A Fair Test of the IAPT LTC/MUS Pathfinders
IAPT data GBU analysis?
Professor Simon Jones
Ms Eleni Theodorou
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www.surrey.ac.uk
Objectives:
To :
• Share our outline analysis plan
• What data to we have for the evaluation?
• What is Good, Bad, or Ugly?
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Subgroups of interest
Long term condition
Medically
unexplained
symptom
Yes
No
Yes
No
Question: How can we identify people in the
various groups?
• Data sources
• Fields and Codes
• GBU analysis
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Data Analysis for LTC &
MUS service users
For each of the subgroups
• Socio-Demographics profile
• Common mental health problems and other
comorbidities
• describe duration and type of intervention
• outcomes of intervention
• explore and quantify relations between
independent/predictor variables
• Question: Are there any other analysis which you
would find useful?
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Outcome scales
• Personal Health Questionnaire (PHQ9)
• Generalised Anxiety Disorder (GAD) score
• Work and Social Adjustment Scale Score
(W&SAS)
Question: Which outcome is the most
appropriate for MUS/LTC?
• GBU analysis
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Data Validation Study
Validate the self-reported co-morbidities from IAPT
dataset a against CHOICE (NIHR Programme Grant)
data set based on routinely collected primary and
secondary healthcare data sets (i.e. Doncaster and
Newham).
Primary care services
• Use of medication
• Psychotropic
• Non-psychotropic
• Referral rate
Acute/Secondary Services
• Outpatient activity
• In-patient activity
• Accident and Emergency
activity
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Economic analysis
To ascertain the cost-effectiveness of the service in
improving the outcomes of the different patient sub-groups
• Convert PHQ-9 into QALYs
– See Brazier, Yang , Tsuchiya , Rowen (2010) A review of studies mapping (or cross walking)
non-preference based measures of health to generic preference-based measures, Eur J Health
Econ.
• To validate the map between PHQ-9 and EQ-5D we will also seek to identify a
dataset where both PHQ-9 and EQ-5D are measured and observed and can be
regressed along with interaction and polynomial effects to account for nonlinearity and other confounding variables.
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IAPT Highlight Report
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IAPT MDS - Personal and
demographic details
M/R
R
R
M
M
M
R
M
R
R
R
R
R
Data Set Data Elements
NHS NUMBER
NHS NUMBER STATUS INDICATOR CODE
LOCAL PATIENT IDENTIFIER
ORGANISATION CODE (CODE OF PROVIDER)
PERSON BIRTH DATE
PERSON GENDER CODE CURRENT
POSTCODE OF USUAL ADDRESS
GENERAL MEDICAL PRACTICE CODE (PATIENT REGISTRATION)
ETHNIC CATEGORY
RELIGIOUS OR OTHER BELIEF SYSTEM AFFILIATION CODE
SEXUAL ORIENTATION (CURRENT)
EX-BRITISH ARMED FORCES INDICATOR
LONG TERM PHYSICAL HEALTH CONDITION INDICATOR
R
(IMPROVING ACCESS TO PSYCHOLOGICAL THERAPIES)
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IAPT MDS - Disability
M/R
R
R
R
R
Data Set Data Elements
NHS NUMBER
LOCAL PATIENT IDENTIFIER
ORGANISATION CODE (CODE OF PROVIDER)
DISABILITY CODE
01
02
03
04
05
06
07
08
09
10
XX
NN
ZZ
Behaviour and Emotional
Hearing
Manual Dexterity
Memory or ability to concentrate, learn or understand (Learning Disability)
Mobility and Gross Motor
Perception of Physical Danger
Personal, Self Care and Continence
Progressive Conditions and Physical Health (such as HIV, cancer, multiple sclerosis, fits etc)
Sight
Speech
Other
No DISABILITY
Not Stated (PERSON asked but declined to provide a response)
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IAPT MDS - Referral details
M/R
R
M
M
M
R
R
R
R
R
R
R
R
R
Data Set Data Elements
NHS NUMBER
LOCAL PATIENT IDENTIFIER
ORGANISATION CODE (CODE OF PROVIDER)
SERVICE REQUEST IDENTIFIER
REFERRAL REQUEST RECEIVED DATE
SOURCE OF REFERRAL FOR MENTAL HEALTH
SERVICE REQUEST ACCEPTANCE INDICATOR
ORGANISATION CODE (CODE OF COMMISSIONER)
PROVISIONAL DIAGNOSIS (ICD)
YEAR AND MONTH OF SYMPTOMS ONSET (IMPROVING
ACCESS TO PSYCHOLOGICAL THERAPIES)
PREVIOUS SYMPTOM INDICATOR
IMPROVING ACCESS TO PSYCHOLOGICAL THERAPIES CARE
SPELL END CODE
END DATE (IMPROVING ACCESS TO PSYCHOLOGICAL
THERAPIES)
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IAPT MDS- Appointment details
M/R
R
M
M
M
M
R
M
R
R
R
R
R
R
R
R
Data Set Data Elements
NHS NUMBER
LOCAL PATIENT IDENTIFIER
ORGANISATION CODE (CODE OF
PROVIDER)
SERVICE REQUEST IDENTIFIER
APPOINTMENT DATE
CARE PROFESSIONAL ROLE CODE
(IMPROVING ACCESS TO PSYCHOLOGICAL
THERAPIES)
ATTENDED OR DID NOT ATTEND CODE
CLINICAL CONTACT DURATION OF
APPOINTMENT
APPOINTMENT TYPE (IMPROVING ACCESS
TO PSYCHOLOGICAL THERAPIES)
CONSULTATION MEDIUM USED
THERAPY TYPE (IMPROVING ACCESS TO
PSYCHOLOGICAL THERAPIES)
(Up to four types may be recorded for each
APPOINTMENT)
EMPLOYMENT STATUS
EMPLOYMENT SUPPORT SUITABILITY
INDICATOR
EMPLOYMENT SUPPORT REFERRAL DATE
PSYCHOTROPIC MEDICATION USAGE
R
R
R
R
R
R
R
R
R
R
R
R
R
R
STATUTORY SICK PAY INDICATOR
PHQ-9 TOTAL SCORE
GENERALISED ANXIETY DISORDER
SCORE
WORK AND SOCIAL ADJUSTMENT
SCALE SCORE
AGORAPHOBIA MOBILITY INVENTORY
SCORE (WHEN ACCOMPANIED)
AGORAPHOBIA MOBILITY INVENTORY
SCORE (WHEN ALONE)
AGORAPHOBIA SCORE
GENERALISED ANXIETY DISORDER
PENN STATE WORRY SCORE
HEALTH ANXIETY INVENTORY SHORT
WEEK SCALE SCORE
OBSESSIVE COMPULSIVE DISORDER
INVENTORY SCORE
PANIC DISORDER SEVERITY SCALE
SCORE
POST TRAUMATIC STRESS DISORDER
IMPACT OF EVENTS SCALE REVISED
SCORE
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SOCIAL PHOBIA INVENTORY
SCORE
SOCIAL PHOBIA SCORE www.surrey.ac.uk
Thanks for listening
Simon Jones
simonjones@surrey.ac.uk
Acknowledgements:
XXX
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