The length of each prescription for NSAIDs was estimated. The risk was calculated for the duration of a prescription plus increments of -30, -25,..., +115, +120 (i.e. 31 increments). Ten unexposed groups were re-sampled for each increment (stratified for age and sex), using the same lengths of risk window as the exposed group. Mean risks and rate-ratios were calculated (per thousand person-years).The NSAID risk rose from 3.52 at -30 days to a peak of 5.82 at -15 days, and then decreased gradually to 2.83 at +120 days. Unexposed risk was variable for the negative increments, and decreased gradually from 2.16 at +0 days to 1.54 at +120 days. The rate-ratio rose from 1.55 at -30 days to a peak of 2.85 at -5 days, and then decreased to 1.85 at +120 days.Risk windows should be the same as (or slightly less than) the calculated length of a prescription. Lengthy windows should not be used for unexposed comparator groups (the exposed windows may be randomly allocated).
- Published
- 2004
15. Prescription of acid-suppressing drugs in relation to endoscopic diagnosis: a record-linkage study
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A T, Prach, M M, McGilchrist, F E, Murray, D A, Johnston, and T M, MacDonald
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Male ,Peptic Ulcer ,Gastrointestinal Diseases ,Humans ,Female ,Antacids ,Medical Record Linkage ,Middle Aged ,Drug Prescriptions ,Drug Utilization ,Endoscopy, Gastrointestinal ,Aged - Abstract
Although widely used, few data are available on the appropriateness of prescribing of acid-suppressing drugs (ASDs), despite guidelines on the investigation and treatment of dyspeptic patients.We created a database of 62 000 endoscopy examinations and record-linked these to a prescribing database. Endoscopic diagnoses were classified into peptic, nonpeptic and others. The H2-antagonists, omeprazole and misoprostol, were studied.35 000 patients had one or more endoscopies during 1978-93; two-thirds were over 45 years of age at first endoscopy. A quarter of all patients who had been endoscoped had consistently normal examinations. Peptic oesophageal pathology was the commonest positive finding. A quarter of those prescribed ASDs between 1989 and 1993 had been endoscoped between 1978 and 1993. In those with a peptic diagnosis prescribed any ASD, the pathologies found were: oesophageal (42.9%), duodenal (36.3%) and gastro-pyloric (21.3%). Patients prescribed omeprazole were more likely to have undergone endoscopy than those prescribed other ASDs, and they were also more likely to have peptic oesophageal pathology. Long-term prescribing (56 days per year) occurred in two-thirds of patients prescribed ASDs and 40% had at least one endoscopy. In those prescribed short-term ASDs, 20% had undergone at least one endoscopy. Peptic and nonpeptic endoscopic pathology was associated with increased ASD prescribing, but a normal endoscopy did not reduce prescribing.ASD prescribing appeared to be mainly symptom-driven. Positive endoscopic findings increased the prescribing of ASDs, but normal findings did not reduce it.
- Published
- 1999
16. The impact on community benzodiazepine prescribing of hospitalization
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Thomas M. MacDonald, Fiona S. Clunie, Alex D. McMahon, Helen Millar, and Mark M. McGilchrist
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Adult ,Hospitals, Psychiatric ,Male ,medicine.medical_specialty ,Pediatrics ,Adolescent ,medicine.drug_class ,Population ,Hospitals, General ,Benzodiazepines ,Sex Factors ,Epidemiology ,medicine ,Confidence Intervals ,Odds Ratio ,Psychiatric hospital ,Humans ,Community Health Services ,Longitudinal Studies ,Medical prescription ,Practice Patterns, Physicians' ,education ,Child ,Aged ,Retrospective Studies ,Benzodiazepine ,education.field_of_study ,Chi-Square Distribution ,business.industry ,Infant, Newborn ,Infant ,Middle Aged ,United Kingdom ,Hospitalization ,Psychiatry and Mental health ,Clinical Psychology ,Anti-Anxiety Agents ,Child, Preschool ,Linear Models ,Population study ,Observational study ,Female ,business ,Record linkage - Abstract
To assess the impact of both general and psychiatric hospitalization on the community prescribing of benzodiazepines, we carried out an observational study using record linkage of prescribing prior to and following hospitalization along with a review of hospital case records at four Tayside General Practices. In a population of 29,672 subjects, 2628 general hospital and 254 psychiatric hospitalizations were studied. The main outcome measure was the change in community benzodiazepine prescribing following hospitalization. We found that admission to a general hospital resulted in 59 of the 2628 subjects (2.2%) commencing and 45 subjects (1.7%) discontinuing benzodiazepines. Admission to a psychiatric hospital resulted in 17 of 254 subjects (6.7%) commencing and 40 (16.7%) discontinuing benzodiazepines. When compared to benzodiazepine prescribing in the study population these effects were trivial. We conclude that hospitalization in both general and psychiatric hospitals had a minor effect on total community prescribing of benzodiazepines. In this study general hospital admission resulted in a small net increase and psychiatric hospitalization a small net decrease in benzodiazepine prescribing.
- Published
- 1997
17. The Pattern of Prescribing of Community Dispensed Ulcer-Healing Drugs in Tayside
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M. M. McGilchrist, Denis G. McDevitt, F. E. Murray, Thomas M. MacDonald, G. White, and A. T. Prach
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Ulcer healing ,education.field_of_study ,medicine.medical_specialty ,business.industry ,Community control ,Internal medicine ,Population ,Medicine ,Optometry ,Conditional logistic regression ,business ,education - Abstract
Few data are available regarding the pattern of prescribing of ulcer-healing drugs (UHDS) in the community, despite their widespread use. The aim of this study was to analyze the pattern of UHD prescribing in Tayside, Scotland (population ≈400 000) between 1989 and 1992.
- Published
- 1997
18. An audit of the accuracy of upper gastrointestinal diagnoses in Scottish Morbidity Record 1 data in Tayside
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S, Dornan, F E, Murray, G, White, M M, McGilchrist, J M, Evans, D G, McDevitt, and T M, MacDonald
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Male ,Medical Audit ,Cross-Sectional Studies ,Scotland ,Incidence ,Stomach Diseases ,Humans ,Female ,Medical Record Linkage ,Middle Aged ,Esophageal Diseases ,Aged - Abstract
Scottish Morbidity Record (SMR1) data are coded by trained clerical staff from case records and discharge summaries. They form the basis of many strategic NHS decisions. Their accuracy for upper gastrointestinal (UGI) diagnosis is unknown and the study was undertaken to assess this accuracy in Tayside.Patients who fulfilled the following criteria were identified using a record-linkage pharmacoepidemiological database, and their case records retrieved: over 50 years of age, had encashed at least one prescription for a non-steroidal anti-inflammatory drug at a Tayside pharmacy and who had SMR1 records containing one or more symptom/diagnosis codes between January 1989 and December 1991. Medically qualified staff were trained to examine case records and to code UGI diagnoses. They searched the case records for every UGI SMR1 entry for these patients from 1980-1992 and produced re-coded diagnoses (RCD) for each hospital event (admission and discharge), using all the data available in the case records. They also abstracted data on the clinical presentation, investigations and management of patients. Each event was then examined by a single medically qualified researcher who compared the original SMR1 codes with the RCDs.2,101 patients had a total of 3,764 events in 1989-1991. 317 events were either day case procedures or elective surgery or the case records were not found. They were therefore excluded. Of the remainder, the SMR1 and RCD codes were judged equivalent in 1,608 events (46.6%). However, 1,005 SMR1 events (29.2%) contained a symptom code but no diagnosis code and the remaining 834 (24.2%) were judged suboptimal for other reasons. Of those with a symptom code only, 406 could not be improved upon and were transformed into RCD symptom codes only, 435 were assigned symptom and diagnostic RCDs and 164 were assigned diagnostic RCDs only. In the other 834 events, 279 had one or more diagnoses missing, 425 had one or more diagnoses inaccurate, 23 had both missing and inaccurate diagnoses and 107 were not UGI. Thus 1,433 (41.6%) of UGI SMR1 events could be more accurately coded. Examination of investigation data revealed that coding inaccuracy was not due to diagnostic procedures being carried out after admission.UGI SMR1 data were satisfactory in about half of all events. In about a quarter there were symptom codes but no satisfactory diagnosis codes, whilst in another quarter the data were inaccurate. These findings have implications for health care activities and research that use these data.
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- 1995
19. Non-steroidal anti-inflammatory drugs and hospitalization for acute renal failure
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J M, Evans, E, McGregor, A D, McMahon, M M, McGilchrist, M C, Jones, G, White, D G, McDevitt, and T M, MacDonald
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Adult ,Aged, 80 and over ,Male ,Adolescent ,Aspirin ,Anti-Inflammatory Agents, Non-Steroidal ,Administration, Oral ,Acute Kidney Injury ,Middle Aged ,Hospitalization ,Logistic Models ,Risk Factors ,Case-Control Studies ,Humans ,Female ,Medical Record Linkage ,Child ,Aged - Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) have been implicated in the aetiology of acute renal failure (ARF), but epidemiological studies examining this association have produced disparate results. We conducted a case-control study using a purpose-built record-linkage database for a population of 420,600 patients, resident in Tayside since May 1990. Patients (n = 207) hospitalized with a diagnostic code for ARF between 1990 and 1992 had their diagnosis validated by a renal physician. Six community controls and two hospital controls, matched for age and sex, were generated for each of these cases. Exposure to dispensed oral NSAIDs, topical NSAIDs and aspirin during the 90 days prior to the index date were investigated (recent exposure), as was exposure at any time since January 1989 (previous exposure). The most significant associations were modelled using conditional logistic regression. When community controls were used, recent exposure to NSAIDs and previous exposure to aspirin were independently associated with hospitalization for ARF, with adjusted odds ratios of 2.20 (1.49-3.25) and 2.19 (1.46-3.30), respectively. Only recent exposure to oral NSAIDs was associated when hospital controls were used: 1.84 (1.14-2.93). No significant interactions were present with previous chronic renal failure, other possible causes of ARF or whether the diagnosis was primary or secondary. There is an approximate doubling of the risk of hospitalization for ARF with use of oral NSAIDs.
- Published
- 1995
20. The utilisation and economic evaluation of antibiotics prescribed in primary care
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Peter Davey, M. M. McGilchrist, Denis G. McDevitt, A.D. McKENDRICK, Thomas M. MacDonald, D. Collins, and J. Stevens
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Microbiology (medical) ,Adult ,Male ,Rural Population ,medicine.medical_specialty ,Adolescent ,Drug Industry ,medicine.drug_class ,Cost-Benefit Analysis ,Antibiotics ,Erythromycin ,Lower respiratory tract infection ,Internal medicine ,Medicine ,Humans ,Pharmacology (medical) ,Medical prescription ,Intensive care medicine ,Child ,Antibacterial agent ,Aged ,Pharmacology ,Aged, 80 and over ,Respiratory tract infections ,business.industry ,Infant, Newborn ,Infant ,Middle Aged ,medicine.disease ,Drug Utilization ,Anti-Bacterial Agents ,Penicillin ,Infectious Diseases ,Upper respiratory tract infection ,Treatment Outcome ,Scotland ,Child, Preschool ,Female ,business ,Family Practice ,medicine.drug - Abstract
This was an observational study of efficacy and resource utilisation over three years in a cohort of 917 patients who received at least one prescription for an oral antibiotic between January and March 1989 in a large rural primary care health centre in Tayside, Scotland. Three thousand, six hundred and sixty three prescriptions were issued (2286 to females) for; 1502 upper respiratory tract infections, 419 lower respiratory tract infections, 441 urinary tract infections, 177 skin and soft tissue infections, 97 gynaecological infections, 103 cases of acne and 71 other infections. Excluding acne, 14% of infections required more than one antibiotic to achieve a successful outcome. The highest success rates for antibiotics were amoxycillin (92%) and penicillin V (92%) in upper respiratory tract infections, erythromycin (90%) in lower respiratory tract infections and co-trimoxazole (83%) in urinary tract infections. The most cost-effective antibiotics were penicillin V for upper respiratory tract infection, erythromycin for lower respiratory tract infection and co-trimoxazole for urinary tract infection. Varying the value placed on general practitioners' time did not change the rank order of antibiotic cost-effectiveness. The efficacy and cost-effectiveness of the treatment of acute infections in primary care varies considerably with the antibiotic used as first choice. More expensive antibiotics might be justified in cost-effectiveness terms if they had high cure rates in clinical practice.
- Published
- 1995
21. The risks of symptomatic vaginal candidiasis after oral antibiotic therapy
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T M, MacDonald, P H, Beardon, M M, McGilchrist, I D, Duncan, A D, McKendrick, and D G, McDevitt
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Adult ,Aged, 80 and over ,Antifungal Agents ,Time Factors ,Adolescent ,Age Factors ,Infant, Newborn ,Administration, Oral ,Infant ,Middle Aged ,Anti-Bacterial Agents ,Risk Factors ,Case-Control Studies ,Child, Preschool ,Humans ,Female ,Child ,Candidiasis, Vulvovaginal ,Aged - Abstract
It is generally accepted that antibiotic use can result in vaginal fungal overgrowth, although evidence estimating the extent to which this causes symptomatic vaginitis is scant. In a study using the prescription of vaginal antifungal preparations as a surrogate measure of vaginal candidiasis, a cohort of women taking antibiotics had a higher incidence of vaginal candidiasis after antibiotic exposure than beforehand (relative risk 2.3; 95% confidence interval 1.9-3.0); this risk was highest in those aged 36-40 years (RR 6.0, 95% CI 2.9-12.5). The attributable risk was highest among those who were taking cephalosporins (AR 12.8%, 95% CI 9.1-16.5). In a case-control study, comparing previous antibiotic exposure among women using vaginal antifungal agents and matched controls, antibiotic exposure was higher among those using vaginal antifungal agents during the previous 28 days, with an odds ratio of 5.5 (95% CI 3.8-7.9).
- Published
- 1993
22. Trends in primary care drug prescribing in children and adolescents
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Martin Kirkpatrick, Stephen A. Greene, Jayakara Shetty, and M. McGilchrist
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medicine.medical_specialty ,Pediatrics ,Drug Prescribing ,business.industry ,Family medicine ,Pediatrics, Perinatology and Child Health ,Medicine ,Primary care ,business - Published
- 2007
23. Book Review: Our Globe and How to Reach it: Seeing the World Evangelized by A.D. 2000 and beyond
- Author
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Donald M. McGilchrist
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medicine.anatomical_structure ,media_common.quotation_subject ,Religious studies ,medicine ,Media studies ,Art history ,Globe ,Art ,media_common - Published
- 1992
24. Topical non-steroidal anti-inflammatory drugs and admission to hospital for upper gastrointestinal bleeding and perforation: a record linkage case-control study.
- Author
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M, Evans J, D, McMahon A, M, McGilchrist M, G, White, E, Murray F, G, McDevitt D, and M, MacDonald T
- Abstract
OBJECTIVE--To evaluate the relation between topically applied non-steroidal anti-inflammatory drugs and upper gastrointestinal bleeding and perforation. DESIGN--A case-control study with 1103 patients admitted to hospital for upper gastrointestinal bleeding or perforation between January 1990 and December 1992 (cases). Two different control groups were used, with six community controls and with two hospital controls for each case. Previous exposure to topical and oral non-steroidal anti-inflammatory drugs and ulcer healing drugs was assessed. STUDY POPULATION--The population of 319,465 people who were resident in Tayside and were registered with a Tayside general practitioner between January 1989 and October 1994. A record linkage database containing all data on hospital events and dispensed drugs between 1989 and 1992 was used for this population. MAIN OUTCOME MEASURES--Unadjusted and adjusted odds ratios of exposure in those admitted to hospital compared with controls. RESULTS--Significant unadjusted associations were detected between all three classes of drug and upper gastrointestinal complications. The significant association detected for topical non-steroidal anti-inflammatory drugs was no longer evident in analyses which adjusted for the confounding effect of concomitant exposure to oral anti-inflammatories and ulcer healing drugs (odds ratio = 1.45; 95% confidence interval 0.84 to 2.50 with community controls; 1.06; 0.60 to 1.88 with hospital controls). CONCLUSION--In this study topical non-steroidal anti-inflammatory drugs were not significantly associated with upper gastrointestinal bleeding and perforation after adjustment for the confounding effects of concomitant use of oral anti-inflammatories and ulcer healing drugs.
- Published
- 1995
25. Association of upper gastrointestinal toxicity of non-steroidal anti-inflammatory drugs with continued exposure: cohort study.
- Author
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M, MacDonald T, V, Morant S, C, Robinson G, J, Shield M, M, McGilchrist M, E, Murray F, and G, McDevitt D
- Abstract
OBJECTIVES: To determine the profile of risk of upper gastrointestinal toxicity during continuous treatment with, and after cessation of, non-steroidal anti-inflammatory drugs. DESIGN: Cohort study with a prospectively constructed, population based, record linkage database containing details of exposure to all community dispensed non-steroidal anti-inflammatory drugs and also all admissions to hospital for upper gastrointestinal diagnoses. SETTING: The population of Tayside, Scotland. SUBJECTS: 52,293 subjects aged 50 and over who received one or more non-steroidal anti-inflammatory between 1 January 1989 and 31 December 1991 and 73,792 subjects who did not receive one during the same period (controls). MAIN OUTCOME MEASURES: Admission to hospital for upper gastrointestinal bleeding and perforation, and admission for other upper gastrointestinal diagnoses. RESULTS: About 2% of the non-steroidal anti-inflammatory cohort were admitted with an upper gastrointestinal event during the study period compared with 1.4% of controls. The risk of admission for upper gastrointestinal haemorrhage and perforation was constant during continuous non-steroidal anti-inflammatory exposure and carried over after the end of exposure. The results were similar for admissions for all upper gastrointestinal events. CONCLUSION: This study provides evidence that non-steroidal anti-inflammatory toxicity persists with continuous exposure. There seems to be carryover toxicity after the end of prescribing. These findings have implications for the management of patients requiring non-steroidal anti-inflammatory drugs.
- Published
- 1997
26. COMPARATIVE VASOCONSTRICTOR ACTIVITIES OF CORTICOSTEROIDS APPLIED TOPICALLY
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W. W. Heseltine, J. M. Mcgilchrist, and R. Gartside
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Pharmacology ,Triamcinolone acetonide ,Hydrocortisone ,business.industry ,Fludrocortisone ,Dermatology ,Triamcinolone Acetonide ,Vasomotor System ,Vasomotor system ,Adrenal Cortex Hormones ,Humans ,Vasoconstrictor Agents ,Medicine ,business ,Glucocorticoids ,medicine.drug - Published
- 1964
27. Serum hepatitis hazard in biochemical control sera
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J M McGilchrist
- Subjects
Hepatitis ,business.industry ,General Engineering ,General Medicine ,Laboratory Infection ,Hepatitis B ,medicine.disease ,Hazard ,Blood ,Immunology ,medicine ,General Earth and Planetary Sciences ,Humans ,Indicators and Reagents ,business ,General Environmental Science ,Research Article - Published
- 1972
28. Sustained release amitriptyline (lentizol) in depressive illness
- Author
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John M. Mcgilchrist
- Subjects
medicine.medical_specialty ,Imipramine ,business.industry ,Depression ,Amitriptyline ,Psychiatry and Mental health ,Text mining ,Delayed-Action Preparations ,Medicine ,Humans ,business ,Psychiatry ,medicine.drug - Published
- 1973
29. Letter: Interactions with monoamine oxidase inhibitors
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J M McGilchrist
- Subjects
Monoamine Oxidase Inhibitors ,Meperidine ,Morphine ,business.industry ,Monoamine oxidase ,General Engineering ,Tyramine ,General Medicine ,Pharmacology ,chemistry.chemical_compound ,Phenelzine ,Biochemistry ,chemistry ,Humans ,General Earth and Planetary Sciences ,Medicine ,Drug Interactions ,business ,Research Article ,General Environmental Science ,medicine.drug - Published
- 1975
30. Inhibition of Lactation with Quinestrol
- Author
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John M. McGilchrist
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World Wide Web ,Information retrieval ,medicine.anatomical_structure ,Computer science ,Lactation ,Correspondence ,General Engineering ,medicine ,Quinestrol ,General Earth and Planetary Sciences ,General Medicine ,General Environmental Science ,medicine.drug - Published
- 1969
31. Campbells in the strand
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M. McGilchrist-Gilchrist
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Linguistics and Language ,Literature and Literary Theory ,Library and Information Sciences ,Language and Linguistics - Published
- 1906
32. A National Network of Safe Havens: Scottish Perspective.
- Author
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Gao C, McGilchrist M, Mumtaz S, Hall C, Anderson LA, Zurowski J, Gordon S, Lumsden J, Munro V, Wozniak A, Sibley M, Banks C, Duncan C, Linksted P, Hume A, Stables CL, Mayor C, Caldwell J, Wilde K, Cole C, and Jefferson E
- Subjects
- Humans, Scotland, Electronic Health Records, Privacy
- Abstract
For over a decade, Scotland has implemented and operationalized a system of Safe Havens, which provides secure analytics platforms for researchers to access linked, deidentified electronic health records (EHRs) while managing the risk of unauthorized reidentification. In this paper, a perspective is provided on the state-of-the-art Scottish Safe Haven network, including its evolution, to define the key activities required to scale the Scottish Safe Haven network's capability to facilitate research and health care improvement initiatives. A set of processes related to EHR data and their delivery in Scotland have been discussed. An interview with each Safe Haven was conducted to understand their services in detail, as well as their commonalities. The results show how Safe Havens in Scotland have protected privacy while facilitating the reuse of the EHR data. This study provides a common definition of a Safe Haven and promotes a consistent understanding among the Scottish Safe Haven network and the clinical and academic research community. We conclude by identifying areas where efficiencies across the network can be made to meet the needs of population-level studies at scale., (©Chuang Gao, Mark McGilchrist, Shahzad Mumtaz, Christopher Hall, Lesley Ann Anderson, John Zurowski, Sharon Gordon, Joanne Lumsden, Vicky Munro, Artur Wozniak, Michael Sibley, Christopher Banks, Chris Duncan, Pamela Linksted, Alastair Hume, Catherine L Stables, Charlie Mayor, Jacqueline Caldwell, Katie Wilde, Christian Cole, Emily Jefferson. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 09.03.2022.)
- Published
- 2022
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33. The TRANSFoRm project: Experience and lessons learned regarding functional and interoperability requirements to support primary care.
- Author
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Ethier JF, McGilchrist M, Barton A, Cloutier AM, Curcin V, Delaney BC, and Burgun A
- Abstract
Introduction: The current model of medical knowledge production, transfer, and application suffers from serious shortcomings. Learning health systems (LHS) have recently emerged as a potential solution-systems in which health information generated from patients is continuously analyzed to improve knowledge that will be transferred to patient care., Method: Various approaches of data integration already exist and could be considered for the implementation of a LHS. We discuss what are the possible informatics approaches to address the functional requirements of LHS, in the specific context of primary care, and present the experience and lessons learned from the TRANSFoRm project., Result: Implemented in 4 countries around 5 systems, TRANSFoRm is based on a local-as-view data mediation approach integrating the structural and terminological models in the same framework. It clearly demonstrated that it has the potential to address the requirements for a LHS in primary care, by dealing with data fragmented across multiple points of service. Also, it has the potential to support the generation of hypotheses from the context of clinical care, retrospective and prospective research, and decision support systems that improve the relevance of medical decisions., Conclusion: The LHS approach embodies a shift from an institution-centered to a patient-centered perspective in knowledge production and transfer and can address important challenges in the primary care setting., Competing Interests: No conflict of interest to be declared by any co‐author.
- Published
- 2017
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34. Association between bisphosphonate therapy and outcomes from rehabilitation in older people.
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Goodbrand JA, Hughes LD, Cochrane L, Donnan PT, McGilchrist M, Frost H, McMurdo ME, and Witham MD
- Subjects
- Aged, Aged, 80 and over, Female, Humans, Male, Proportional Hazards Models, United Kingdom, Bone Density Conservation Agents therapeutic use, Diphosphonates therapeutic use, Hospitalization, Mortality, Rehabilitation
- Abstract
Background: Bisphosphonate therapy may have actions beyond bone, including effects on cardiovascular, immune and muscle function. We tested whether bisphosphonate treatment is associated with improved outcomes in older people undergoing inpatient rehabilitation., Methods: Analysis of prospectively collected, linked routine clinical datasets. Participants were divided into never users of bisphosphonates, use prior to rehabilitation only, use after rehabilitation only, and current users (use before and after rehabilitation). We calculated change in 20-point Barthel scores during rehabilitation, adjusting for comorbid disease and laboratory data using multivariable regression analysis. Cox regression analyses were performed to analyse the association between bisphosphonate use and time to death or hospitalisation., Results: 2797 patients were included in the analysis. Current bisphosphonate users showed greater improvement in Barthel score during rehabilitation than non-users (5.0 points [95%CI 4.3-5.7] vs 3.8 [95%CI 3.6-3.9]), but no difference compared to those receiving bisphosphonates only after discharge (5.1 [95%CI 4.6-5.5]). Previous bisphosphonate use was significantly associated with time to death (adjusted hazard ratio 1.41 [95%CI 1.15-1.73]) but less strongly with time to combined endpoint of hospitalisation or death (adjusted hazard ratio 1.18 [95%CI 0.98-1.48]). Use after discharge from rehabilitation was associated with reduced risk of death (adjusted hazard ratio 0.64 [95%CI 0.55-0.73]; hazard ratio per year of bisphosphonate prescription 0.98 [95%CI 0.97-0.99])., Conclusion: Bisphosphonate use is unlikely to be causally associated with improved physical function in older people, but continuing use may be associated with lower risk of death., (Copyright © 2017 Elsevier B.V. All rights reserved.)
- Published
- 2017
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- View/download PDF
35. Common data elements for secondary use of electronic health record data for clinical trial execution and serious adverse event reporting.
- Author
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Bruland P, McGilchrist M, Zapletal E, Acosta D, Proeve J, Askin S, Ganslandt T, Doods J, and Dugas M
- Subjects
- Biomedical Research methods, Biomedical Research statistics & numerical data, Clinical Trials as Topic methods, Europe, Health Information Exchange statistics & numerical data, Hospital Records statistics & numerical data, Humans, Medical Informatics methods, Research Design, Adverse Drug Reaction Reporting Systems statistics & numerical data, Clinical Trials as Topic statistics & numerical data, Common Data Elements, Electronic Health Records statistics & numerical data, Medical Informatics statistics & numerical data
- Abstract
Background: Data capture is one of the most expensive phases during the conduct of a clinical trial and the increasing use of electronic health records (EHR) offers significant savings to clinical research. To facilitate these secondary uses of routinely collected patient data, it is beneficial to know what data elements are captured in clinical trials. Therefore our aim here is to determine the most commonly used data elements in clinical trials and their availability in hospital EHR systems., Methods: Case report forms for 23 clinical trials in differing disease areas were analyzed. Through an iterative and consensus-based process of medical informatics professionals from academia and trial experts from the European pharmaceutical industry, data elements were compiled for all disease areas and with special focus on the reporting of adverse events. Afterwards, data elements were identified and statistics acquired from hospital sites providing data to the EHR4CR project., Results: The analysis identified 133 unique data elements. Fifty elements were congruent with a published data inventory for patient recruitment and 83 new elements were identified for clinical trial execution, including adverse event reporting. Demographic and laboratory elements lead the list of available elements in hospitals EHR systems. For the reporting of serious adverse events only very few elements could be identified in the patient records., Conclusions: Common data elements in clinical trials have been identified and their availability in hospital systems elucidated. Several elements, often those related to reimbursement, are frequently available whereas more specialized elements are ranked at the bottom of the data inventory list. Hospitals that want to obtain the benefits of reusing data for research from their EHR are now able to prioritize their efforts based on this common data element list.
- Published
- 2016
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36. Feasibility and acceptability of TRANSFoRm to improve clinical trial recruitment in primary care.
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Mastellos N, Bliźniuk G, Czopnik D, McGilchrist M, Misiaszek A, Bródka P, Curcin V, Car J, Delaney BC, and Andreasson A
- Subjects
- Attitude of Health Personnel, Feasibility Studies, Female, Health Personnel, Humans, Male, Patient Acceptance of Health Care, Poland, Telemedicine, Translational Research, Biomedical methods, Clinical Trials as Topic methods, Gastroesophageal Reflux, General Practice, Patient Selection, Primary Health Care methods
- Abstract
Background: Recruitment of study participants is a challenging process for health professionals and patients. The Translational Medicine and Patient Safety in Europe (TRANSFoRm) clinical trial tools enable automated identification, recruitment and follow-up in clinical trials, potentially saving time, effort and costs for all parties involved., Objectives: This study evaluates the acceptability and feasibility of TRANSFoRm to improve clinical trial recruitment in primary care., Methods: A feasibility study was conducted in three general practices in Poland. Participants were physicians and patients with gastro-oesophageal reflux disease. Semi-structured interviews were held to obtain feedback about the usefulness, ease of use and overall experience with the TRANSFoRm tools and to identify potential usability issues. Data were analysed thematically., Results: A total of 5 physicians and 10 patients participated in the study. Physicians were satisfied with the usefulness of the system, as it enabled easier and faster identification, recruitment and follow-up of patients compared with existing methods. Patients found the TRANSFoRm apps easy to use to report patient outcomes. However, they also felt that the apps may not be useful for patients with limited exposure to smartphone and web technologies. Two main usability issues were identified: physicians could not access the result of the randomization at the end of each visit, and participants could not locate the follow-up reminder email., Conclusions: This study provides new evidence on the acceptability and feasibility of TRANSFoRm to enable automated identification, recruitment and follow-up of study participants in primary care trials. It also helps to better understand and address users' requirements in eHealth-supported clinical research., (© The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Published
- 2016
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37. Association between allopurinol use and hip fracture in older patients.
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Basu U, Goodbrand J, McMurdo MET, Donnan PT, McGilchrist M, Frost H, George J, and Witham MD
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- Aged, Female, Humans, Male, Proportional Hazards Models, Time Factors, Allopurinol adverse effects, Hip Fractures chemically induced, Hip Fractures epidemiology
- Abstract
Background: Allopurinol reduces oxidative stress and interacts with purinergic signalling systems important in bone metabolism and muscle function. We assessed whether allopurinol use was associated with a reduced incidence of hip fracture in older people., Methods: Analysis of prospective, routinely-collected health and social care data on patients undergoing health and social work assessment in a single geographical area over a 12year period. Exposure to allopurinol was derived from linked community prescribing data, and hospitalisation for hip fracture and comorbid disease was derived from linked hospitalisation data. Fine and Gray modelling was used to model time to hip fracture accounting for the competing risk of death, incorporating previous use of allopurinol, cumulative exposure to allopurinol as a time dependent variable, and covariate adjustments., Results: 17,308 patients were alive at the time of first social work assessment without previous hip fracture; the mean age was 73years. 10,171 (59%) were female, and 1155 (8%) had at least one exposure to allopurinol. 618 (3.6%) sustained a hip fracture, and 4226 (24%) died during a mean follow-up of 7.2years. In fully-adjusted analyses, each year of allopurinol exposure conferred a hazard ratio of 1.01 (95% CI 0.99, 1.02; p=0.37) for hip fracture and 1.00 (0.99, 1.01; p=0.47) for death. Previous use of allopurinol conferred a hazard ratio of 0.76 (0.45, 1.26; p=0.28) for hip fracture and 1.13 (0.99, 1.29; p=0.07) for death., Conclusion: Greater cumulative use of allopurinol was not associated with a reduced risk of hip fracture or death in this cohort., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2016
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38. Translational Medicine and Patient Safety in Europe: TRANSFoRm--Architecture for the Learning Health System in Europe.
- Author
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Delaney BC, Curcin V, Andreasson A, Arvanitis TN, Bastiaens H, Corrigan D, Ethier JF, Kostopoulou O, Kuchinke W, McGilchrist M, van Royen P, and Wagner P
- Subjects
- Europe, Humans, Decision Support Systems, Clinical, Electronic Health Records, Models, Theoretical, Patient Safety standards, Translational Research, Biomedical
- Abstract
Unlabelled: The Learning Health System (LHS) describes linking routine healthcare systems directly with both research translation and knowledge translation as an extension of the evidence-based medicine paradigm, taking advantage of the ubiquitous use of electronic health record (EHR) systems. TRANSFoRm is an EU FP7 project that seeks to develop an infrastructure for the LHS in European primary care., Methods: The project is based on three clinical use cases, a genotype-phenotype study in diabetes, a randomised controlled trial with gastroesophageal reflux disease, and a diagnostic decision support system for chest pain, abdominal pain, and shortness of breath., Results: Four models were developed (clinical research, clinical data, provenance, and diagnosis) that form the basis of the projects approach to interoperability. These models are maintained as ontologies with binding of terms to define precise data elements. CDISC ODM and SDM standards are extended using an archetype approach to enable a two-level model of individual data elements, representing both research content and clinical content. Separate configurations of the TRANSFoRm tools serve each use case., Conclusions: The project has been successful in using ontologies and archetypes to develop a highly flexible solution to the problem of heterogeneity of data sources presented by the LHS.
- Published
- 2015
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39. Construction of a linked health and social care database resource--lessons on process, content and culture.
- Author
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Witham MD, Frost H, McMurdo M, Donnan PT, and McGilchrist M
- Subjects
- Aged, Attitude of Health Personnel, Computer Security, Confidentiality, Humans, Information Management organization & administration, Medical Record Linkage methods, National Health Programs, Organizational Culture, Scotland, Databases, Factual, Delivery of Health Care organization & administration, Electronic Health Records organization & administration, Social Work organization & administration, Systems Integration
- Abstract
Background: Combining routinely collected health and social care data on older people is essential to advance both service delivery and research for this client group. Little data is available on how to combine health and social care data; this article provides an overview of a successful data linkage process and discusses potential barriers to executing such projects., Methods and Results: We successfully obtained and linked data on older people within Dundee from three sources: Dundee Social Work Department database (30,000 individuals aged 65 years and over), healthcare data held on NHS Tayside patients by the Health Informatics Centre (400,000 individuals), Dundee, and the Dundee of Medicine for the Elderly rehabilitation database (4300 individuals). Data were linked, anonymized and transferred to a Safe Haven environment to ensuring confidentiality and strict access control. Challenges were faced around workflows, culture and documentation. Exploiting the resultant data set raises further challenges centered on database documentation, understanding the way data were collected, dealing with missing data, data validity and collection at different time periods., Conclusion: Routinely collected health and social care data sets can be linked, but significant process barriers must be overcome to allow successful linkage and integration of data and its full exploitation.
- Published
- 2015
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40. Detailed clinical modelling approach to data extraction from heterogeneous data sources for clinical research.
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Lim Choi Keung SN, Zhao L, Rossiter J, McGilchrist M, Culross F, Ethier JF, Burgun A, Verheij RA, Khan N, Taweel A, Curcin V, Delaney BC, and Arvanitis TN
- Abstract
The reuse of routinely collected clinical data for clinical research is being explored as part of the drive to reduce duplicate data entry and to start making full use of the big data potential in the healthcare domain. Clinical researchers often need to extract data from patient registries and other patient record datasets for data analysis as part of clinical studies. In the TRANSFoRm project, researchers define their study requirements via a Query Formulation Workbench. We use a standardised approach to data extraction to retrieve relevant information from heterogeneous data sources, using semantic interoperability enabled via detailed clinical modelling. This approach is used for data extraction from data sources for analysis and for pre-population of electronic Case Report Forms from electronic health records in primary care clinical systems.
- Published
- 2014
41. An approach for utilizing clinical statements in HL7 RIM to evaluate eligibility criteria.
- Author
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Bache R, Daniel C, James J, Hussain S, McGilchrist M, Delaney B, and Taweel A
- Subjects
- Information Storage and Retrieval standards, Internationality, Clinical Trials as Topic standards, Electronic Health Records standards, Eligibility Determination standards, Health Level Seven standards, Practice Guidelines as Topic, Terminology as Topic, Vocabulary, Controlled
- Abstract
The HL7 RIM (Reference Information Model) is a commonly used standard for the exchange of clinical data and can be employed for integrating the patient care and clinical research domains. Yet it is not sufficiently well specified to ensure a canonical representation of structured clinical data when used for the automated evaluation of eligibility criteria from a clinical trial protocol. We present an approach to further constrain the RIM to create a common information model to hold clinical data. In order to demonstrate our approach, we identified 132 distinct data elements from 10 rich clinical trails. We then defined a taxonomy to (i) identify the types of data elements that would need to be stored and (ii) define the types of predicate that would be used to evaluate them. This informed the definition of a pattern used to represent the data, which was shown to be sufficient for storing and evaluating the clinical statements required by the trials.
- Published
- 2014
42. Piloting the EHR4CR feasibility platform across Europe.
- Author
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Doods J, Bache R, McGilchrist M, Daniel C, Dugas M, and Fritz F
- Subjects
- Database Management Systems, Feasibility Studies, Humans, Pilot Projects, Electronic Health Records, Patient Selection, Research Report, Software
- Abstract
Background: Pharmaceutical clinical trials are primarily conducted across many countries, yet recruitment numbers are frequently not met in time. Electronic health records store large amounts of potentially useful data that could aid in this process. The EHR4CR project aims at re-using EHR data for clinical research purposes., Objective: To evaluate whether the protocol feasibility platform produced by the Electronic Health Records for Clinical Research (EHR4CR) project can be installed and set up in accordance with local technical and governance requirements to execute protocol feasibility queries uniformly across national borders., Methods: We installed specifically engineered software and warehouses at local sites. Approvals for data access and usage of the platform were acquired and terminology mapping of local site codes to central platform codes were performed. A test data set, or real EHR data where approvals were in place, were loaded into data warehouses. Test feasibility queries were created on a central component of the platform and sent to the local components at eleven university hospitals., Results: To use real, de-identified EHR data we obtained permissions and approvals from 'data controllers' and ethics committees. Through the platform we were able to create feasibility queries, distribute them to eleven university hospitals and retrieve aggregated patient counts of both test data and de-identified EHR data., Conclusion: It is possible to install a uniform piece of software in different university hospitals in five European countries and configure it to the requirements of the local networks, while complying with local data protection regulations. We were also able set up ETL processes and data warehouses, to re-use EHR data for feasibility queries distributed over the EHR4CR platform.
- Published
- 2014
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43. Cohort Profile: Generation Scotland: Scottish Family Health Study (GS:SFHS). The study, its participants and their potential for genetic research on health and illness.
- Author
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Smith BH, Campbell A, Linksted P, Fitzpatrick B, Jackson C, Kerr SM, Deary IJ, Macintyre DJ, Campbell H, McGilchrist M, Hocking LJ, Wisely L, Ford I, Lindsay RS, Morton R, Palmer CN, Dominiczak AF, Porteous DJ, and Morris AD
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Cognition, Cohort Studies, Female, Genetic Research, Humans, Male, Medical Record Linkage, Mental Health, Middle Aged, Molecular Epidemiology, Phenotype, Risk Factors, Scotland epidemiology, Socioeconomic Factors, Surveys and Questionnaires, Young Adult, DNA analysis, Family Health statistics & numerical data, Genetic Predisposition to Disease, Pedigree
- Abstract
GS:SFHS is a family-based genetic epidemiology study with DNA and socio-demographic and clinical data from about 24 000 volunteers across Scotland aged 18-98 years, from February 2006 to March 2011. Biological samples and anonymized data form a resource for research on the genetics of health, disease and quantitative traits of current and projected public health importance. Specific and important features of GS:SFHS include the family-based recruitment, with the intent of obtaining family groups; the breadth and depth of phenotype information, including detailed data on cognitive function, personality traits and mental health; consent and mechanisms for linkage of all data to comprehensive routine health-care records; and 'broad' consent from participants to use their data and samples for a wide range of medical research, including commercial research, and for re-contact for the potential collection of other data or samples, or for participation in related studies and the design and review of the protocol in parallel with in-depth sociological research on (potential) participants and users of the research outcomes. These features were designed to maximize the power of the resource to identify, replicate or control for genetic factors associated with a wide spectrum of illnesses and risk factors, both now and in the future.
- Published
- 2013
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44. Business Process Modelling is an Essential Part of a Requirements Analysis. Contribution of EFMI Primary Care Working Group.
- Author
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de Lusignan S, Krause P, Michalakidis G, Vicente MT, Thompson S, McGilchrist M, Sullivan F, van Royen P, Agreus L, Desombre T, Taweel A, and Delaney B
- Subjects
- Humans, Primary Health Care
- Abstract
Objectives: To perform a requirements analysis of the barriers to conducting research linking of primary care, genetic and cancer data., Methods: We extended our initial data-centric approach to include socio-cultural and business requirements. We created reference models of core data requirements common to most studies using unified modelling language (UML), dataflow diagrams (DFD) and business process modelling notation (BPMN). We conducted a stakeholder analysis and constructed DFD and UML diagrams for use cases based on simulated research studies. We used research output as a sensitivity analysis., Results: Differences between the reference model and use cases identified study specific data requirements. The stakeholder analysis identified: tensions, changes in specification, some indifference from data providers and enthusiastic informaticians urging inclusion of socio-cultural context. We identified requirements to collect information at three levels: micro- data items, which need to be semantically interoperable, meso- the medical record and data extraction, and macro- the health system and socio-cultural issues. BPMN clarified complex business requirements among data providers and vendors; and additional geographical requirements for patients to be represented in both linked datasets. High quality research output was the norm for most repositories., Conclusions: Reference models provide high-level schemata of the core data requirements. However, business requirements' modelling identifies stakeholder issues and identifies what needs to be addressed to enable participation.
- Published
- 2012
45. Developing a survey instrument to assess the readiness of primary care data, genetic and disease registries to conduct linked research: TRANSFoRm International Research Readiness (TIRRE) survey instrument.
- Author
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Leppenwell E, de Lusignan S, Vicente MT, Michalakidis G, Krause P, Thompson S, McGilchrist M, Sullivan F, Desombre T, Taweel A, and Delaney B
- Subjects
- Data Collection, Databases, Genetic, Europe, Humans, Interviews as Topic, Registries, Research Design, Medical Record Linkage, Medical Records Systems, Computerized, Primary Health Care, Surveys and Questionnaires, Translational Research, Biomedical
- Abstract
Background: Clinical data are collected for routine care in family practice; there are also a growing number of genetic and cancer registry data repositories. The Translational Research and Patient Safety in Europe (TRANSFoRm) project seeks to facilitate research using linked data from more than one source. We performed a requirements analysis which identified a wide range of data and business process requirements that need to be met before linking primary care and either genetic or disease registry data., Objectives: To develop a survey to assess the readiness of data repositories to participate in linked research - the Transform International Research Readiness (TIRRE) survey., Method: We develop the questionnaire based on our requirement analysis; with questions at micro-, meso- and macro levels of granularity, study-specific questions about diabetes and gastro-oesophageal reflux disease (GORD), and research track record. The scope of the data required was extensive. We piloted this instrument, conducting ten preliminary telephone interviews to evaluate the response to the questionnaire., Results: Using feedback gained from these interviews we revised the questionnaire; clarifying questions that were difficult to answer and utilising skip logic to create different series of questions for the various types of data repository. We simplified the questionnaire replacing free-text responses with yes/no or picking list options, wherever possible. We placed the final questionnaire online and encouraged its use (www.clininf.eu/jointirre/info.html)., Conclusion: Limited field testing suggests that TIRRE is capable of collecting comprehensive and relevant data about the suitability and readiness of data repositories to participate in linked data research.
- Published
- 2012
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46. Sero-prevalence and incidence of A/H1N1 2009 influenza infection in Scotland in winter 2009-2010.
- Author
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McLeish NJ, Simmonds P, Robertson C, Handel I, McGilchrist M, Singh BK, Kerr S, Chase-Topping ME, Sinka K, Bronsvoort M, Porteous DJ, Carman W, McMenamin J, Leigh-Brown A, and Woolhouse ME
- Subjects
- Adolescent, Adult, Aged, Cross Reactions, Female, Humans, Influenza A Virus, H1N1 Subtype immunology, Influenza, Human prevention & control, Male, Middle Aged, Scotland epidemiology, Seroepidemiologic Studies, Vaccination, Young Adult, Influenza A Virus, H1N1 Subtype pathogenicity, Influenza, Human epidemiology, Seasons
- Abstract
Background: Sero-prevalence is a valuable indicator of prevalence and incidence of A/H1N1 2009 infection. However, raw sero-prevalence data must be corrected for background levels of cross-reactivity (i.e. imperfect test specificity) and the effects of immunisation programmes., Methods and Findings: We obtained serum samples from a representative sample of 1563 adults resident in Scotland between late October 2009 and April 2010. Based on a microneutralisation assay, we estimate that 44% (95% confidence intervals (CIs): 40-47%) of the adult population of Scotland were sero-positive for A/H1N1 2009 influenza by 1 March 2010. Correcting for background cross-reactivity and for recorded vaccination rates by time and age group, we estimated that 34% (27-42%) were naturally infected with A/H1N1 2009 by 1 March 2010. The central estimate increases to >40% if we allow for imperfect test sensitivity. Over half of these infections are estimated to have occurred during the study period and the incidence of infection in late October 2009 was estimated at 4.3 new infections per 1000 people per day (1.2 to 7.2), falling close to zero by April 2010. The central estimate increases to over 5.0 per 1000 if we allow for imperfect test specificity. The rate of infection was higher for younger adults than older adults. Raw sero-prevalences were significantly higher in more deprived areas (likelihood ratio trend statistic = 4.92,1 df, P = 0.03) but there was no evidence of any difference in vaccination rates., Conclusions: We estimate that almost half the adult population of Scotland were sero-positive for A/H1N1 2009 influenza by early 2010 and that the majority of these individuals (except in the oldest age classes) sero-converted as a result of natural infection with A/H1N1 2009. Public health planning should consider the possibility of higher rates of infection with A/H1N1 2009 influenza in more deprived areas.
- Published
- 2011
- Full Text
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47. Assuring the confidentiality of shared electronic health records.
- Author
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McGilchrist M, Sullivan F, and Kalra D
- Subjects
- Computer Security standards, Confidentiality, Medical Records Systems, Computerized standards
- Published
- 2007
- Full Text
- View/download PDF
48. Data integration in eHealth: a domain/disease specific roadmap.
- Author
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Ure J, Procter R, Martone M, Porteous D, Lloyd S, Lawrie S, Job D, Baldock R, Philp A, Liewald D, Rakebrandt F, Blaikie A, McKay C, Anderson S, Ainsworth J, van Hemert J, Blanquer I, Sinnott R, Barillot C, Gibaud FB, Williams A, Hartswood M, Watson P, Smith L, Burger A, Kennedy J, Gonzalez-Velez H, Stevens R, Corcho O, Morton R, Linksted P, Deschenes M, McGilchrist M, Johnson P, Voss A, Gertz R, and Wardlaw J
- Subjects
- Education, Humans, Medical Oncology, United Kingdom, Medical Informatics organization & administration, Systems Integration
- Abstract
The paper documents a series of data integration workshops held in 2006 at the UK National e-Science Centre, summarizing a range of the problem/solution scenarios in multi-site and multi-scale data integration with six HealthGrid projects using schizophrenia as a domain-specific test case. It outlines emerging strategies, recommendations and objectives for collaboration on shared ontology-building and harmonization of data for multi-site trials in this domain.
- Published
- 2007
49. Generation Scotland: the Scottish Family Health Study; a new resource for researching genes and heritability.
- Author
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Smith BH, Campbell H, Blackwood D, Connell J, Connor M, Deary IJ, Dominiczak AF, Fitzpatrick B, Ford I, Jackson C, Haddow G, Kerr S, Lindsay R, McGilchrist M, Morton R, Murray G, Palmer CN, Pell JP, Ralston SH, St Clair D, Sullivan F, Watt G, Wolf R, Wright A, Porteous D, and Morris AD
- Subjects
- Adolescent, Adult, Bioethical Issues, Cohort Studies, Data Interpretation, Statistical, Databases, Genetic, Epidemiologic Research Design, Genetic Research, Humans, Middle Aged, Patient Selection, Pilot Projects, Scotland, Surveys and Questionnaires, Family Health, Genetic Predisposition to Disease, Genetic Variation, Quantitative Trait, Heritable
- Abstract
Background: Generation Scotland: the Scottish Family Health Study aims to identify genetic variants accounting for variation in levels of quantitative traits underlying the major common complex diseases (such as cardiovascular disease, cognitive decline, mental illness) in Scotland., Methods/design: Generation Scotland will recruit a family-based cohort of up to 50,000 individuals (comprising siblings and parent-offspring groups) across Scotland. It will be a six-year programme, beginning in Glasgow and Tayside in the first two years (Phase 1) before extending to other parts of Scotland in the remaining four years (Phase 2). In Phase 1, individuals aged between 35 and 55 years, living in the East and West of Scotland will be invited to participate, along with at least one (and preferably more) siblings and any other first degree relatives aged 18 or over. The total initial sample size will be 15,000 and it is planned that this will increase to 50,000 in Phase 2. All participants will be asked to contribute blood samples from which DNA will be extracted and stored for future investigation. The information from the DNA, along with answers to a life-style and medical history questionnaire, clinical and biochemical measurements taken at the time of donation, and subsequent health developments over the life course (traced through electronic health records) will be stored and used for research purposes. In addition, a detailed public consultation process will begin that will allow respondents' views to shape and develop the study. This is an important aspect to the research, and forms the continuation of a long-term parallel engagement process., Discussion: As well as gene identification, the family-based study design will allow measurement of the heritability and familial aggregation of relevant quantitative traits, and the study of how genetic effects may vary by parent-of-origin. Long-term potential outcomes of this research include the targeting of disease prevention and treatment, and the development of screening tools based on the new genetic information. This study approach is complementary to other population-based genetic epidemiology studies, such as UK Biobank, which are established primarily to characterise genes and genetic risk in the population.
- Published
- 2006
- Full Text
- View/download PDF
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