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Can we use routinely collected primary care medical records to assess and explain variations in amputation rates across the UK?


Project Description

Using routinely collected data to look at rates of amputation requires amputation to be recorded to a high standard in medical records. There are three main databases in which such data are recorded routinely: (1) Primary care data such as CPRD using READ codes; (2) Hospital data using ICD-10 clinical codes and OPCS-4 procedure codes; and (3) ONS data for cause of death using ICD-10 clinical codes.

Of these three the hospital data are probably the most reliable recording of amputation. It is not known how well amputations are recorded in primary care. Clinical Practice Research Datalink (CPRD) is a large ongoing primary care database containing anonymised data from 674 practices across the UK. It contains a wealth of information including – data on demographics, symptoms, tests, diagnoses, therapies, health-related behaviours and referrals to secondary care. A subset of English practices (58% of all CPRD practices) have consented to data linkage, including HES and ONS.

This PhD will develop the best way to identify all amputations across these databases, it will then compare the level of agreement of recording of amputation across these databases. If adequate recording of amputation is found in the primary care data, this can be used to compare the prevalence of amputation across the UK and to compare regional amputation rates. To date amputation rates have only been assessed across England using hospital data. This project would compare rates across the UK and by using CPRD, if variations across region are found, will allow statistical modeling of risk factors to see if variations can be explained.

Entry requirements

Applicants are required to hold/or expect to obtain a UK Bachelor Degree 2:1 or better in a relevant subject and an MSc in Medical Statistics (or equivalent). The University of Leicester English language requirements apply where applicable: https://le.ac.uk/study/research-degrees/entry-reqs/eng-lang-reqs

How to apply

You should submit your application using our online application system: https://www2.le.ac.uk/research-degrees/phd/applyphd

Apply for Health Sciences Research /September 2019

In the funding section of the application please state you want to be considered for the Health Science (BRG) studentship.

In the proposal section include the supervisors name and project title. You do not need a full research proposal

In the personal statement section please state why you want to be consider for this project.

Project / Funding Enquiries: Prof Laura Gray, / Prof Rob Sayers

Application enquiries to

Funding Notes

Funded by the George Davies charitable donation to University of Leicester.
The Studentship is for three years, starting September 2019, and offers tuition fees at UK/EU rate and a Stipend at an enhanced rate. UK/EU Fees plus a 3 year enhanced stipend £15,777 for 2018/19, £15,999 2nd year and £16,224 for final year

References

Ahmad N et al. Lower limb amputation in England: prevalence, regional variation and relationship with revascularisation, deprivation and risk factors. A retrospective review of hospital data. J R Soc Med. 2014 Dec;107(12):483-9. doi: 10.1177/0141076814557301. Epub 2014 Nov 11.

Hippisley-Cox J, Coupland C. Development and validation of risk prediction equations to estimate future risk of blindness and lower limb amputation in patients with diabetes: cohort study. BMJ. 2015 Nov 11;351:h5441. doi: 10.1136/bmj.h5441.

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