Informatics and Data Analytics; How to make data meaningful? AHIMA World Congress Middle East Healthcare Information Summit October 2017

Transcription

1 Informatics and Data Analytics; How to make data meaningful? AHIMA World Congress Middle East Healthcare Information Summit October 2017 Dr Kadhim Alabady, FRCP (Glasgow) MBBS; MPH; MSc, DrPH Senior Specialist, Public Health and Safety Department Dr. Muhammad Wasiful Alam, MD (USA); MSPH (USA) Director Public Health and Safety Department

2 Why data/research is essential for Public Health? To gather information to support planning and changing services. To build a picture of current services, i.e. a baseline. To encourage discussion on whether service changes are necessary.

3 Why data/research is essential for Public Health? Intelligence Provide a baseline of the current picture of health or health related issues which can then be used to measure the impact of interventions or service development. Equity Reduce health inequalities through early identification and improving the spatial allocation of resources between and within different groups. Involvement of stakeholders Conducting a public health research can stimulate the involvement and ownership of the various stakeholders in the process.

4 Public Health practice Public health is always Public health is always evidence-based practice that lead to more effective programs

5 Main Public Health Data sources Population Risk factors & Life style Clinical Data Registries Others 1. Population Estimates 2. GP Practice registries 3. Projected 1. Surveys 2. Registry 1. Hospital 2. GP practice 3. Prescriptions 4. Others i.e. Laboratory 1. Birth 2. Mortality 3. Disease registry 1. Screening 2. Modelling 3. vaccinations 4. Others

6 Registries Issues with disease registries or surveillance systems Missing data Validation tools Up to date Evaluation Classification (i.e. disease classifications ICD 10 code)

7 Mortality Registries There is always an issue with ICD coding Completeness Birth Require extra information i.e. birth weight, age of mother etc.).

8 Surveys Occasionally Repetitive does not focus on certain groups Sample size Analysing and interpretations of statistics Capacity building (tools SPSS, STATA SAS, interviewers, epidemiologists, databases).

9 How to make data meaningful? Modelling Mental health (ADHD) In the UAE, according to health experts; school children are wrongly being branded naughty and at risk of being expelled instead of being treated for a psychological disorder. There are no official figures for the UAE but it is suggested that; 1 or 2 per cent of school age children have had the disorder diagnosed, although the true figures could be between 3 and 5 per cent of children with the condition. It is suggested that half of the children with attention deficit hyperactivity disorder (ADHD) have yet to have the condition diagnosed. This may be due to lack of awareness and stigma.

10 Public Health Research Qualitative approach Participant observation is appropriate for collecting data on naturally occurring behaviors in their usual contexts. In-depth interviews are optimal for collecting data on individuals personal histories, perspectives, and experiences, particularly when sensitive topics are being explored. Focus groups are effective in eliciting data on the cultural norms of a group and in generating broad overviews of issues of concern to the cultural groups or subgroups represented. Tools for the analysis Invivo 10. Quantitative approach Cohort studies or longitudinal studies Prospective. Retrospective. Ambi-directional cohort study Case control studies. Cross sectional study designs Tools for the analysis SPSS STATA SAS.

11 Public Health Research

12 Public health research To use where possible data available. Quantitative approach i.e. hospital data, mortality, birth, surveys, prescriptions, screening, funding, others. Qualitative approach i.e. focus groups, in-depth interviews with stakeholders. Examples what public health Dept. achievements using data in past Examples what public health Dept. achievements using data in past 3 years Mental health needs assessment for Dubai, 2016 Vision impairment needs assessment for Dubai, 2017 Cancer needs assessment for Dubai, 2018 Stress survey among DHA employee 2016 Health promotion awareness strategy survey input from all DHA sectors. Participation in WHO household survey with MoH.

13 Interventions Outcomes of Public health research Public health promotion / awareness programs Health polices i.e. car seats policy for new born babies; HCPs immunization and infection control immunization and infection control Strategies i.e. mental health strategy, public health promotion awareness strategy Guidelines: School canteen healthy food; car seat; health care professionals safety; heat stress on smart phones Repetition of situational analysis / needs assessments to measure the effectiveness of interventions

14 How to make data meaningful? Issues to consider Bias: refers to systematic errors in any type of epidemiologic study that result in an incorrect estimate of the association between exposures and outcomes. Selection Bias. Information Bias. Confounding: is a distortion of the association between an exposure and an outcome that occurs (is an unobserved exposure associated with the exposure of interest and is a potential cause of the outcome of interest). Confounders lead to bias that distorts the magnitude of the relationship between two factors of interest.

15 Public Health Research / Selection Bias / Types Referral bias. Recall bias Interviewer Bias Loss of follow up bias. Healthy workers Bias. Confounding by indication. Differences in the Quality of Information

16 How to make data meaningful? Presentations of results Statistics: numbers, percentages, crude rates, standardised rates, relative risks, odds ratios. Statistics: Significant statistically p value versus 95% confidence interval. Statistics: stratification by age gender, socioeconomic classes, nationalities, education, etc. How to present the results? How to make public understand the results?

17 Going forward Surveys Studies Quality Others - Limited - Households surveys - Continuity - Sample size - Randomisation - Method of analysis - Mainly universities, limited clinical and public health - Limited registries retrospective studies - Prospective studies - Case control rarely focused on infectious diseases - Publications in peer reviewed journals - Research - Methodology - Tools - Electronic Medical Records (Hospital and GP practice data) - Registries - Modelling - Funding - Socio-economic groups

18 References (1) Schulte SJ, Thomas J. Relationship between eating pathology, body dissatisfaction and depressive symptoms among male and female adolescents in the United Arab Emirates. Eating behaviors 2013;14(2): (2) Griffiths KM. Towards a framework for increasing help-seeking for social anxiety disorder. Aust N Z J Psychiatry 2013 October 1;47(10): (3) Psychology and mental health services in the United Arab Emirates. Available at: Accessed June 26, (4) Organization WH, others. Risks to mental health: An overview of vulnerabilities and risk factors. Geneva: WHO (5) Moselhy HF, Ghubach R, El-Rufaie O, Zoubeidi T, Badrinath P, Sabri S, et al. The association of depression and anxiety with unhealthy lifestyle among United Arab Emirates adults. Epidemiology and psychiatric sciences 2012;21(02): (6) Norhayati MN, Nik Hazlina NH, Asrenee AR, Wan Emilin, W M A. Magnitude and risk factors for postpartum symptoms: A literature review. Journal of Affective Disorders 2015 April 1;175: (7) Hamdan A, Hawamdeh S, Hussein A. The prevalence and correlates of depressive symptoms among Arab women in a primary health care setting. The International Journal of Psychiatry in Medicine 2008;38(4): (8) Ghubach R, El-Rufaie O, Zoubeidi T, Sabri S, Yousif S, Moselhy HF. Subjective life satisfaction and mental disorders among older adults in UAE in general population. International journal of geriatric psychiatry 2010;25(5): (9) Psychology and mental health services in the United Arab Emirates. Available at: Accessed June 26, (10) Eapen V, Ghubash R. Help-Seeking for Mental Health Problems of Children: Preferences and Attitudes in the United Arab Emirates. Psychol Rep 2004 April 1;94(2): (11) Eapen V, Mabrouk AA, Bin-Othman S. Disordered eating attitudes and symptomatology among adolescent girls in the United Arab Emirates. Eating behaviors 2006;7(1):53 60.

19 Thank you. Dr. Kadhim Alabady, FRCP (Glasgow) MBBS; MPH; MSc, DrPH Senior Specialist Public Health and Safety Department, Dubai Health Authority Head Quarter Telephone: Kalabady@dha.gov.ae