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DID case study


The Health and Social Care Information Centre (HSCIC) is playing a pivotal role in contributing to work taking place to understand how outcomes for patients can be improved especially those with cancer, musculoskeletal disease and neurological conditions. In particular, understanding why there is variation in terms of mortality and morbidity and in patients with symptoms, who are subsequently diagnosed, present much later than other patients who present earlier.

It is doing this through the collection and development of a new dataset - the Diagnostic Imaging Dataset (DID). The new dataset will enable analysis of demographic and geographic variation in access to different tests and different providers which will lead to better analysis of pathways. For example by linking Cancer Registry data to diagnostic imaging test data for cancer patients its possible to look at the care pathway for patients and understand at what points diagnostic imaging is used and whether any improvements can be made to support earlier diagnosis which could lead to better outcomes for patients.

There has been recent focus on improved access to four key diagnostic tests for cancer for patients referred by their GP. These are:

  • Chest x-ray: to support the diagnosis of lung cancer
  • Non-obstetric ultrasound: to support the diagnosis of ovarian cancer
  • Flexible sigmoidoscopy/colonoscopy: to support the diagnosis of bowel cancer
  • Magnetic Resonance Imaging (MRI) brain: to support the diagnosis of brain cancer

Through the DID, data is collected monthly and shared about GP usage of these four diagnostic tests for NHS patients so that GPs can benchmark their usage of them. In addition, the dataset supports the evaluation of the public symptom awareness campaigns, for example, the recent Be Clear on Cancer awareness campaign to raise awareness of the symptoms of lung cancer and get those with persistent symptoms to go to see their GP.

Professor Erika Denton, National Clinical Director for Imaging Department of Health and Consultant Radiologist in Norwich, said: "Access to the new diagnostic imaging dataset is vital to stimulate discussion and debate between patients, clinicians, providers and commissioners to ensure diagnostic tests are being utilised at the right point in pathways of care. This will inform radiology planning and drive improvements in diagnosis and care as well as helping us to understand why there are variations particularly for the late presentation of symptoms of cancer.

"We asked the HSCIC to create this national dataset for diagnostic imaging and they have responded with an effective system so we now have data flowing from all providers of NHS imaging services and this is then available quickly in an easy to access and analyse format for all those interested."

Andrew Haw, Interim Director of Data Services said, "We are pleased that we have been able to get this national dataset flowing and available in a relatively short timescale of around nine months. Getting a dataset to flow nationally for the first time is often challenging but it is a credit to all those involved that we have been able to achieve this. We have staff who support the Trusts collecting the data, answering queries and helping them capture the data in the right way so that when it flows it is of a good enough quality to be useful and meaningful. We undertake data quality activity once that data reaches us before we assimilate it and publish it."

The DID is labelled as a provisional and experimental statistic because it is the first time that information stored on hospital's Radiological Information Systems has been centrally compiled. It is anticipated that the coverage and quality of records submitted will improve as providers become more familiar and the information is further evaluated.

Experimental official statistics are new official statistics undergoing evaluation. They are published in order to involve users and stakeholders in their development and as a means to build in quality at an early stage.

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