A case study in distributed team science in research using electronic health records

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Jiao Song Elizabeth Elliot Andrew D Morris Joannes J Kerssens Ashley Akbari Simon Ellwood-Thompson Ronan A Lyons
Published online: Sep 21, 2018



Safety issue of the new non-vitamin K Target Specific Oral Anticoagulants (TSOAC) in people who have had an intracranial haemorrhage required large numbers and data from multiple countries in a European study. To support this scientific research project, we report our approach and success in rapidly replicating datasets and analyses across Wales and Scotland.



To develop an approach to rapidly replicate analyses and data which is reproducible and scalable, as an option towards development of an infrastructure that allows for and supports cross-country research within the UK/EU using Electronic Health Records (EHRs).



Advantages and disadvantages of five potential approaches we considered are summarized. Welsh study cohort was generated through linking various datasets held in Secure Anonymous Information Linkage (SAIL) databank in Swansea using data linkage techniques. Scottish study cohort was generated from linking relevant datasets held in multiple data warehouses and brought to the Scottish National Data Safe Haven. Analysts based in Swansea and Edinburgh gained simultaneous access to both data safe havens which allowed for real time viewing and creation of analytical codes. A detailed comparison between Welsh and Scottish data has been conducted on the relevant datasets in this project. A set of high level results have been combined between study cohorts in Wales and Scotland.



The study cohort included pseudonymised information of 2,676 individuals in Wales and 4,153 in Scotland, 6,829 in total. A common R code script has been produced to harmonise individual data and outputs, which can be applied to a wide range of scientific projects under cross-centre working requirements.



The approach we adopted is the simplest, yet a very efficient and cost-effective method to ensure consistency in analysis and coherence with the governance systems of both Welsh and Scottish safe havens. It can also be considered as an initialisation of developing infrastructure to support research using EHRs across the UK and EU.

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