Citation

Carson L, Jewell A, Downs J, Stewart R. Lancet Psychiatry 2020; 7(10): e61.

Copyright

(Copyright © 2020, Elsevier Publishing)

DOI

10.1016/S2215-0366(20)30375-8

PMID

32949523

Abstract

Registers based on electronic health records have substantially enhanced the capabilities of mental health research. These registers can be further supported by linked administrative data, generating evidence with a high level of external validity, reproducibility, and applicability for policy making.1 This approach has been achieved for a single site through the Clinical Record Interactive Search (CRIS) research platform at the South London and Maudsley National Health Service (NHS) Foundation Trust (SLaM; a large mental health provider serving 1·4 million residents in south London, UK).2 Since 2008, the CRIS platform at SLaM has supported more than 200 research publications, many of which used linked national administrative data, including the National Pupil Database,3 Hospital Episode Statistics,4 and the National Cancer Registry.

Replication of such linkages at other sites is technically straightforward and would allow valuable opportunities for improving generalisability and cross-testing hypotheses. It is also good policy to provide access to regional level data that local decision makers can use to directly care for their populations, as recognised by the launch of The Lancet Regional Health. In 2018, a Medical Research Council award supported SLaM and King's College London (London, UK) to provide such a programme, assisting other mental health NHS trusts by use of CRIS-like databases with the legal and governance pathways required to replicate pre-existing SLaM-CRIS linkages. However, although successful in its deliverables, this programme was complex and time consuming, and, in our view, ultimately unsustainable nationally without a change in approval processes. In particular, one of the principal obstacles to achieving wider coverage is the current requirement to complete full applications on research ethics and legality for each new data owner (NHS trust), even if the linkage protocols are identical ...

Language: en