Evaluating Preventative Interventions

The development of the Secure Anonymised Information Linkage (SAIL) system in which AWISS operates, has extended opportunities for AWISS to engage in the evaluation of simple and complex interventions.

Over the years AWISS data has been used to plan and evaluate several interventions including the Wales Vitamin D Fracture Prevention Study, the Advocacy for Pedestrian Safety Study and CHALICE project (Change in alcohol outlet density and alcohol-related harm to population health).

Listed below are several projects currently utilising the AWISS system to evaluate interventions, trials or natural experiments.

Carmarthenshire Housing Regeneration and Health Study

The AWISS system is being utilised as part of the NIHR funded Housing Regeneration and Health project in Carmarthenshire. This project seeks to evaluate the impact of a mixture of different types of housing improvements to 9,254 social homes in Carmarthenshire occurring between 2009 and 2014 on the health of the residents. By using record linkage of individual routine longitudinal data, including ED, hospital admissions and GP consultations, the study will evaluate the health impact of the interventions on the residents compared with the rest of the population and neighbouring areas without such interventions. The AWISS system is being used to determine the health service utilisation amongst the study population associated with falls and burns, together with providing advice on the linkage of the longitudinal data.

The study team includes involvement of PHW trainees and consultants. http://www.nets.nihr.ac.uk/projects/phr/09300602

Evaluation of ARBED Energy Efficiency Intervention

ARBED aims to examine whether improving the energy-efficiency of houses in low-income neighbourhoods can improve physical and mental health of its occupants.  The AWISS system is supporting the evaluation of the ARBED intervention, by enabling admission and consultation rates for cardio-respiratory conditions, mental health and injuries for the intervention group to be compared to the comparator groups in the same periods before and after the ARBED intervention.

Evaluation of Emergency Medicine Transport and Retrieval Service (EMRTS) Cymru

Seconded AWISS Staff are conducting an evaluation of the Emergency Medicine Transport and Retrieval Service Cymru (EMRTS Cymru).  EMRTS has been operational since April 2015, which has seen anaesthetists and emergency medicine consultants join Welsh Air Ambulance missions. EMRTS provides Welsh residents with rapid access to consultant led and, time sensitive critical care. The project evaluates the effectiveness of EMRTS on patient and service outcomes. Outcomes will include measures of impact on survival, quality of life, functional status, NHS resource use and costs.  Currently, data are being assembled from multi-sourced datasets. Data will be anonymised and made available for research and evaluation through the Secure Anonymised Information Linkage (SAIL) facility. Patients will be interviewed six months and one-year post incident for longer-term functional and quality of life outcomes. Geographic Information System (GIS) techniques will be used in time-saved analyses, model unmet needs, and develop service allocation models using Wales Ambulance Service NHS Trust and EMRTS collected data. Cases from both pre-EMRTS, using historical data, and EMRTS-offline (restricted flying at night/bad weather) will be used as comparators in the evaluation.