Strengths
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One of the greatest advantages with using data from Tayside is the unique patient identifier.
STRENGTHS
PATIENT IDENTIFICATION
One
of the greatest advantages with using data from Tayside is the unique patient
identifier. This allows for relative ease of record-linkage and generation of
comparator groups from the population. Selection of patients for both cohort
and case–control studies is efficient.
POPULATION-BASED DATA
MEMO
is regularly supplied with updated copies of the Community Health Master
Patient Index from the Tayside Health Board, and uses this to track the
population of patients alive and resident in Tayside to define study
populations for drug safety studies. Such population-based data allow the
calculation of incidence rates, excess risk and attributable risk.
DRUG EXPOSURE DATA
The
data captured at MEMO represent prescriptions that have been dispensed at a
pharmacy and so primary non-compliance is eliminated. In a study carried out to
assess the extent of primary non-compliance in Tayside, a large family practice
(11 500 patients) wrote all prescriptions in duplicate (carbon copy) form over
a 3-month period (Beardon et al.,
1993). The copies were sent to MEMO. The original top-copy forms that were
redeemed by the patients at community pharmacies were also returned to MEMO by
PPD. Duplicate forms for which no original was present represented the
prescriptions that were not redeemed.
A further advantage of Tayside is that there is currently no
structure to inhibit the prescribing of newly marketed drugs. Thus, studies of
new agents that penetrate the market at a high rate are possible.
ACCESSIBILITY TO MEDICAL RECORDS
A
major strength of MEMO is the ability to examine original hospital records
where necessary. Several studies validating the computerised diagnos-tic data
with the case records have been carried out, with variable results depending on
the criteria used (Kohli and Knill-Jones, 1992; Park, McCabe and Russell, 1992;
Pears et al., 1992). Within the National
Health Service, such case record search-ing for the purposes of drug safety
evaluation is ethically permissible once Medical Ethics Commit-tee approval
from the Caldicott Guardians has been obtained (HMSO, 1992).
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