1. CPRD Clinical Practice Research Datalink john.parkinson@cprd.com June 2012 john.parkinson@cprd.com

2. R esearch C apability P rogramme

3. Clinical Practice Research Datalink

4. CPRD – more dimensions to data Quality NHS Clinical Linkage Real World Randomised PROs 52M+ Metrics and validation, Gold and Silver, metadata Gatekeeper approach, universal, free at point of care Unique, universally adopted NHS number Well coded data Point of Care and P3/4 trials NHS and specifically collected Large population, age, sex, s-e class, ethnicity Many national datasets

5. Clinical Care Observational Data Observational Research Clinical Guidelines New drugs/devices Interventional Research

6. Unlocking the potential of NHS Patient Data in Research Observational & Interventional + other

7. All England 52 million + 12 million – Scotland, Wales and NI. by agreement Incremental approach

8. UK wide data Rare diseases and outcomes Risk Management Tracking new products 4 nation studies (NICE and SMC)

9. Health and Wealth Agenda All research studies benefit the NHS in some way CPRD welcomes research from Pharma, Biotech, Devices & CROs

10. Feasibility Optimisation Site recruitment atient recruitment Lost to follow u First in, last out P3…real world Adaptive EHR data Integrated ROs Rando, at Point of care Clinical Trials Ethics Pan studies eGCP Clinical…Process atient Power P3/4 P NIHR NHS Coding Unique ID $£ P-ECONOMICS £$ OBSERVATIONAL Risk - Benefit Outcomes Journey of care Disease Knowledge Geno LINK

11. Partnerships NIHR NHS Research Networks Topic specific Primary Care Comprehensive. Thousands of Researchers Thousands of Sites Detailed and specific expertise HSC Information Centre Diabetes, Mental Health, Children, Cancer, Stroke, Neurod.

12. CPRD – 3 key services Real world data and linked data NHS Social Care Other health related Interventional Clinical Trials PROs Bio-samples Full service Research team

13. Master Datasets Local Data Environ. Air Poll. Key Linkage Datasets, including multiple linkages Other data CPRD Data and Linked Data Consented data, with permissions to link to above Clinical Trials Bio- samples Patient Reported Outcomes ONS Census Data HQIP Disease Audit 40 IMS Drugs in Hospital PHE Cancer BINOCAR + Social Care Disease Reg. 5 I o Care 8500Practices 8LRNs 6 IT systems Lab Path Microb. HOSPITAL HES DEATH ONS BIRTH ONS

14. CPRD Data- 2012 10 million active patients (20% England) 2700 million Consultations 98 million Hospital referrals 1400 million Laboratory results 2 Billion Prescriptions 220 million Immunisations 10 billion Events 25+ Years of data Diabetes Type 20.5 million Hypertension1.5 million Asthma1 million Dementia 200,000 Parkinson’s 240,000 Fabry 200!

15. CPRD TRACKers Pregnancy - TRACK From first coded notification- Primary Care Data Primary care (clinical events, prescriptions, labs etc) Birth record- HES and Primary Care Central Birth record BINOCAR Kids – TRACK In-utero events- surgery Birth record Primary and Secondary care to age 18

16. CPRD TRACK-marts Drug Track Device Track Cohort Track Cost Track Vac Track Niche Track PRO Track Gen Track OUT Track

17. CPRD Interventional * Clinical Trials Working in partnership with NIHR Point of Care randomisation eCRF P3/P4 * Samples * PRO collections enabled efficiency

18. CPRD Point of Care randomisation Auto-detection of patients via EHR On screen messages Randomisation Normal prescription All data in EHR

19. Feasibility Real World Data Powerful Tool CPRD Interventional efficiency Optimisation Real World Data Powerful Tool eCRFs e Linked EHR CTMS Central Recruitment S + P Low Loss To follow up Link to other data Dash Boards Just in time EHR Follow up NIHR Sites Efficacy…….effectiveness….real world P3….adaptive eGCP

20. CPRD-Clinical Trials Point of Care Randomisation (BMJ) P3/P4 Rapid feasibility, national, local, practice level Protocol optimisation Web based training Messaging –site recruitment Central Patient recruitment (PET) eCRF-eHR Trial stats- dashboard Randomisation/rx logistics Loss to follow up, reduced Rapid close EHR Data, data linkage eGCP (International Partners) Unique

21. Trial Feasibility

25. CPRD Want to know more REGISTER Medication and devices Drug utilisation-compliance and persistence Pharmacovigilance Pharmacoepidemiology Pharmacoeconomics Life cycle planning Licence extension research Comparative effectiveness research Clinical outcomes Patient Reported Outcomes Public health research Epidemiology Health Services research Risk management research Risk-benefit research Risk score development Cutting edge research Clinical trials Genetic, geno-pheno studies CPRD observational data resources and services Disease and drug registers Pan European and US data Particular Disease areas CNS, Gastro, CVD, Diabetes, Skin, Oncology, etc Register at CPRD.com

26. Thank you john.parkinson@cprd.com www.cprd.com