Drowning in data?

Clinical work generates data! It might be contact time, or diary entries, or narratives in continuation notes, or questionnaires completed. One of the things that I have observed is that there is often more data collected than there is capacity to analyse it. There might be a bottleneck due to access to relevant knowledge and skills to make best use of it. However sometimes the simplest possible analysis is the most valuable.

A few years ago I had the chance to analyse a dataset of patient reported outcome measures (PROMS) from a Cambridgeshire community rehabilitation team. The EQ5D-5L, a health related quality of life tool, was built into the trust’s electronic patient record and it enabled item-by-item storage of the responses to each question. The data warehouse team extracted it into a datasheet reporting findings from 9,148 patients. I then worked with other experts to complete several interesting and complicated analyses, even developing a completely new analysis technique, borrowing from biodiversity statistics. I also worked with colleagues to think about which key messages from these data would make sense to them in their day to day work. 

To help share my results in my presentation I asked illustrator Lucy Driver to draw her interpretation of what the questions meant to her. A simple figure reporting how many patients were reporting a severe problem was one of the more helpful ways – of course we would expect people being seen by a community rehab team to have problems with ‘usual activities’. I don’t think we’d really geared our services to attend to the 680 people reporting severe anxiety/depression. 

So this is a simple approach to probing the extent to which our services were meeting the patient needs, by looking carefully at the responses to each item of a questionnaire.

If all team members can recognise the potential value of routine clinical data capture, this is a great first step in being ready to be involved in research. Systematic entry onto the patient record, and an ability to extract the data for analysis and reporting can then follow.

In my NIHR role I am looking forward to helping teams apply for funding that might help solve more community rehabilitation problems and can be contacted at a.bateman@essex.ac.uk 

• Andrew Bateman is director National Institute of Health Research’s (NIHR) research design service in the East of England