Chronic Diseases Epidemiology And Audit

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Diabetes Audit and Research in Tayside, Scotland (DARTS)

The MEMO/DARTS collaboration is a joint initiative of the Department of Medicine and MEMO at the University of Dundee, together with the Diabetes Units at three Tayside Health Care Trusts (Ninewells Hospital and Medical School, Dundee; Perth Royal Infirmary and Stracathro Hospital, Brechin) and all Tayside GPs with an interest in diabetes care. They have combined their expertise to create the Diabetes Audit and Research in Tayside, Scotland (DARTS) initiative (Morris et al., 1997a). It has been in operation since 1995, continually developing and gathering data from the population base of Tayside.

The MEMO/DARTS collaboration has used electronic record-linkage of information to create a robust clinical information system of all patients with type 1 and type 2 diabetes in Tayside whether they attend primary or secondary care. The DARTS database has information from many different sources including: patients attending hospital diabetes clinics, dispensed prescriptions for diabetes-related medication and monitoring equipment, patients discharged from hospital, patients attending a community-based mobile diabetic eye screening facility, glycosylated haemoglobin and plasma glucose results from the regional biochemistry database, and information collected from case records of patients in every general practice in Tayside. The register has been used for pharmaco-epidemiologic research (Morris et al., 1997b, 1997c).

Epidemiology of Liver Disease in Tayside (ELDIT)

The Epidemiology of Liver Disease in Tayside (ELDIT) study group has registered and validated a group of patients with potential and definite liver disease in Tayside for research purposes only. This disease register has a range of liver diseases that affect the whole organ including viral hepatitis (A, B and C) (Steinke et al., 2000b), autoimmune hepatitis, alcoholic liver disease (Steinke et al., 2000c), primary biliary cirrhosis and hepatocellular carcinoma (Weston et al., 2000) and complications of liver disease like ascites. The ascertainment of liver disease by electronic record-linkage was maximised because of the unique integration of multiple sources of data to create a patient-specific information system. The specificity of virology, immunology and biochemistry tests increase the completeness of the data. Accurate incidence and prevalence rates of liver disease and its complications are used to ensure that hepatology services run effectively and efficiently.

Heart-disease, Evidence-based Audit and Research in Tayside, Scotland (HEARTS)

The latest addition to MEMO's disease management databases is the HEARTS database of cardiovascular disease in Tayside. This is a regional collaborative effort to support improvements in clinical care, education and research in cardiovascular disease and to provide GPs with information that will be useful for audit and clinical governance purposes. The database contains information on high-risk patient populations like those who have suffered a myocardial infarction (MI) and those who have undergone coronary angioplasty or artery bypass grafting (CABG). The database includes a variety of other cardiovascular diseases. For example, those with angina pectoris, peripheral vascular disease, ischaemic stroke, cardiac failure, hypertension and those undergoing primary prevention for cardiovascular disease. The aims of HEARTS are to identify and determine the risk factors of cardiovascular disease from a population base and to evaluate and determine whether medications are optimised in these patients. This information is fed back in various ways to GP practices in an effort to support them in improving care. HEARTS also provides high quality epidemiological data for research, understanding and care of similar patients and their families.

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