ViewpointThe UK General Practice Research Database
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The General Practice Research Database
The UK General Practice Research Database was set up by a commercial company, VAMP Ltd, in May, 1987.2 General practitioners were offered free computer equipment in return for entering clinical data in a standard manner into the computer database and providing the anonymised data to VAMP. Photocopied hospital letters were also to be provided if requested. The objective was to develop an automated clinical research database containing longitudinal and ongoing information on four million
The population
In July, 1996, the General Practice Research Database had data on over 25 million patient years, and covered a population of 3·5 million. This population is broadly representative of the UK population in age and sex structure, with a national coverage of 6·4% of the population in England, 5·1% in Wales, 2·8% in Scotland, and 5·8% in Northern Ireland.
In April, 1997, 480 practices were participating in the General Practice Research Database. There is a slight under-representation of smaller
The data
Data recorded
Participating general practices are not required to record all consultations, although many do. They must record demographic data for all patients, including dates of birth and date of registration with the practice. Practices record all major illnesses (those resulting in admission to hospital or referral to a specialist) as well as the diagnosis and outcome of any procedure; any event resulting in a prescription or withdrawal of a drug or other treatment, including the indication
Uses
Drug safety
When a possible drug hazard is noted by spontaneous adverse-reaction reporting schemes, the General Practice Research Database can identify a large cohort of patients using the drug. This cohort can be looked at prospectively or retrospectively, and yield information on the severity of the reaction, its duration, any deaths, and identify which subgroups of patients are at particular risk.
The General Practice Research Database has proven its value in the investigation of drug safety.
Access to the General Practice Research Database
The General Practice Research Database may be used only for medical and health research purposes on a nonprofit making basis. Data can be accessed by purchase of a licence to hold the entire or partial contents of the database updated regularly or by requests for data for a specific research study, either through the Office for National Statistics or through the licensees. (Contacts for further information are: Office for National Statistics, Ms J Hollowell, St Catherines House, 10 Kingsway,
Concerns
The General Practice Research Database is a major resource, yet it receives no funding from the UK Department of Health and is funding by fees from licence holders, by payments for specific studies, and by grants from pharmaceutical companies. However this funding (approximately £1·1 million per year) is barely adequate, and the continued operation of the database remains uncertain. Lack of funding slows the development of systems to download data, and prevents realistic payments to the
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