Value of using data
A vast amount of data is generated by clinical, population, cellular and molecular studies. Interrogating data within clinical trials, cohort studies, imaging, genetic and other ‘omic’ studies, together with patient records and other routine data such as education and environmental data, offers great potential for gaining new insights into health and diseases.
Analysing and linking health related data enables research on a scale, speed and costs that is not possible using alternative methods. Benefits of using large patient and population datasets include development of more effective diagnostics and treatments, identification of public health risks, insights into causes of disease and improvements in health services.
The following case studies demonstrate the value of using health data in research:
Wider health benefits of diabetes drug
Metformin is a drug widely used by patients with type 2 diabetes. Following an observed reduction in cancer incidence in these patients, record linkage was used to test the hypothesis that Metformin decreases the risk of developing cancer in diabetic patients. Researchers linked several Scottish health datasets, including the cancer and diabetes registers and the database of dispensed prescriptions. They found that Metformin is associated with a reduction in cancer incidence. Subsequent biochemical and genetic studies have shown that the potential mechanism for this protective effect is through a cancer suppressor gene associated with the response to Metformin. Record linkage studies such as these will play an important role in identifying new potential drug targets and therapies.
Mortality in patients with and without colectomy admitted to hospital for ulcerative colitis and Crohn’s disease
Inflammatory bowel disease (IBD) is a group of debilitating inflammatory conditions of the gut. Ulcerative colitis and Crohn’s disease are the two main types of IBD. The removal of all or part of the colon, known as a colectomy, is required for severe cases as an emergency treatment. However, patients with milder symptoms may choose to have surgery to treat their condition. To investigate three-year mortality for emergency surgery, elective surgery and no surgery, researchers brought together data on hospital admissions and mortality for over 20,000 patients with chronic IBD from 1968 to 2003. They found that three-year mortality was significantly lower among patients who underwent an elective colectomy than among those who either had no colectomy or an emergency colectomy. This suggests that it may be beneficial for hospitals in England to carry out more elective surgery for IBD at an earlier stage than to wait until emergency intervention is required. This depends on physicians referring IBD patients to surgery earlier than they are doing at present.
The impact of smoke-free legislation on pregnancy complications in Scotland
Women who smoke, or are exposed to tobacco smoke, during pregnancy are known to have an increased risk of pregnancy complications and low birth-weight babies. Following the introduction of smoke-free legislation in Scotland in 2006, a study was carried out to discover whether the legislation had an impact on the number of preterm deliveries and low birth-weight infants in Scotland. The Scottish Morbidity Record (SMR2) was used to gather 14 years’ worth of data on over 700,000 births between 1996 and 2009. In the three years after the ban was introduced, there was an associated drop of more than 10% in the number of preterm deliveries and a decrease in the number of low-birth weight infants. This finding has contributed to evidence supporting the public health benefits of smoke-free legislation.
For a compendium of case studies on the benefits of using health data in research, visit www.farrinstitute.org.