Short list of options for monitoring coronary heart disease in Scotland
| Option A: Status quo | No dedicated central coordination or structure | |
| National data collection of hospital activity and deaths | ||
| Cardiac surgery and angioplasty databases | ||
| Record linkage between inpatient episodes and death records possible | ||
| Quality assurance from the Information and Statistics Division in Edinburgh | ||
| Primary care data collection from a sample of self selected general practices | ||
| Dispensed prescription data analysable by general practitioner but not by diagnosis | ||
| Ad hoc risk factor surveys | ||
| Option B: Enhanced routine data model | Central coordination from the Information and Statistics Division in Edinburgh | |
| Designated director of CHD monitoring, small support staff, including data manager and statistician | ||
| Enhanced capability for data linkage and harmonisation between routine datasets | ||
| Patient function and quality of life surveys for discharged hospital patients | ||
| Accident and emergency database | ||
| Option B1: Enhanced routine data model plus risk factor surveys | Addition of national risk factor surveys as per option D | |
| Option C: Community epidemiology model | Central coordination. Nurses based in eight selected communities | |
| Full myocardial infarction registration and extended CHD detection (including heart failure) from 80 spotter general practices in selected communities | ||
| Hospital and primary care use: attendances, investigations, admissions, bed use, interventions | ||
| Diagnostic definitions and quality assurance derived from WHO MONICA standards | ||
| Risk factor, patient function, and quality of life surveys for CHD patients in selected locations | ||
| Option D: Australian cardiovascular disease monitoring scheme | Central office with researchers collating data from spotter practices and surveys | |
| Sentinel registers in hospitals for AMI based upon a simplified WHO MONICA protocol | ||
| National risk factor and health behaviour surveys | ||
| CHD population prevalence surveys | ||
| Option D1: Australian model plus quality of life surveys | Addition of quality of life surveys as per option B | |
| Option E: CHD registry | Central office at the Information and Statistics Division in Edinburgh | |
| Routine links with hospital and general practice information systems for case notification | ||
| Regional data collection via peripatetic staff. Standard diagnostic definitions | ||
| Follow up investigations of reported sudden deaths | ||
| Option E1: CHD registry plus risk factor surveys | Addition of risk factor surveys as per option D | |
| Option E2: CHD registry plus patient function and quality of life surveys | Addition of patient function and quality of life surveys as per option B | |
| Option E3: CHD registry plus risk factor, patient function, and quality of life surveys | Addition of risk factor surveys (as option D) plus patient function and quality of life (as option B) | |
AMI, acute myocardial infarction; CHD, coronary heart disease; MONICA, monitoring trends and determinants in cardiovascular disease study.