The Health Improvement Network (THIN) is a large

database In computing, a database is an organized collection of data stored and accessed electronically. Small databases can be stored on a file system, while large databases are hosted on computer clusters or cloud storage. The design of databases sp ...

of anonymised electronic

medical record The terms medical record, health record and medical chart are used somewhat interchangeably to describe the systematic documentation of a single patient's medical history and care across time within one particular health care provider's jurisdic ...

s collected at

primary care Primary care is the day-to-day healthcare given by a health care provider. Typically this provider acts as the first contact and principal point of continuing care for patients within a healthcare system, and coordinates other specialist care t ...

clinics throughout the UK. The THIN database is owned and managed by The Health Improvement Network Ltd in collaboration with In Practice Systems Ltd. The Health Improvement Network Ltd & In Practice Systems Ltd are both subsidiary companies o
Cegedim SA

History

The THIN database is similar in structure and content to the

Clinical Practice Research Datalink The Clinical Practice Research Datalink (CPRD) is an observational and interventional research service that operates as part of the Department of Health (United Kingdom), UK Department of Health. It is jointly funded by the National Institute for ...

(CPRD, previously known as GPRD), which is now managed by the United Kingdom Medicines and Healthcare products Regulatory Agency ( MHRA). Between 1994 and 2002, EPIC (UK), a

not-for-profit A nonprofit organization (NPO) or non-profit organisation, also known as a non-business entity, not-for-profit organization, or nonprofit institution, is a legal entity organized and operated for a collective, public or social benefit, in co ...

company, held a non-exclusive licence to use GPRD for research benefitting public health. On the expiry of that licence, THIN was developed by EPIC as an alternative to the GPRD, and a substantial number of primary care practitioners now contribute data to both resources. In 2005 EPIC was acquired by

Cegedim Cegedim SA is a health technology company based in Boulogne-Billancourt, founded in 1969. It employs more than 4,200 people in more than 10 countries. Revenue in 2017 was €457 million. The American subsidiary, Cegedim Inc., is based in Bedminst ...

, a global technology and services company specialising in the healthcare field. THIN data are made available under more permissive terms than other similar resources (such as the CPRD, which does not allow for-profit use by private companies), but access is subject to ethical approval by an independent Scientific Review Committee.

Data

Data collection commenced in January 2003, using information extracted fro
VISION
a widely used general practice management software package developed b
In Practice Systems Ltd
a company also owned by Cegedim SA. The database is regularly updated and currently contains data on over 10 million individuals living in the

United Kingdom The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Europe, off the north-western coast of the continental mainland. It comprises England, Scotland, Wales and North ...

. Clinical data in THIN are catalogued using

Read codes Read codes are a clinical terminology system that was in widespread use in General Practice in the United Kingdom until around 2018, when NHS England switched to using SNOMED CT. Read codes are still in use in Scotland and in England are permitted ...

, a comprehensive and searchable classification scheme for medical conditions, symptoms and important background information. This system is complemented by a set of Additional Health Data (AHD) codes which provide a

standardised Standardization or standardisation is the process of implementing and developing technical standards based on the consensus of different parties that include firms, users, interest groups, standards organizations and governments. Standardization ...

system for the recording of a wide variety of clinical measurements, and by drug codes which identify prescribed medications. Since 2004, the UK

Quality and Outcomes Framework The Quality and Outcomes Framework (QOF) is a system for the performance management and payment of general practitioners (GPs) in the National Health Service (NHS) in England, Wales, Scotland and Northern Ireland. It was introduced as part of a n ...

, a

performance-related pay Performance-related pay or pay for performance, not to be confused with performance-related pay rise, is a salary or wages paid system based on positioning the individual, or team, on their pay band according to how well they perform. Car salesmen o ...

scheme for primary care practitioners, has effectively mandated the use of computer systems (such as Vision) to maintain patient medical records, and has imposed standardised recording methods for a wide range of important medical conditions. In addition, practitioners contributing data to THIN receive training to ensure consistent recording of important clinical outcomes and indicators including: *

Asthma Asthma is a long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wheezing, cou ...

Coronary heart disease Coronary artery disease (CAD), also called coronary heart disease (CHD), ischemic heart disease (IHD), myocardial ischemia, or simply heart disease, involves the reduction of blood flow to the heart muscle due to build-up of atherosclerotic pla ...

Diabetes mellitus Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level ( hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ap ...

Epilepsy Epilepsy is a group of non-communicable neurological disorders characterized by recurrent epileptic seizures. Epileptic seizures can vary from brief and nearly undetectable periods to long periods of vigorous shaking due to abnormal electrical ...

Menopause Menopause, also known as the climacteric, is the time in women's lives when menstrual periods stop permanently, and they are no longer able to bear children. Menopause usually occurs between the age of 47 and 54. Medical professionals often d ...

Hypertension Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high bl ...

Hypothyroidism Hypothyroidism (also called ''underactive thyroid'', ''low thyroid'' or ''hypothyreosis'') is a disorder of the endocrine system in which the thyroid gland does not produce enough thyroid hormone. It can cause a number of symptoms, such as po ...

*Leg

ulcers An ulcer is a discontinuity or break in a bodily membrane that impedes normal function of the affected organ. According to Robbins's pathology, "ulcer is the breach of the continuity of skin, epithelium or mucous membrane caused by sloughing o ...

Heart failure Heart failure (HF), also known as congestive heart failure (CHF), is a syndrome, a group of signs and symptoms caused by an impairment of the heart's blood pumping function. Symptoms typically include shortness of breath, excessive fatigue, a ...

Warfarin Warfarin, sold under the brand name Coumadin among others, is a medication that is used as an anticoagulant (blood thinner). It is commonly used to prevent blood clots such as deep vein thrombosis and pulmonary embolism, and to prevent strok ...

use *

Lithium Lithium (from el, λίθος, lithos, lit=stone) is a chemical element with the symbol Li and atomic number 3. It is a soft, silvery-white alkali metal. Under standard conditions, it is the least dense metal and the least dense solid el ...

use *Use of

hormonal contraception Hormonal contraception refers to birth control methods that act on the endocrine system. Almost all methods are composed of steroid hormones, although in India one selective estrogen receptor modulator is marketed as a contraceptive. The origin ...

Pernicious anaemia Pernicious anemia is a type of Vitamin B12 deficiency, vitamin B12 deficiency anemia, a disease in which not enough red blood cells are produced due to the malabsorption of Vitamin B12, vitamin B12. Malabsorption in pernicious anemia results fr ...

Rheumatoid arthritis Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and hands are involv ...

* Secondary stroke prevention *

Lower back pain Low back pain (LBP) or lumbago is a common disorder involving the muscles, nerves, and bones of the back, in between the lower edge of the ribs and the lower fold of the buttocks. Pain can vary from a dull constant ache to a sudden sharp feeli ...

Mental health Mental health encompasses emotional, psychological, and social well-being, influencing cognition, perception, and behavior. It likewise determines how an individual handles stress, interpersonal relationships, and decision-making. Mental health ...

Smoking Smoking is a practice in which a substance is burned and the resulting smoke is typically breathed in to be tasted and absorbed into the bloodstream. Most commonly, the substance used is the dried leaves of the tobacco plant, which have bee ...

status THIN is an important resource in the fields of epidemiology, drug safety and health outcomes research, providing an inexpensive means to study the causes of disease and effectiveness of

interventions ''Interventions'' is a book by Noam Chomsky, an American academic linguist and political activist. Published in May 2007, ''Interventions'' is a collection of 44 op-ed articles, post-9/11, from September 2002, through March 2007. The book's sub ...

in a large, representativeBourke, Dattani, and Robinson, “Feasibility Study and Methodology to Create a Quality-evaluated Database of Primary Care Data.�

/ref> population.

References

External links

The Health Improvement Network (THIN)Cegedim SA
{{DEFAULTSORT:Health Improvement Network Medical and health organisations based in the United Kingdom Medical databases in the United Kingdom