Data resource profile: cardiovascular disease research using linked bespoke studies and electronic health records (CALIBER)

Spiros C Denaxas, Julie George, Emily Herrett, Anoop D Shah, Dipak Kalra, Aroon D Hingorani, Mika Kivimaki, Adam D Timmis, Liam Smeeth, Harry Hemingway, Spiros C Denaxas, Julie George, Emily Herrett, Anoop D Shah, Dipak Kalra, Aroon D Hingorani, Mika Kivimaki, Adam D Timmis, Liam Smeeth, Harry Hemingway

Abstract

The goal of cardiovascular disease (CVD) research using linked bespoke studies and electronic health records (CALIBER) is to provide evidence to inform health care and public health policy for CVDs across different stages of translation, from discovery, through evaluation in trials to implementation, where linkages to electronic health records provide new scientific opportunities. The initial approach of the CALIBER programme is characterized as follows: (i) Linkages of multiple electronic heath record sources: examples include linkages between the longitudinal primary care data from the Clinical Practice Research Datalink, the national registry of acute coronary syndromes (Myocardial Ischaemia National Audit Project), hospitalization and procedure data from Hospital Episode Statistics and cause-specific mortality and social deprivation data from the Office of National Statistics. Current cohort analyses involve a million people in initially healthy populations and disease registries with ∼10(5) patients. (ii) Linkages of bespoke investigator-led cohort studies (e.g. UK Biobank) to registry data (e.g. Myocardial Ischaemia National Audit Project), providing new means of ascertaining, validating and phenotyping disease. (iii) A common data model in which routine electronic health record data are made research ready, and sharable, by defining and curating with meta-data >300 variables (categorical, continuous, event) on risk factors, CVDs and non-cardiovascular comorbidities. (iv) Transparency: all CALIBER studies have an analytic protocol registered in the public domain, and data are available (safe haven model) for use subject to approvals. For more information, e-mail s.denaxas@ucl.ac.uk.

Figures

Figure 1
Figure 1
Longitudinal nature of multiple linked data sources in CALIBER. ECG = Electrocardiography, STEMI = ST-segment elevation Myocardial Infarction, ACEI = Angiotensin-converting-enzyme Inhibitor
Figure 2
Figure 2
The CALIBER framework of transforming raw electronic health record data into usable research-ready data sets
Figure 3
Figure 3
Example of a CALIBER cohort showing initial presentation of specific cardiac endpoints (n = 32 390) with counts and sources. Appendix A illustrates the approach to defining cardiovascular diseases using multiple record sources in CALIBER
Figure 4
Figure 4
Example of CALIBER research projects registered in the public domain
Figure 5
Figure 5
Example of one CALIBER research variable, hypertension, created from multiple raw electronic health record sources. The variable uses a combination of (i) repeat continuous blood pressure measurements; (ii) categorical data on measured blood pressure (over 130 Read codes); (iii) hypertension diagnosis in primary care (over 180 Read codes); and (iv) prescription of blood pressure lowering medications

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Source: PubMed

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