CALIBER platform provides insights from national health data to inform healthcare policy and practice
Nationwide electronic health records (EHR from the NHS provide a rich, secure resource for studying the onset and progression of common and rare diseases. A team of clinicians and computer scientists at UCLH/UCL have pioneered an approach of open sharing of disease definitions using these health records, which are joined up across primary and secondary care. Initially the team used samples of 5 million people, but most recently it is at the vanguard of analyses in cohorts of 56 million people in England.
Defining diseases and other relevant phenotypes is fundamental for reproducible analysis of ‘big data’. The CALIBER platform (https://phenotypes.healthdatagateway.org/) which currently has about 2000 uique users per month gives researchers and healthcare professionals access to more than 700 different ‘phenotypes’ defined in national health record data across the patient journey. It provides a springboard for new developments in healthcare policy and practice.
The platform has already been used successfully to demonstrate that blood pressure (BP) confers risk of 12 different cardiovascular diseases at lower levels than previously thought (1). The finding has changed the American Heart Association and European Society of Hypertension 2017 guidelines, to reduce the threshold BP for definition of hypertension, with an additional 8 million US citizens defined as having hypertension as a result.
UCLH researchers used the CALIBER platform to understand how the COVID-19 pandemic has affected mortality pathways for people with underlying risk of cardiovascular disease, obesity, kidney disease and respiratory disease (2). A public-facing risk calculator –OurRisk.CoV – developed in collaboration with public and patient groups has had 1.3 million page views and was winner of the Health Data Research UK’s Impact Award, 2020.
In cancer, this team combined models of excess mortality from CALIBER with near real-time data from 5 hospitals across the UK that demonstrated a dramatic decline in cancer services during the pandemic, including at UCLH.(3)
This is one of the first examples in the UK of rapidly surfacing data insights across multiple hospitals for research, in the timescales (days-weeks) required to inform policy.
This UCLH BRC research won the Royal College of Physicians Excellence in Research Award 2021, and informed the NHS Recovery Plan published July 2020 prioritising the return of cancer services post pandemic.
1.Rapsomaniki E The Lancet 2014.
2.Banerjee A, The Lancet 2020
3.Lai A G BMJ Open 2020
