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example_manifest.json
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example_manifest.json
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{
"URI": "https://clinicalcodes.rss.mhs.man.ac.uk/medcodes/article/5",
"abstract": "Objectives:\r\nTo investigate the effect of withdrawing incentives on recorded quality of care, in the context of the UK Quality and Outcomes Framework pay-for-performance scheme.\r\n\r\nDesign:\r\nRetrospective longitudinal study.\r\n\r\nSetting:\r\nData for 644 general practices, from 2004/5 to 2011/12, extracted from the Clinical Practice Research Datalink.\r\n\r\nParticipants:\r\nAll patients registered with any of the practices over the study period, 13,772,992 in total.\r\n\r\nIntervention:\r\nThe removal of financial incentives for aspects of care for patients with asthma, coronary heart disease, diabetes, stroke and psychosis.\r\n\r\nMain outcome measures:\r\nPerformance on eight clinical quality indicators withdrawn from a national incentive scheme: influenza immunisation (asthma) and lithium therapy monitoring (psychosis), removed in April 2006; blood pressure monitoring (coronary heart disease, diabetes, stroke), cholesterol level monitoring (coronary heart disease, diabetes) and blood glucose monitoring (diabetes), removed in April 2011. Multilevel mixed effects multiple linear regression models were used to quantify the effect of incentive withdrawal.\r\n\r\nResults:\r\nMean levels of performance were generally stable after the removal of the incentives, both short- and long-term. For the two indicators removed in April 2006/7, levels in 2011/12 were very close to 2005/6 levels, although a small but statistically significant drop was estimated for influenza immunisation. For five of the six indicators withdrawn in from April 2011/12, there was no significant impact on performance in that year following removal and differences between predicted and observed scores were small. Performance on related outcome indicators retained in the scheme (e.g. blood pressure control) was generally unaffected.\r\n\r\nConclusions:\r\nFollowing the removal of incentives, levels of performance across a range of clinical activities generally remained stable. This indicates that health\r\nbenefits from incentive schemes can potentially be increased by periodically replacing existing indicators with new indicators relating to alternative aspects of care. However, most of the aspects of care we investigated remained indirectly incentivised and further work is required to assess the generalisability of the findings when incentives are fully withdrawn.\r\n",
"article_ID": 5,
"article_title": "Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework",
"article_type": "Research article",
"authors": "Kontopantelis, Evangelos; Springate, David; Reeves, David; Ashcroft, Darren; Valderas, Jose M; Doran, Tim",
"codelists": {
"angina": {
"associated_articles": {
"5": {
"title": "Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework",
"year": 2014
}
},
"codelist_name": "angina",
"codelist_url": "https://clinicalcodes.rss.mhs.man.ac.uk/medcodes/article/5/codelist/angina/download/",
"comments": {
"comment_10": {
"comment": "Codes used to identify patients meeting QOF indicator CHD 2",
"submit_date": "2014-01-27 11:49:17",
"user_name": "David Springate"
}
},
"num_codes": 33,
"user_field_1": "",
"user_field_2": "",
"user_field_3": ""
},
"asthma_clinicals": {
"associated_articles": {
"5": {
"title": "Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework",
"year": 2014
}
},
"codelist_name": "asthma_clinicals",
"codelist_url": "https://clinicalcodes.rss.mhs.man.ac.uk/medcodes/article/5/codelist/asthma_clinicals/download/",
"comments": {
"comment_6": {
"comment": "Asthma diagnosis is defined as a patient having at least one code from [asthma_clinicals] up to the end of the QOF year in question plus at least one code from [asthma_drugs] in the preceding year. Patients whose most recent clinical code in a year is a resolve code in a given year are not included in the definition.",
"submit_date": "2014-01-27 10:42:27",
"user_name": "David Springate"
}
},
"num_codes": 66,
"user_field_1": "resolve_code",
"user_field_2": "",
"user_field_3": ""
},
"asthma_drugs": {
"associated_articles": {
"5": {
"title": "Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework",
"year": 2014
}
},
"codelist_name": "asthma_drugs",
"codelist_url": "https://clinicalcodes.rss.mhs.man.ac.uk/medcodes/article/5/codelist/asthma_drugs/download/",
"comments": {},
"num_codes": 575,
"user_field_1": "BNF_code",
"user_field_2": "BNF_header",
"user_field_3": "drug_substance_name"
},
"blood_pressure": {
"associated_articles": {
"5": {
"title": "Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework",
"year": 2014
}
},
"codelist_name": "blood_pressure",
"codelist_url": "https://clinicalcodes.rss.mhs.man.ac.uk/medcodes/article/5/codelist/blood_pressure/download/",
"comments": {
"comment_13": {
"comment": "Codes for blood pressure measurements. Used to identify patients meeting criteria for QOF indicators CHD 5, CHD 6, DM 11, DM 12, STROKE 5, STROKE 6",
"submit_date": "2014-01-27 12:06:58",
"user_name": "David Springate"
}
},
"num_codes": 49,
"user_field_1": "",
"user_field_2": "",
"user_field_3": ""
},
"body_mass_index": {
"associated_articles": {
"5": {
"title": "Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework",
"year": 2014
}
},
"codelist_name": "Body_mass_index",
"codelist_url": "https://clinicalcodes.rss.mhs.man.ac.uk/medcodes/article/5/codelist/body_mass_index/download/",
"comments": {
"comment_15": {
"comment": "Codes to identify patients meeting QOF indicator DM 2",
"submit_date": "2014-01-27 12:18:29",
"user_name": "David Springate"
}
},
"num_codes": 65,
"user_field_1": "",
"user_field_2": "",
"user_field_3": ""
},
"chronic_obstructive_pulmonary_disease": {
"associated_articles": {
"5": {
"title": "Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework",
"year": 2014
}
},
"codelist_name": "Chronic_obstructive_pulmonary_disease",
"codelist_url": "https://clinicalcodes.rss.mhs.man.ac.uk/medcodes/article/5/codelist/chronic_obstructive_pulmonary_disease/download/",
"comments": {
"comment_14": {
"comment": "Codes used to identify patients with COPD. COPD treated as a chronic condition. Patients with any codes from this list prior to the end of a given QOF year are included for that year.",
"submit_date": "2014-01-27 12:11:50",
"user_name": "David Springate"
}
},
"num_codes": 48,
"user_field_1": "",
"user_field_2": "",
"user_field_3": ""
},
"coronary_heart_disease": {
"associated_articles": {
"5": {
"title": "Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework",
"year": 2014
}
},
"codelist_name": "Coronary_Heart_Disease",
"codelist_url": "https://clinicalcodes.rss.mhs.man.ac.uk/medcodes/article/5/codelist/coronary_heart_disease/download/",
"comments": {
"comment_12": {
"comment": "Codes used to identify patients with CHD. CHD treated as a chronic condition. Patients with any codes from this list prior to the end of a given QOF year are included for that year.",
"submit_date": "2014-01-27 12:01:47",
"user_name": "David Springate"
}
},
"num_codes": 79,
"user_field_1": "",
"user_field_2": "",
"user_field_3": ""
},
"diabetes": {
"associated_articles": {
"5": {
"title": "Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework",
"year": 2014
}
},
"codelist_name": "Diabetes",
"codelist_url": "https://clinicalcodes.rss.mhs.man.ac.uk/medcodes/article/5/codelist/diabetes/download/",
"comments": {
"comment_22": {
"comment": "Codes used to identify patients with diabetes. Diabetes is treated as a chronic condition. Patients with any codes from this list prior to the end of a given QOF year are included for that year.",
"submit_date": "2014-01-27 13:24:31",
"user_name": "David Springate"
}
},
"num_codes": 256,
"user_field_1": "",
"user_field_2": "",
"user_field_3": ""
},
"epilepsy_clinicals": {
"associated_articles": {
"5": {
"title": "Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework",
"year": 2014
}
},
"codelist_name": "Epilepsy_clinicals",
"codelist_url": "https://clinicalcodes.rss.mhs.man.ac.uk/medcodes/article/5/codelist/epilepsy_clinicals/download/",
"comments": {
"comment_24": {
"comment": "Patients are classed as being diagnosed with epilepsy if they have at least one code from [epilepsy_clinicals] up to the end of the QOF year in question plus at least one code from [epilepsy_drugs] in the preceding year. Patients whose most recent clinical code in a given year is a resolve code are not included in the definition.\r\n",
"submit_date": "2014-01-27 13:57:53",
"user_name": "David Springate"
},
"comment_25": {
"comment": "'type' coding:\r\n\r\n'diagnostic' - Used to diagnose condition. \r\n'EPILEPSY_2' - QOF indicator EPILEPSY 2. \r\n'EPILEPSY_3' - QOF indicator EPILEPSY 3. \r\n'EPILEPSY_4' - QOF indicator EPILEPSY 4. ",
"submit_date": "2014-01-27 13:59:50",
"user_name": "David Springate"
}
},
"num_codes": 119,
"user_field_1": "resolve_code",
"user_field_2": "type",
"user_field_3": ""
},
"epilepsy_drugs": {
"associated_articles": {
"5": {
"title": "Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework",
"year": 2014
}
},
"codelist_name": "epilepsy_drugs",
"codelist_url": "https://clinicalcodes.rss.mhs.man.ac.uk/medcodes/article/5/codelist/epilepsy_drugs/download/",
"comments": {},
"num_codes": 353,
"user_field_1": "BNF_header",
"user_field_2": "BNF_code",
"user_field_3": "drug_substance_name"
},
"exercise_testing": {
"associated_articles": {
"5": {
"title": "Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework",
"year": 2014
}
},
"codelist_name": "exercise_testing",
"codelist_url": "https://clinicalcodes.rss.mhs.man.ac.uk/medcodes/article/5/codelist/exercise_testing/download/",
"comments": {
"comment_11": {
"comment": "Codes used to identify patients meeting QOF indicator CHD 2",
"submit_date": "2014-01-27 11:54:12",
"user_name": "David Springate"
}
},
"num_codes": 18,
"user_field_1": "",
"user_field_2": "",
"user_field_3": ""
},
"hba1c_testing": {
"associated_articles": {
"5": {
"title": "Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework",
"year": 2014
}
},
"codelist_name": "HbA1C_testing",
"codelist_url": "https://clinicalcodes.rss.mhs.man.ac.uk/medcodes/article/5/codelist/hba1c_testing/download/",
"comments": {
"comment_21": {
"comment": "QOF indicators DM 5, Dm 6, DM 7",
"submit_date": "2014-01-27 13:10:10",
"user_name": "David Springate"
}
},
"num_codes": 23,
"user_field_1": "",
"user_field_2": "",
"user_field_3": ""
},
"influenza_immunisation": {
"associated_articles": {
"5": {
"title": "Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework",
"year": 2014
}
},
"codelist_name": "influenza_immunisation",
"codelist_url": "https://clinicalcodes.rss.mhs.man.ac.uk/medcodes/article/5/codelist/influenza_immunisation/download/",
"comments": {
"comment_8": {
"comment": "Codes used to identify patients matching QOF indicators ASTHMA 7, CHD 12, COPD 8, DM 18, STROKE 10",
"submit_date": "2014-01-27 11:04:30",
"user_name": "David Springate"
}
},
"num_codes": 5,
"user_field_1": "",
"user_field_2": "",
"user_field_3": ""
},
"lithium_drugcodes": {
"associated_articles": {
"5": {
"title": "Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework",
"year": 2014
}
},
"codelist_name": "Lithium_drugcodes",
"codelist_url": "https://clinicalcodes.rss.mhs.man.ac.uk/medcodes/article/5/codelist/lithium_drugcodes/download/",
"comments": {},
"num_codes": 23,
"user_field_1": "BNF_header",
"user_field_2": "BNF_code",
"user_field_3": "drug_substance_name"
},
"lithium_therapy": {
"associated_articles": {
"5": {
"title": "Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework",
"year": 2014
}
},
"codelist_name": "lithium_therapy",
"codelist_url": "https://clinicalcodes.rss.mhs.man.ac.uk/medcodes/article/5/codelist/lithium_therapy/download/",
"comments": {},
"num_codes": 18,
"user_field_1": "resolve_code",
"user_field_2": "type",
"user_field_3": ""
},
"micro-albuminuria_testing": {
"associated_articles": {
"5": {
"title": "Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework",
"year": 2014
}
},
"codelist_name": "Micro-albuminuria_testing",
"codelist_url": "https://clinicalcodes.rss.mhs.man.ac.uk/medcodes/article/5/codelist/micro-albuminuria_testing/download/",
"comments": {
"comment_16": {
"comment": "QOF indicator DM 13",
"submit_date": "2014-01-27 12:35:09",
"user_name": "David Springate"
}
},
"num_codes": 15,
"user_field_1": "",
"user_field_2": "",
"user_field_3": ""
},
"neuropathy": {
"associated_articles": {
"5": {
"title": "Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework",
"year": 2014
}
},
"codelist_name": "Neuropathy",
"codelist_url": "https://clinicalcodes.rss.mhs.man.ac.uk/medcodes/article/5/codelist/neuropathy/download/",
"comments": {
"comment_20": {
"comment": "QOf indicator DM 10",
"submit_date": "2014-01-27 12:38:53",
"user_name": "David Springate"
}
},
"num_codes": 29,
"user_field_1": "",
"user_field_2": "",
"user_field_3": ""
},
"proteinuria": {
"associated_articles": {
"5": {
"title": "Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework",
"year": 2014
}
},
"codelist_name": "Proteinuria",
"codelist_url": "https://clinicalcodes.rss.mhs.man.ac.uk/medcodes/article/5/codelist/proteinuria/download/",
"comments": {
"comment_17": {
"comment": "QOF indicator DM 13 exceptions. ",
"submit_date": "2014-01-27 12:36:27",
"user_name": "David Springate"
}
},
"num_codes": 11,
"user_field_1": "",
"user_field_2": "",
"user_field_3": ""
},
"retinal_screening": {
"associated_articles": {
"5": {
"title": "Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework",
"year": 2014
}
},
"codelist_name": "Retinal_screening",
"codelist_url": "https://clinicalcodes.rss.mhs.man.ac.uk/medcodes/article/5/codelist/retinal_screening/download/",
"comments": {
"comment_19": {
"comment": "QOF indicator DM 8",
"submit_date": "2014-01-27 12:37:35",
"user_name": "David Springate"
}
},
"num_codes": 67,
"user_field_1": "",
"user_field_2": "",
"user_field_3": ""
},
"serum_creatine_testing": {
"associated_articles": {
"5": {
"title": "Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework",
"year": 2014
}
},
"codelist_name": "serum_Creatine_testing",
"codelist_url": "https://clinicalcodes.rss.mhs.man.ac.uk/medcodes/article/5/codelist/serum_creatine_testing/download/",
"comments": {
"comment_18": {
"comment": "QOF indicator DM 14",
"submit_date": "2014-01-27 12:37:11",
"user_name": "David Springate"
}
},
"num_codes": 12,
"user_field_1": "",
"user_field_2": "",
"user_field_3": ""
},
"smoking_status": {
"associated_articles": {
"5": {
"title": "Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework",
"year": 2014
}
},
"codelist_name": "smoking_status",
"codelist_url": "https://clinicalcodes.rss.mhs.man.ac.uk/medcodes/article/5/codelist/smoking_status/download/",
"comments": {
"comment_9": {
"comment": "Codes used to identify patients meeting QOF indicators ASTHMA 4, ASTHMA 5, CHD 3, CHD 4, COPD 4, COPD 5, DM 3, DM 4, STROKE 3, STROKE 4.\r\n\r\nSmoking_status codes: \r\n0 : Non smoker\r\n1 : Ex smoker\r\n2 : Current smoker",
"submit_date": "2014-01-27 11:36:16",
"user_name": "David Springate"
}
},
"num_codes": 151,
"user_field_1": "smoking_status",
"user_field_2": "cessation_advice",
"user_field_3": ""
},
"spirometry": {
"associated_articles": {
"5": {
"title": "Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework",
"year": 2014
}
},
"codelist_name": "spirometry",
"codelist_url": "https://clinicalcodes.rss.mhs.man.ac.uk/medcodes/article/5/codelist/spirometry/download/",
"comments": {
"comment_7": {
"comment": "Codes used to identify patients achieving QOF indicators ASTHMA 2, COPD 2",
"submit_date": "2014-01-27 10:56:13",
"user_name": "David Springate"
}
},
"num_codes": 14,
"user_field_1": "",
"user_field_2": "",
"user_field_3": ""
},
"stroke": {
"associated_articles": {
"5": {
"title": "Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework",
"year": 2014
}
},
"codelist_name": "Stroke",
"codelist_url": "https://clinicalcodes.rss.mhs.man.ac.uk/medcodes/article/5/codelist/stroke/download/",
"comments": {
"comment_27": {
"comment": "Codes used to identify Stroke patients. Stroke treated as a chronic condition. Patients with any codes from this list prior to the end of a given QOF year are included for that year.",
"submit_date": "2014-01-27 14:47:40",
"user_name": "David Springate"
}
},
"num_codes": 84,
"user_field_1": "",
"user_field_2": "",
"user_field_3": ""
},
"thyroid_function": {
"associated_articles": {
"5": {
"title": "Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework",
"year": 2014
}
},
"codelist_name": "Thyroid_function",
"codelist_url": "https://clinicalcodes.rss.mhs.man.ac.uk/medcodes/article/5/codelist/thyroid_function/download/",
"comments": {
"comment_26": {
"comment": "To be used with codelist [serum_creatine_testing] to define QOF indicator MH 4 (severe mental health)",
"submit_date": "2014-01-27 14:16:22",
"user_name": "David Springate"
}
},
"num_codes": 82,
"user_field_1": "",
"user_field_2": "",
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},
"comments": {},
"correspondence_author": "Evangelos Kontopantelis",
"correspondence_email": "e.kontopantelis@manchester.ac.uk",
"date_accessed": "2014-03-05 09:05:17 GMT",
"doi": "http://dx.doi.org/10.1136/bmj.g330",
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"journal": "British Medical Journal",
"link": "http://www.bmj.com/content/348/bmj.g330?ijkey=AwxEb4LKHleAKNk&keytype=ref",
"publication_year": 2014,
"uploading_user": "David Springate"
}