Version: 1.0.0 | Published: 10 Apr 2024 | Updated: 409 days ago
Documentation
Description:
Clinical response thresholds (acuity) in acutely unwell patients: onset-outcome
Early warning systems (EWS) are bedside tools used to assess basic physiological parameters to identify patients with potential or established critical illness. Evidence suggests that they may predict risk of intensive care admission, death and length of hospital stay. In 2017, the Royal College of Physicians (RCP) published an updated National Early Warning Score, referred to as NEWS2, based upon six physiological parameters. It is associated with specific clinical response recommendations in which a step change occurs at a threshold NEWS2 score ?5, requiring an urgent clinical response no matter what the presenting complaint or condition.
PIONEER geography The West Midlands (WM) has a population of 5.9 million & includes a diverse ethnic & socio-economic mix. There is a higher than average percentage of minority ethnic groups. WM has a large number of elderly residents but is the youngest population in the UK. Birmingham has the highest birth rate in England. It also has the highest infant mortality rate. WM life expectancy is 1.8 years less than in London. There are particularly high rates of physical inactivity, obesity, smoking & diabetes. Each day >100,000 people are treated in hospital, see their GP or are cared for by the NHS.
EHR. University Hospitals Birmingham NHS Foundation Trust (UHB) is one of the largest NHS Trusts in England, providing direct acute services & specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds & 100 ITU beds. UHB runs a fully electronic healthcare record (EHR) (PICS; Birmingham Systems), a shared primary & secondary care record (Your Care Connected) & a patient portal “My Health”.
Scope: All hospitalised patients to UHB from 2000 – current day. Updated monthly. Longitudinal & individually linked, so that the preceding & subsequent health journey can be mapped & healthcare utilisation prior to & after acute admission interrogated. The dataset includes all admission ICD-10 & SNOMED-CT codes including medical, surgical, paediatrics. Serial, structured data pertaining to process of care (timings, staff grades, specialty review, wards), presenting complaint, all physiology readings (pulse, blood pressure, respiratory rate, oxygen saturations), all blood results, microbiology, all prescribed & administered treatments (fluids, antibiotics, inotropes, vasopressors, organ support), all outcomes. Linked images available (radiographs, CT, MRI, ultrasound). Includes but not limited to COVID-19 wave 1 and wave 2 data.
Available supplementary data: Matched ‘elective’ controls; ambulance, 111, 999 data, synthetic data.
Available supplementary support: Analytics, Model build, validation & refinement; A.I.; Data partner support for ETL (extract, transform & load) process, Clinical expertise, Patient & end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen.
Is Part Of:
NOT APPLICABLE
Coverage
Spatial:
United Kingdom, England, West Midlands
Typical Age Range:
0-110
Follow Up:
0 - 6 MONTHS
Physical Sample Availability:
NOT AVAILABLE
Pathway:
Data focuses on in-patient stay in hospital during the acute episode but can be
supplemented on request to include previous and subsequent hospital contacts
(including outpatient appointments) and ambulance, 111, 999 data.
Provenance
Origin
Purposes:
CARE
Sources:
EPR
Collection Situations:
- COMMUNITY
- IN-PATIENTS
- OUTPATIENTS
Temporal
Accrual Periodicity:
QUARTERLY
Distribution Release Date:
19 November 2020
Start Date:
01 January 2018
End Date:
19 November 2020
Time Lag:
LESS 1 WEEK
Accessibility
Access
Access Service:
Trusted Research Environments (TRE) are built using Microsoft Azure services and
hosted in the UK to provide research teams a safe, secure and agile environment
which allows users to quickly analyse, interpret and form an enriched view of
primary care information through a range of integrated datasets. Health data
collated from multiple sources is ingested into a secure data lake which will
then allow subsets of data to be made available to research teams on approval of
a data request. Once approved a customer specific TRE is made available with a
standard set of leading analytical tools from Microsoft including Azure
Databricks, Azure Machine Learning, Azure SQL and Azure Synapse (for large-scale
data warehouses). Specific tools can be provided at an additional cost over the
standard platform data access charge and the PIONEER team will work with you to
determine your exact needs. Access to the TRE is managed using the latest
virtual desktop technology to provide a safe and secure end-user experience. By
utilising leading edge design PIONEER are able to create TREs rapidly to enable
us to service any customer requirement.
Access Request Cost:
www.pioneerdatahub.co.uk/data/data-services-costs/
Delivery Lead Time:
OTHER
Jurisdictions:
GB
Data Controller:
University Hospitals Birmingham NHS Foundation Trust
Data Processor:
NOT APPLICABLE
Usage
Data Use Limitations:
GENERAL RESEARCH USE
Data Use Requirements:
PROJECT SPECIFIC RESTRICTIONS
Resource Creators:
- This publication uses data from PIONEER
- an ethically approved database and analytical environment (East Midlands Derby Research Ethics 20/EM/0158)
Is Referenced By:
- \Are current NEWS2 clinical response thresholds optimised for a general in-patient population? Tanya Pankhurst
- Elizabeth Sapey
- Helen Gyves
- Felicity Evison
- Suzy Gallier
- Georgios Gkoutos
- Simon Ball medRxiv 2020.09.12.20136804; doi: https://doi.org/10.1101/2020.09.12.20136804.\
Format and Standards
Vocabulary Encoding Schemes:
- ICD10
- SNOMED CT
Conforms To:
LOCAL
Languages:
en
Formats:
SQL
Observations
Statistical Population
Population Description
Population Size
Measured Property
Observation Date
Events
366174 spells in the dataset as shown on infographic but data can be extended back to 2004 and will be refreshed monthly.
366174
COUNT
19 November 2020