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Creating a Research-Ready Data Asset version of primary care data for Wales and investigating the impact of COVID-19 on utilisation of primary care services

by Hoda Abbasizanjani, Stuart Bedston, Ashley Akbari

Objectives

We developed an efficient Research-Ready Data Asset (RRDA) for the Welsh Longitudinal General Practice (WLGP) data within the Secure Anonymised Information Linkage Databank to standardise curation, enhance reproducibility, and facilitate research on primary care trends. Using this, we investigated primary care activity trends during and after the COVID-19 pandemic.

Methods

The RRDA involves cleaning, curation using GP-registration history, and transforming data into a structured, normalised format to support efficient large-scale queries. A comprehensive clinical code look-up was developed, incorporating official, local, and supplementary categories to enhance event classification. To enable patient-practice interaction analysis, a four-layer approach was developed to capture healthcare providers, access mode, interaction type, and event details. We assessed RRDA coverage, defined as the proportion of residents with shared primary care records, stratified by demographic and geographic factors, using longitudinal binomial Generalised Additive Mixed Models (GAMMs). We categorised GP events into key activity types and summarised averaged daily rates per month per 100,000 people (2000–2024), with trends analysed using negative binomial GAMMs.

Results

Curating 4.6 billion records for 5.1 million people (1990–2024) revealed significant improvements in data quality and completeness over time, with data retention increased from 40% to 94%, and patient inclusion from 43% to 98%. Use of SNOMED-CT and local codes increased after Read-V2 discontinuation in 2018, while invalid codes declined—reflecting evolving coding practices and improved data quality. WLGP RRDA coverage rose from 35% in 1990 to 86% in 2024, with regional variation but modest demographic differences. From 2000 to 2024, consultation rates rose by 1.9 times, with post-COVID-19 pandemic levels 8% above 2019. Prescription-only activity doubled with little variation associated with the pandemic. Vaccination rates spiked during the pandemic, and remain 1.8 times above pre-pandemic levels. Other less frequent activities were significantly disrupted during the COVID-19 pandemic but recovered to 2019 levels.

Conclusions

The WLGP RRDA improves the usability of primary care data, supporting timely, scalable analysis of healthcare delivery and system-level trends.

Bridging the gap: development of a methodology for retrieving and harmonising body mass index (BMI) from population-level linked electronic health records

Por: Childs · M. J. · Aldridge · S. J. · Daniels · H. · Davies · G. I. · Best · V. · Abbasizanjani · H. · Lyons · R. · Akbari · A. · Torabi · F.
Objective

This study aims to develop a methodology to retrieve, harmonise and evaluate the completeness of national body mass index (BMI) data from linked electronic health record (EHR) sources to build a longitudinal research-ready data asset (RRDA).

Design

A longitudinal study of BMI records spanning 23 years (1 January 2000 to 31 December 2022) from four data sources.

Setting

The national BMI RRDA is created within the Secure Anonymised Information Linkage (Databank), encompassing the entire population of Wales, UK.

Procedure and participants

We built a methodology that provides a reproducible framework for extracting and harmonising BMI data from four major linked EHRs across two age groups: children and young people (CYP; 2–18 years old) and adults (19 years and older). The methodology is adaptable across different trusted research environments. We evaluated the completeness and retention of records over 1-, 5- and 23-year periods by calculating the proportion of missing data relative to each year’s population.

Results

We retrieved 53.4 million records for 3.2 million individuals across Wales from 1st January 2000 to 31 December 2022. Among these, 3% of CYP and 34% of adults had repeat BMI measurements recorded over periods ranging from 5 to 23 years. Throughout the entire population of Wales during this period, 49% of CYP and 26% of adults had at least one BMI reading recorded, resulting in a missingness rate of 51% for CYP and 74% for adults. Preserving BMI information by retaining the most recently recorded BMI over 1-, 5- and 23-year intervals from 2022 showed coverage rates of 10%, 33% and 68%, respectively, for CYP, and 25%, 51% and 73%, respectively, for adults.

Conclusions

Our findings highlight substantial variations in BMI data availability and retention across CYP and adults, as well as time periods within EHR in Wales. Wider adoption of this approach can enhance standardised approaches in using accessible measures like BMI to assess disease risk in population-based studies, strengthening public health initiatives and research efforts.

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