Analysis of electronic health records finds effective medicines
quicker and cheaper than clinical trials
13 August 2014
Analysing electronic health records of large patient populations
can efficiently select the right patients and identify the
effectiveness of treatments with minimal impact on patients and
reduce the need for expensive clinical trials.
A study published in Health Technology Assessment 
chose 300 people with high risk of cardiovascular disease from
patient populations of 23 GP practices and looked at the outcomes of
the use of statins by analysing their electronic records.
A second part of the study involved 31 participants and looked at
the use of antibiotics in those with chronic obstructive pulmonary
disease — where people have difficulty breathing, primarily due to
the narrowing of their airways.
Currently, when researchers want to investigate whether one
treatment is better than another they need to organise lengthy and
expensive trials that require heavy form filling by patients and
GP’s, additional staff resource, regular attendance at appointments
and can create artificial test environments that do not represent
the reality of patient’s behaviour in regular day-to-day life.
For the purposes of this study, researchers instead installed
special software in 23 approved GP surgeries across England and
Scotland. This software was able to confidentially identify which
patients were eligible to take part and allowed doctors to sign up
relevant participants at the click of a button, saving time and
money for the public purse.
Researchers then used data extracted from the qualifying
patients’ electronic health records, as recorded in the Clinical
Practice Research Datalink, updated as part of their regular medical
appointments, to monitor the impact of the treatments they had been
By studying these records, researchers were able to understand
health outcomes of specific medications with potentially much larger
and more diverse members of the public, and to determine which
treatment gave the best results. The research was conducted with
minimal impact on the lives of the patients who, after offering
their consent for the use of their medical data were not required to
have any active involvement.
Research leader Prof van Staa, then a member of the Clinical
Practice Research Datalink (CPRD) and now based at The University of
Manchester’s Health eResearch Centre, said, “The use of electronic
health records in simplifying clinical trials means that we no
longer need to remain uncertain about which medicine offers the best
health benefits for patients. This study shows that scientists are
able to conduct research which will highlight which treatment is
best for patients.”
Following participation in the study, interviews took place with
27 GPs, 26 of whom expressed strong support for the use of patients’
electronic records to support clinical trial. Ten patients were also
interviewed who all agreed that discussion of their involvement in
the trial as part of a routine health appointment was a wholly
Future studies regarding the use of electronic records in
clinical trials will be delivered as part of the Farr Institute of
Health Informatics. A national organisation that encompasses four
centres of excellence in the field of eHealth research with Centres
based in the North of England, East of England and Wales, Scotland
The study was done in collaboration with researchers from the
London school of Hygiene & Tropical Medicine and the Universities of
York, Liverpool and Brighton and Kings’ College; it was funded by
the National Institute for Health Research and the Wellcome Trust.
1. van Staa T-P. The opportunities and challenges of
pragmatic point-of-care randomised trials using routinely collected
electronic records: evaluations of two exemplar trials. Health
Technology Assessment; Year: 2014, Volume: 18 Issue: 43.