Latest news and views from around the Bennett Institute
This repository contains the data cleaning notebook, all necessary datasets, and the code for running the COVID-19 TrialsTracker website at covid19.trialstracker.net. Docker files are included to ensure a consistent environment for reproducibility.
The following is a rapid analysis of the “top 10” medicines in NHS England primary care in 2019. We prepared this analysis for a user who wanted to use the list in a teaching session with students to prepare them for the medicines they will most commonly see in general practice. We are sure others will find it useful — please get in touch and tell us how you use it via Twitter or feedback@openprescribing.net. As always our analysis with complete analytical code is openly available on our GitHub page. You can also investigate the prescribing of any medicines you like using our tools like our Analyse page, chemical trends and our brand new browser for the NHS Dictionary of Medicines and Devices. Read on below where we describe the “top 10” medicines and class of medicines, in terms of volume and cost.
Covid-19 shows that we must overcome organisational barriers to deliver clean, realtime, standardised data in support of direct care, system planning, and urgent response
At the Bennett Institute we like to work in the open and share our insights for the whole community, so we can fix a problem for us, then share the solution, and help fix it for everyone. We think this is efficient for us and the whole system. In this blog our magnificent coder Peter Inglesby sets out some analysis he has done of changes to the NHS prescribing data we use. It took us a few hours to investigate these problems for our own purposes, then document our findings and solutions internally; it took an extra 20 minutes to share in this blog post and now we give it to you so you don’t have to replicate our effort and can maybe find some insights we have missed!
Update September 2020: NHS England have announced a reduction in the number of planned measures including the majority of the measures on OpenPrescribing. We will remove the IIF dashboard in a future update.
Update: Due to COVID19 response NHS England has announced that the IIF will be postponed. We will continue to make this dashboard available as NHS England also states that they will continue to monitor the data to understand any impact.
At the Bennett Institute we get many people contacting us every month asking us when OpenPrescribing will be available in their country. In this blog we are outlining OpenPrescribing.yourcountry where we give you the information that you can use locally to build a case for OpenPrescribing in your country and obtain funding to support development. We aren’t quite ready to build OpenPrescribing.yourcountry yet, but we will be soon and we wanted to share our plans so you can be ready when we are.
Most people share their end of year roundup during late December when everyone is too full of cake to read. Now you’re back in the saddle, here’s our roundup of everything the Bennett Institute threw out into the world over the previous 12 months!
OpenPrescribing.net went from strength to strength, with over 135,000 unique users last year. We now have over 80 measures of prescribing safety, efficacy and cost-effectiveness and have been working on new types of measures and alerts to identify “outlier” prescribing, such as with zuclopenthixol. In 2019 we also: launched new dashboards and bespoke alerts for every single primary care network (PCN), sustainability and transformation partnership (STP), and NHS region; upgraded the Analyse page to support more organisations with bespoke medicines queries; and developed tools to help solve the problem of Ghost Branded Generics which cost the NHS an extra £11.6million per annum but has massively reduced during 2019.
This is the repository containing everything you need to recreate our analysis published in The Lancet assessing compliance with the Final Rule of The Food and Drug Administration Amendments Act (FDAAA) (2007). The code can also be easily adapted for future analyses of interest using ClinicalTrials.gov data.
Today on OpenPrescribing.net we have launched our Greener NHS prescribing dashboards. Over recent months there has been increasing attention on the environment and the effects society is having on climate change. The NHS announced specific targets as part of its long term plan to become more sustainable, reduce waste and shift to lower carbon inhalers. At OpenPrescribing we have already launched our first prescribing measure related to the environment and this week we are launching our Greener NHS prescribing dashboard for every single general practice, primary care network (PCN), clinical commissioning group (CCG), sustainability and transformation partnership (STP), NHS region and for the whole of England.To access your Greener NHS prescribing dashboard, simply go to your organisation’s measures page and select “Greener NHS” from the drop-down. You can read more about our categories on our blog or watch our short Youtube video.
Today on OpenPrescribing.net we have launched our National Institute for Health and Care Excellence — NICE Prescribing Dashboard. We have a NICE prescribing dashboard for every single general practice, primary care network (PCN), clinical commissioning group (CCG), sustainability and transformation partnership (STP), NHS region and for the whole of England. This allows anyone to explore how NICE guidance has been implemented in their organisation, supporting effective, safer and more efficient prescribing. To access yours, simply go to your organisation’s measures page and select “NICE” from the drop-down. You can read more about our categories here or watch our short Youtube video:
We have now launched our long-awaited Primary Care Networks (PCNs) dashboard, made possible thanks to the the membership list being published by NHS England last week.
We have PCN prescribing dashboards for every single NHS PCN and their member general practices. (Don’t know your PCN’s name? You can find it on your practice dashboard). This allows anyone to explore NHS prescribing patterns in their PCN and how this compares to others across England — supporting safer, more efficient prescribing.
Our EU TrialsTracker has been assessing compliance with EU trial reporting guidelines for over a year now. Our data has been used by Parliamentary Committees and trial sponsors to improve the reporting of clinical trials registered on the EU Clinical Trials Register (EUCTR).
We previously shared some of the data issues that make complete assessments of trials on the EUCTR difficult. One particularly troubling issue is dealing with trials that never began. Sometimes trials get all the necessary approvals to begin, and therefore are automatically registered on the EUCTR. In rare instances, and for any number of reasons, they then simply never begin; they are cancelled before they enroll a single participant or collect any data. Obviously, these trials have no results to report.
A guest blog from Calum Polwart (Twitter @ShinyBlackShoe)
At the Bennett Institute we value openness and transparency as we believe open discussion of ideas and methods are the key ingredients for high quality data analysis. We think it is unhelpful that so much NHS data analysis is outsourced, or done behind closed doors, as this prevents coalface clinicians from engaging with data and sharing their expertise and insights. We build OpenPrescribing.net, not just for ourselves, but for anyone to explore NHS prescribing data. This democratisation of prescribing data removes gatekeepers and barriers to accessing the data, allows anyone to scrutinise prescribing and produces new insights.
Today on OpenPrescribing.net we have launched our Primary Care Networks (PCNs) dashboard. We have PCN prescribing dashboards available for every single NHS PCN and their member general practices. This allows anyone to explore NHS prescribing patterns in their PCN and see how this compares to other PCNs across England — supporting safer, more efficient prescribing.
Figure 1: South Islington PCN OpenPrescribing Dashboard
PCNs are groups of practices, which together serve communities of around 30,000-50,000 people, with the aim of improving care for patients. PCNs were announced as part of the NHS long term plan and many PCNs have formed already and started to recruit staff such as clinical directors and clinical pharmacists to improve and optimise the use of medicines. We hope our PCN prescribing dashboards will assist everyone across the country to identify and prioritise areas where prescribing can be improved.
Last week, the Commons Science and Technology Select Committee convened an inquiry following-up their previous clinical trials transparency efforts. The Select Committee has been very active in the trials transparency space over the past two years. Earlier this year they sent letters to every public university and NHS trust in the UK that sponsors clinical trials on the EU register. These letters reminded sponsors of their trial reporting responsibilities and provided them with reporting performance figures based on data from our EU TrialsTracker.
Our newest paper is now out in the BMJ! Here we show huge variation in adoption of warranted changes in prescribing behaviour, using some exciting new openly available change detection methods.
This month we have launched a range of new measures. As always, measures are prioritised on your dashboard by potential for improvement so you can quickly and easily spot where your organisation is an outlier. You can also sort by potential savings or group measures by clinical condition.
This is the third instalment in our series of commentaries on using reference ranges to interpret pathology test results.
Classically, the reference range is defined statistically: it is the interval within which 95% of the values of a healthy reference population fall into. Therefore 2.5% of the time, healthy people will have (for example) haemoglobin concentrations less than the lower limit, and 2.5% of the time it will be over the upper limit. (Read more in our previous blog).
This is the second installment in our series of commentaries on reference ranges used to interpret pathology test results. Here we describe two issues relating to how meaningful reference ranges are.
The most common type of reference range is defined as the interval between which 95% of the values of a healthy reference population fall into. In other words, 2.5% of the time, healthy people will have haemoglobin concentrations less than the lower limit.
