Embed Size (px)
DESCRIPTION
Outline of presentation (workshop!). Data sources Exploration and comparison of prevalence data from different sources Discussion. Data sources. PRIMIS data extractions Cumulative 01.01.2003 – 31.01.2005 0.5 million patients (Epilepsy); 16 million (DM, BP) Key Health Statistics 1998 - PowerPoint PPT Presentation
Citation preview
Prevalence in Perspective
PRIMIS
Fifth Annual Conference 11 – 12 May 2005
Piecing Together the Future
Dr Pete HorsfieldPRIMIS Clinical Director
Dr Dai EvansPRIMIS Clinical Adviser
PRIMIS
Outline of presentation (workshop!)
• Data sources
• Exploration and comparison of prevalence data from different sources
• Discussion
PRIMIS
Data sources• PRIMIS data extractions
– Cumulative 01.01.2003 – 31.01.2005– 0.5 million patients (Epilepsy); 16 million (DM, BP)
• Key Health Statistics 1998– Office for National Statistics– General Practice Research Database– 1.2 million patients
• QMAS– National prevalence day– Entire population (almost)– www.qualitymedicalsolutions.co.uk
• QResearch (2003)– University of Nottingham research database– 426 practices– 2.9 million patients
PRIMIS
• Medical Statistics are like a bikini
• What they reveal is interesting, but what they conceal is vital
Hypertension Prevalence: Age/Sex Breakdown rate per thousand
0
50
100
150
200
250
300
350
400
450
500
Age bands
Rat
e Pe
r Tho
usan
d
Female 0.10 0.22 0.38 1.29 3.76 7.55 14.26 24.30 41.59 73.69 126.40 188.54 257.36 331.31 396.08 443.26 453.88 415.10 343.66 242.93 134.89 50.00
Male 0.16 0.28 0.46 0.87 2.33 5.46 12.19 22.84 42.16 76.67 124.33 178.02 237.04 303.79 357.07 384.70 378.86 324.34 253.44 161.87 72.70 16.67
All 0.13 0.25 0.42 1.07 3.04 6.50 13.20 23.55 41.88 75.22 125.35 183.21 247.14 317.84 377.81 417.88 425.48 386.37 320.42 226.45 121.64 42.31
0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99100-104
105-109
Prevalence of treated hypertension, KHS, 1998
0.0
50.0
100.0
150.0
200.0
250.0
300.0
350.0
400.0
0 - 34 35 - 44 45 - 54 55 - 64 65 - 74 75 - 84 85+
Age group
Rat
e pe
r th
ousa
nd
FemalesMales All
Hypertension Prevalence: Age/Sex Breakdown rate per thousand
0
50
100
150
200
250
300
350
400
450
500
Age bands
Ra
te P
er T
ho
us
an
d
Female 0.10 0.22 0.38 1.29 3.76 7.55 14.26 24.30 41.59 73.69 126.40 188.54 257.36 331.31 396.08 443.26 453.88 415.10 343.66 242.93 134.89 50.00
Male 0.16 0.28 0.46 0.87 2.33 5.46 12.19 22.84 42.16 76.67 124.33 178.02 237.04 303.79 357.07 384.70 378.86 324.34 253.44 161.87 72.70 16.67
All 0.13 0.25 0.42 1.07 3.04 6.50 13.20 23.55 41.88 75.22 125.35 183.21 247.14 317.84 377.81 417.88 425.48 386.37 320.42 226.45 121.64 42.31
0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99100-104
105-109
Prevalence of treated hypertension, KHS, 1998
0.0
50.0
100.0
150.0
200.0
250.0
300.0
350.0
400.0
0 - 34 35 - 44 45 - 54 55 - 64 65 - 74 75 - 84 85+
Age group
Rate p
er t
housand
FemalesMales All
PRIMIS
Prevalence of Hypertension
95% CI
PRIMIS (n=16 million) 103.6 103.5 – 103.8
Key Statistics 79.5 79.0 – 80.0
QMAS 108.9
QResearch 117.8 117.4 – 118.2
PRIMIS
Hypertension
1198
1073
1360
1081
530
933
1100
859
499 500579
506
1511
1222
627
1108
2055
0
500
1000
1500
2000
2500
B C D E H L M Q R S T U V X Z AA Network 7
Research Practices
Pat
ien
ts c
on
sult
ing
per
10,
000
2nd audit cycle 3rd audit cycle 4th audit cycle 5th audit cycle 6th audit cycle 7th audit cycle
Ischaemic Heart Disease Prevalence: Age/Sex Breakdown rate per thousand
0
20
40
60
80
100
120
140
160
180
200
220
240
260
Age bands
Rat
e Pe
r Tho
usan
d
Female 0.02 0.05 0.08 0.11 0.18 0.28 0.49 0.94 2.61 6.84 15.08 27.43 52.47 82.12 118.65 151.58 169.19 176.57 172.61 146.75 121.95 128.57
Male 0.06 0.03 0.08 0.11 0.20 0.32 0.89 2.26 7.13 18.12 37.04 64.79 112.01 162.08 208.82 240.45 248.26 239.93 215.35 160.94 84.75 41.67
All 0.04 0.04 0.08 0.11 0.19 0.30 0.70 1.62 4.93 12.59 26.18 46.30 82.29 121.26 160.63 189.83 199.11 196.49 183.40 149.53 114.56 106.38
0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99100-104
105-109
Prevalence of treated ischaemic heart disease, KHS, 1998
0.0
50.0
100.0
150.0
200.0
250.0
0 - 34 35 - 44 45 - 54 55 - 64 65 - 74 75 - 84 85+
Age group
Rat
e pe
r th
ousa
nd
FemalesMales All
Prevalence of treated ischaemic heart disease, KHS, 1998
0.0
50.0
100.0
150.0
200.0
250.0
0 - 34 35 - 44 45 - 54 55 - 64 65 - 74 75 - 84 85+
Age group
Rat
e pe
r th
ousa
nd
FemalesMales All
Ischaemic Heart Disease Prevalence: Age/Sex Breakdown rate per thousand
0
20
40
60
80
100
120
140
160
180
200
220
240
260
Age bands
Ra
te P
er T
ho
us
an
d
Female 0.02 0.05 0.08 0.11 0.18 0.28 0.49 0.94 2.61 6.84 15.08 27.43 52.47 82.12 118.65 151.58 169.19 176.57 172.61 146.75 121.95 128.57
Male 0.06 0.03 0.08 0.11 0.20 0.32 0.89 2.26 7.13 18.12 37.04 64.79 112.01 162.08 208.82 240.45 248.26 239.93 215.35 160.94 84.75 41.67
All 0.04 0.04 0.08 0.11 0.19 0.30 0.70 1.62 4.93 12.59 26.18 46.30 82.29 121.26 160.63 189.83 199.11 196.49 183.40 149.53 114.56 106.38
0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99100-104
105-109
Prevalence of treated ischaemic heart disease, KHS, 1998
0.0
50.0
100.0
150.0
200.0
250.0
0 - 34 35 - 44 45 - 54 55 - 64 65 - 74 75 - 84 85+
Age group
Rate p
er t
housand
FemalesMales All
PRIMIS
Prevalence of Ischaemic heart disease
95% CI
PRIMIS (n=7.6 million) 37.9 37.7 – 38.0
Key Statistics 37.2 36.8 – 37.5
QMAS 34.6
QResearch 40.6 40.3 – 40.8
PRIMIS
MIs over last 6yrs in JKP (7400pts)
0
2
4
6
8
10
12
14
16
18
20
1 2 3 4 5 6
Year
MI
1999 2000 2001 2002 2003 2004
Transient Ischaemic Attack or Cerebrovascular Accident Prevalence: Age/Sex Breakdown rate per thousand
0
20
40
60
80
100
120
140
160
Age bands
Rat
e Pe
r Tho
usan
d
Female 0.21 0.25 0.24 0.27 0.54 0.62 1.05 1.42 2.12 3.70 5.92 10.10 18.21 30.09 47.44 70.48 98.85 122.43 134.09 136.76 133.65 73.17
Male 0.19 0.25 0.24 0.37 0.34 0.44 0.67 0.94 1.91 3.81 7.64 14.73 27.08 45.82 67.79 97.37 124.95 141.70 143.61 120.26 85.31 0.00
All 0.20 0.25 0.24 0.32 0.44 0.53 0.86 1.17 2.01 3.75 6.79 12.43 22.65 37.79 56.97 82.08 108.74 128.55 136.55 133.55 123.93 56.60
0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99100-104
105-109
Transient Ischaemic Attack or Cerebrovascular Accident Prevalence: Age/Sex Breakdown rate per thousand
0
20
40
60
80
100
120
140
160
Age bands
Rat
e Pe
r Tho
usan
d
Female 0.21 0.25 0.24 0.27 0.54 0.62 1.05 1.42 2.12 3.70 5.92 10.10 18.21 30.09 47.44 70.48 98.85 122.43 134.09 136.76 133.65 73.17
Male 0.19 0.25 0.24 0.37 0.34 0.44 0.67 0.94 1.91 3.81 7.64 14.73 27.08 45.82 67.79 97.37 124.95 141.70 143.61 120.26 85.31 0.00
All 0.20 0.25 0.24 0.32 0.44 0.53 0.86 1.17 2.01 3.75 6.79 12.43 22.65 37.79 56.97 82.08 108.74 128.55 136.55 133.55 123.93 56.60
0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99100-104
105-109
Prevalence of stroke disease, KHS, 1998
0.0
5.0
10.0
15.0
20.0
25.0
0 - 34 35 - 44 45 - 54 55 - 64 65 - 74 75 - 84 85+
Age group
Rat
e pe
r th
ousa
nd
FemalesMales All
Prevalence of stroke disease, KHS, 1998
0.0
5.0
10.0
15.0
20.0
25.0
0 - 34 35 - 44 45 - 54 55 - 64 65 - 74 75 - 84 85+
Age group
Rate p
er t
housand
FemalesMales All
Transient Ischaemic Attack or Cerebrovascular Accident Prevalence: Age/Sex Breakdown rate per thousand
0
20
40
60
80
100
120
140
160
Age bands
Ra
te P
er T
ho
us
an
d
Female 0.21 0.25 0.24 0.27 0.54 0.62 1.05 1.42 2.12 3.70 5.92 10.10 18.21 30.09 47.44 70.48 98.85 122.43 134.09 136.76 133.65 73.17
Male 0.19 0.25 0.24 0.37 0.34 0.44 0.67 0.94 1.91 3.81 7.64 14.73 27.08 45.82 67.79 97.37 124.95 141.70 143.61 120.26 85.31 0.00
All 0.20 0.25 0.24 0.32 0.44 0.53 0.86 1.17 2.01 3.75 6.79 12.43 22.65 37.79 56.97 82.08 108.74 128.55 136.55 133.55 123.93 56.60
0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99100-104
105-109
PRIMIS
Prevalence of Stroke disease
95% CI
PRIMIS (n=5.3 million) 15.3 15.2 – 15.4
Key Statistics 2.3 2.2 – 2.3
QMAS 16.5
QResearch 17.9 17.8 – 18.1
Heart Failure Prevalence: Age/Sex Breakdown rate per thousand
0
20
40
60
80
100
120
140
160
Age bands
Rat
e Pe
r Tho
usan
d
Female 0.16 0.18 0.19 0.15 0.13 0.11 0.17 0.18 0.40 0.61 1.23 2.63 6.07 12.74 24.22 45.41 71.26 104.38 131.85 147.35 138.42 121.95
Male 0.17 0.22 0.15 0.15 0.16 0.11 0.22 0.31 0.66 1.27 2.69 5.77 11.97 22.28 37.69 60.37 86.75 124.45 141.78 110.46 99.53 0.00
All 0.17 0.20 0.17 0.15 0.14 0.11 0.19 0.25 0.53 0.95 1.97 4.21 9.03 17.41 30.53 51.86 77.13 110.76 134.41 140.17 130.60 94.34
0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99100-104
105-109
PRIMIS
Prevalence of Heart failure
95% CI
PRIMIS (n=5.3 million) 9.2 9.1 – 9.3
QMAS 4.2
Diabetes Mellitus Prevalence: Age/Sex Breakdown rate per thousand
0
10
20
30
40
50
60
70
80
90
100
110
120
130
Age bands
Rat
e Pe
r Tho
usan
d
Female 0.28 1.18 2.42 3.01 3.46 4.61 6.37 9.18 13.73 20.28 27.26 36.81 54.88 76.26 88.93 88.26 80.47 70.12 57.55 41.31 27.13 10.00
Male 0.30 1.21 2.36 3.29 3.70 5.07 7.48 11.11 17.78 28.70 40.99 55.16 77.63 104.26 118.22 117.23 103.99 93.11 74.02 48.09 24.69 16.67
All 0.29 1.19 2.38 3.15 3.58 4.84 6.94 10.18 15.82 24.61 34.25 46.11 66.32 89.97 102.64 100.81 89.37 77.40 61.80 42.69 26.61 11.54
0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99100-104
105-109
Prevalence of treated diabetes mellitus, KHS, 1998
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
0 - 4 5 - 15 16 - 24 25 -34 35 - 44 45 - 54 55 - 64 65 - 74 75 - 84 85+
Age group
Rat
e pe
r th
ousa
nd
FemalesMales All
Diabetes Mellitus Prevalence: Age/Sex Breakdown rate per thousand
0
10
20
30
40
50
60
70
80
90
100
110
120
130
Age bands
Ra
te P
er T
ho
us
an
d
Female 0.28 1.18 2.42 3.01 3.46 4.61 6.37 9.18 13.73 20.28 27.26 36.81 54.88 76.26 88.93 88.26 80.47 70.12 57.55 41.31 27.13 10.00
Male 0.30 1.21 2.36 3.29 3.70 5.07 7.48 11.11 17.78 28.70 40.99 55.16 77.63 104.26 118.22 117.23 103.99 93.11 74.02 48.09 24.69 16.67
All 0.29 1.19 2.38 3.15 3.58 4.84 6.94 10.18 15.82 24.61 34.25 46.11 66.32 89.97 102.64 100.81 89.37 77.40 61.80 42.69 26.61 11.54
0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99100-104
105-109
Prevalence of treated diabetes mellitus, KHS, 1998
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
0 - 4 5 - 15 16 - 24 25 -34 35 - 44 45 - 54 55 - 64 65 - 74 75 - 84 85+
Age group
Rate p
er t
housand
FemalesMales All
PRIMIS
Prevalence of Diabetes mellitus
95% CI
PRIMIS (n=8 million) 30.0 29.9 – 30.2
Key Statistics 16.7 16.5 – 17.0
QMAS 33.5
QResearch 32.0 31.8 – 32.2
Keele GPRN Core 36.4
PRIMIS
Diabetes
328 332
435
342331 338
362
210
270
351
276 279
322
345 340355
388
0
50
100
150
200
250
300
350
400
450
500
B C D E H L M Q R S T U V X Z AA Network7Research Practices
Pat
ient
s co
nsul
ting
per
10,
000
2nd audit cycle 3rd audit cycle 4th audit cycle 5th audit cycle 6th audit cycle 7th Audit cycle
Asthma (diagnosis ever) Prevalence: Age/Sex Breakdown rate per thousand
0
20
40
60
80
100
120
140
160
180
200
220
Age bands
Rat
e Pe
r Tho
usan
d
Female 34.13 118.99 162.02 171.27 156.31 132.93 114.68 111.76 103.24 100.38 98.16 98.50 105.44 106.31 106.48 101.70 89.15 76.15 61.95 40.93 21.98 0.00
Male 57.10 156.98 202.25 187.71 147.92 118.09 100.05 88.48 86.24 74.56 71.50 65.86 76.14 85.36 90.13 94.66 88.12 72.70 55.98 19.90 0.00 0.00
All 45.92 138.49 182.65 179.71 152.06 125.41 107.31 99.96 94.62 87.26 84.74 82.05 90.85 96.09 98.93 98.67 88.77 75.05 60.47 37.10 18.18 0.00
0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99100-104
105-109
Active Asthma* Prevalence: Age/Sex Breakdown rate per thousand
0
10
20
30
40
50
60
70
80
90
100
110
Age bands
Rat
e P
er T
ho
usan
d
Female 23.65 65.40 77.87 77.14 64.15 67.32 65.05 67.70 64.04 65.36 65.28 70.02 80.46 85.04 85.25 83.26 69.67 59.02 45.62 27.65 10.99 0.00
Male 41.23 90.62 100.14 66.71 49.04 52.60 54.33 49.67 49.67 45.56 44.42 44.43 57.02 67.37 70.71 77.83 72.54 56.99 40.71 14.93 0.00 0.00
All 32.68 78.35 89.29 71.79 56.49 59.86 59.65 58.56 56.76 55.30 54.79 57.13 68.79 76.42 78.53 80.92 70.75 58.37 44.40 25.34 9.09 0.00
0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99100-104
105-109
*Active asthma = asthma requiring medication in the last year
Prevalence of treated asthma, KHS, 1998
0.0
20.0
40.0
60.0
80.0
100.0
120.0
140.0
0 - 4 5 - 15 16 - 24 25 -34 35 - 44 45 - 54 55 - 64 65 - 74 75 - 84 85+
Age group
Rat
e pe
r th
ousa
nd
FemalesMales All
Prevalence of treated asthma, KHS, 1998
0.0
20.0
40.0
60.0
80.0
100.0
120.0
140.0
0 - 4 5 - 15 16 - 24 25 -34 35 - 44 45 - 54 55 - 64 65 - 74 75 - 84 85+
Age group
Rate p
er t
housand Females
Males All
Active Asthma* Prevalence: Age/Sex Breakdown rate per thousand
0
10
20
30
40
50
60
70
80
90
100
110
Age bands
Rate P
er T
ho
usan
d
Female 23.65 65.40 77.87 77.14 64.15 67.32 65.05 67.70 64.04 65.36 65.28 70.02 80.46 85.04 85.25 83.26 69.67 59.02 45.62 27.65 10.99 0.00
Male 41.23 90.62 100.14 66.71 49.04 52.60 54.33 49.67 49.67 45.56 44.42 44.43 57.02 67.37 70.71 77.83 72.54 56.99 40.71 14.93 0.00 0.00
All 32.68 78.35 89.29 71.79 56.49 59.86 59.65 58.56 56.76 55.30 54.79 57.13 68.79 76.42 78.53 80.92 70.75 58.37 44.40 25.34 9.09 0.00
0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99100-104
105-109
*Active asthma = asthma requiring medication in the last year
PRIMIS
Prevalence of Asthma (treated)
95% CI
PRIMIS (n=0.9 million) 63.5 62.9 – 64.0
Key Statistics 74.3 73.8 – 74.8
QMAS 55.5
QResearch (all asthma) 72.3 71.6 – 72.9
Severe Mental Illness Prevalence: Age/Sex Breakdown rate per thousand
0
20
40
60
80
100
120
140
Age bands
Rat
e P
er T
ho
usan
d
Female 1.38 1.74 6.50 32.76 67.52 70.84 75.54 77.18 74.98 70.91 66.66 62.09 58.04 51.37 55.80 67.54 81.26 103.70 106.13 116.51 82.35 0.00
Male 1.60 2.53 4.41 13.45 36.87 41.93 41.63 42.13 41.11 39.78 37.59 34.09 32.34 28.24 30.94 45.56 50.83 65.23 56.54 69.44 0.00 0.00
All 1.49 2.14 5.43 22.85 52.04 56.45 58.62 59.50 57.88 55.07 51.97 48.02 45.24 40.06 44.31 58.17 69.91 91.81 93.81 107.36 69.65 0.00
0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99100-104
105-109
Prevalence of schizophrenia, KHS, 1998
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
0 - 4 5 - 15 16 - 24 25 -34 35 - 44 45 - 54 55 - 64 65 - 74 75 - 84 85+
Age group
Rat
e pe
r th
ousa
nd
FemalesMales All
Prevalence of schizophrenia, KHS, 1998
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
0 - 4 5 - 15 16 - 24 25 -34 35 - 44 45 - 54 55 - 64 65 - 74 75 - 84 85+
Age group
Rate p
er t
housand
FemalesMales All
Severe Mental Illness Prevalence: Age/Sex Breakdown rate per thousand
0
20
40
60
80
100
120
140
Age bands
Rate P
er T
ho
usan
d
Female 1.38 1.74 6.50 32.76 67.52 70.84 75.54 77.18 74.98 70.91 66.66 62.09 58.04 51.37 55.80 67.54 81.26 103.70 106.13 116.51 82.35 0.00
Male 1.60 2.53 4.41 13.45 36.87 41.93 41.63 42.13 41.11 39.78 37.59 34.09 32.34 28.24 30.94 45.56 50.83 65.23 56.54 69.44 0.00 0.00
All 1.49 2.14 5.43 22.85 52.04 56.45 58.62 59.50 57.88 55.07 51.97 48.02 45.24 40.06 44.31 58.17 69.91 91.81 93.81 107.36 69.65 0.00
0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99100-104
105-109
PRIMIS
Prevalence of Epilepsy
95% CI
PRIMIS (n=0.5 million) 10.7 10.4 – 11.0
QMAS 5.7
QResearch 10.2 10.1 – 10.4
PRIMIS
Issues
• Data quality• Definitions and standards• Selection bias• ‘Creative accounting’• Data extraction / interrogation routines
