The first day of Medical Informatics Europe 2016 for me consisted of a tutorial led by Dr Niels Peek and Dr Evan Kontopantelis from the University of Manchester on the topic of Learning Health Systems followed by two very interesting Keynotes from Martin McKee and Andre Kushniruk.
First, Learning Health Systems. The original concept was developed by the Institute of Medicine in the US in 2007:
Since then, the concept has been adopted for several large research studies such as the PCORI network in the US and the Transform EU project. In Manchester Neils and Evan are using the concept in their research using CPRD and other large UK health databases through the Health e-Research Centre.
Our research group at Oxford has also been looking into Learning Health Systems, particularly for use in low-resource settings such as Kenya and we recently published a paper in PLOS Medicine about this opportunity.
The MIE Learning Health Systems tutorial highlighted a number of great resources and concepts which I tweeted as the tutorial progressed. Niels was first presenting on the original concepts and research about learning health systems:
Learning from Big Health Care Data NEJM: https://t.co/7LgqxdaGD7 #hec2016
— Chris Paton (@DrChrisPaton) August 28, 2016
Best Care at Lower Cost: https://t.co/8JerfSLenv #HEC2016 #LearningHealthSystems
— Chris Paton (@DrChrisPaton) August 28, 2016
@NielsPeek: Learning Health Systems examples: Clinical Trials; Biosurveillance; Pharmacovigilance; Precision Medicine #HEC2016
— Chris Paton (@DrChrisPaton) August 28, 2016
https://twitter.com/DrChrisPaton/status/769817435939676160
@NielsPeek: LHSs should reduce the 'data-action latency'; LHSs are 'Fractal' (global – national – regional – local – individual) #HEC2016
— Chris Paton (@DrChrisPaton) August 28, 2016
https://twitter.com/DrChrisPaton/status/769821123005546496
@NielsPeek text-mining for unstructured data is a solution for messy data in Learning Health Systems #HEC2016
— Chris Paton (@DrChrisPaton) August 28, 2016
https://twitter.com/DrChrisPaton/status/769824992037113856
@dataevan – Missing data: always use a multiple imputation framework; do not use LOCF or complete case analyses #HEC2016
— Chris Paton (@DrChrisPaton) August 28, 2016
Niels was also kind enough to package up all the tutorial resources including the research papers mentioned and has shared them on Twitter:
Learning Healthcare System tutorial: Download our slides at https://t.co/57q1wR72cV #hec2016 @dataevan
— Niels Peek (@NielsPeek) August 28, 2016
Dr Kontopantelis’s presentation gave a great overview of the statistical issues relating to learning health systems:
@dataevan: rEHR (https://t.co/GVJ7ILeEmj) – Open source tools for data analysis of EHR records. #HEC2016
— Chris Paton (@DrChrisPaton) August 28, 2016
@dataevan: https://t.co/pUJ11kL0lM – freely available developed code lists for all EHR/EMR studies. #HEC2016
— Chris Paton (@DrChrisPaton) August 28, 2016
@dataevan: RECORD statement – REporting of studies Conducted using Observational Routine-collected Data: https://t.co/Ai060wlphs #HEC2016
— Chris Paton (@DrChrisPaton) August 28, 2016
@dataevan: EHR data analysis: complex; 80% of the work is creating a dataset to analyse; p-values often irrelevant. #HEC2016
— Chris Paton (@DrChrisPaton) August 28, 2016
Pragmatic e-Trial example: eCRT to reduce abx prescribing using CPRD database: https://t.co/BM8fBYufcA #HEC2016
— Chris Paton (@DrChrisPaton) August 28, 2016
After the tutorial, we had two great keynotes to kick off the conference proper. The first by Martin McKee was a very entertaining overview of the political economy of health:
@martinmckee opening keynote at #HEC2016 on the political economy of health pic.twitter.com/AeuI7nInGn
— Chris Paton (@DrChrisPaton) August 28, 2016
Prof McKee’s speech generated lots of questions and discussion about how politics impacts on healthcare from the audience and also on twitter:
Keynote speaker @martinmckee take home message: keep it simple despite health complexity … #hec2016 pic.twitter.com/d0UG7tBFrY
— MirjamBauer (@MirjamBauer) August 28, 2016
#hec2016 McKee @LSHTMpress on complexity: Corporations shape what we eat and drink/ and media what we think about it pic.twitter.com/5VTQegtmvL
— Michael Reiter (@MichaelReiterPR) August 28, 2016
The second keynote was a very good overview of current usability methods by Prof Andre Kushnurik:
@AndreKushniruk #HEC2016 keynote on Usability and UX in healthcare pic.twitter.com/VrMgULCzwC
— Chris Paton (@DrChrisPaton) August 28, 2016
@AndreKushniruk low cost rapid usability testing kit pic.twitter.com/2Eikddb7y7
— Chris Paton (@DrChrisPaton) August 28, 2016
Andre is a guru of UX research in healthcare and it was great to hear that he has two (two!) new books coming out in early 2017:
I’m looking forward to business meetings with IMIA colleagues today and another interesting keynote this afternoon. Stay tuned…