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Characterisation of hospitalised COPD exacerbations using real world data

Population Size

14,852

People

Population Size statistic card

Years

2018 - 2020

Years statistic card

Associated BioSamples

None/not available

Associated BioSamples statistic card

Geographic coverage

United Kingdom

England

Geographic coverage statistic card

Lead time

1-2 months

Lead time statistic card

Summary

Chronic Obstructive Pulmonary Disease (COPD) patients admitted or using hospital services. Granular care pathways. Multi-morbidity, investigations, interventions, treatments. Serial physiology, blood biomarkers, physiotherapy, outcome. Deeply phenotyped.

Documentation

Chronic respiratory diseases remain one of the leading causes of death from non-communicable disease, with the majority of deaths due to Chronic Obstructive Pulmonary Disease (COPD). COPD presents a significant healthcare burden and is detrimental to quality of life. Currently, there are no disease modifying treatments.

Further to the burden of stable COPD, patients experience acute exacerbations (AECOPD), defined as an acute worsening of symptoms which requires a change in treatment. These are important events, associated with increased mortality, morbidity and long-term health impacts. Patients who exacerbate frequently are more likely to have a faster decline in lung function, have a lower quality of life and experience adverse cardiovascular events. Whilst there are therapies to reduce exacerbation frequency and treat the acute event, options have limited efficacy and have not changed in overall drug class for many years.

Exacerbations are defined by the severity of the symptoms and the treatments involved – so a severe exacerbation is one which requires hospitalisation. However, in our ageing and increasingly frail population, hospitalisation can be required for even a minor event, if a person is already struggling to cope at home.

PIONEER geography The West Midlands (WM) has a population of 5.9 million & includes a diverse ethnic & socio-economic mix.

EHR. 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 & an expanded 250 ITU bed capacity during COVID. 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 admitted to UHB between January 2018 to January 2020 curated to focus on COPD exacerbations. Longitudinal & individually linked, so that the preceding & subsequent health journey can be mapped & healthcare utilisation prior to & after admission understood. The dataset includes highly granular patient demographics & co-morbidities taken from ICD-10 & SNOMED-CT codes. Serial, structured data pertaining to acute care process (timings, staff grades, specialty review, wards), presenting complaint, acuity, all physiology readings (pulse, blood pressure, respiratory rate, oxygen saturations), all blood results, imaging reports, all prescribed & administered treatments (fluids, blood products, procedures), all outcomes.

Available supplementary data: Matched controls; ambulance, synthetic data, differing time periods including/excluding COVID-19 pandemic periods.

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” services.

Dataset type

Health and disease, Treatments/Interventions

Dataset sub-type

Respiratory

Dataset population size

14852

Keywords

Observations

Observed Node

Disambiguating Description

Measured Value

Measured Property

Observation Date

Persons

14,852 Spells of hospitalised COPD exacerbations

14852

Count

26 May 2021

Provenance

Purpose of dataset collection

Care

Source of data extraction

EPR

Collection source setting

Secondary care - Accident and Emergency, Secondary care - In-patients, Secondary care - Outpatients

Patient pathway description

Data is representative of the multi-ethnicity population within the West Midlands (42% non white). Data includes all patients admitted during this timeframe, with National data Opt Outs applied, and therefore is representative of admissions to secondary care. 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.

Image contrast

Not stated

Biological sample availability

None/not available

Structural Metadata

Details

Publishing frequency

Quarterly

Version

1.0.0

Modified

08/10/2024

Distribution release date

26/05/2021

Citation Requirements

This publication uses data from PIONEER, an ethically approved database and analytical environment (East Midlands Derby Research Ethics 20/EM/0158)

Coverage

Start date

01/01/2018

End date

01/01/2020

Time lag

Other

Geographic coverage

United Kingdom, England, West Midlands

Minimum age range

15

Maximum age range

105

Follow-up

1 - 10 Years

Accessibility

Language

en

Alignment with standardised data models

LOCAL

Controlled vocabulary

SNOMED CT, ICD10, OPCS4

Format

SQL

Data Access Request

Dataset pipeline status

Available

Time to dataset access

1-2 months

Access request cost

www.pioneerdatahub.co.uk/data/data-services-costs/

Access method category

TRE/SDE

Access service description

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.

Jurisdiction

GB-ENG, GB-SCT

Data use limitation

General research use

Data use requirements

Project-specific restrictions

Data Controller

University Hospitals Birmingham NHS Foundation Trust

Dataset Types: Health and disease, Treatments/Interventions

Dataset Sub-types: Respiratory


Collection Sources: Secondary care - Accident and Emergency, Secondary care - In-patients, Secondary care - Outpatients

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