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  • Writer's pictureBecky Sarson

Real World, Real Data

RWE (real-world evidence) is often used to glean statistical data, which is then reported as facts. However, RWE practitioners understand that data should be analysed in the context of how it was gathered and reported. This allows for a deeper understanding of the information.

With various new data sources, it's becoming easier to access real-time information about patients and healthcare organisations. However, a metric that appears across these datasets may not always match up. This is where a deep understanding of how and why this data is collected comes into play.

This article will explore some of the challenges and opportunities of using real-world data for research and decision-making.

Why Is There A Need For RWE?

Knowing which metrics to look at and how to interpret them is critical for making sound decisions based on RWE. The data collected in the real world can be messy and challenging to work with. But with the right tools and approach, it can provide valuable insights that can help improve patient care.

Key UK Datasets

Let's consider some key UK datasets currently in use.

Hospital Episode Statistics (HES)

HES is a database that gathers information on all second-care providers in England and can be used to track a patient's activity regardless of where they are admitted.

HES is used for the reimbursement of hospitals from their CCG, this is in admitted patient care only and therefore the recording of activity is generally very reliable. However, outpatient care is reimbursed using a different approach and the recording of diagnoses and activities here is poor compared with admitted patient care.


Primary care information was collected from clinics that use EMIS prescribing systems. A rolling panel of individuals accounts for most of the UK population (approximately 13%). This is a representative sample of the general public. CPRD offers another data set known as CPRD GOLD. Since this uses Vision software, a software with a market share that's going down, there's a move away from this as a data source.


The Quality and Outcomes Framework data is an opt-in survey that requests information from UK healthcare providers. In the last year, this has been decoupled from payments to account for COVID strain on the system. In the past, this was linked to payment schemes and therefore had a high response rate.QOF will more closely represent the CPRD database, though the coverage will be lower as this data is volunteered rather than mined as CPRD data is.

Finding The Right Data

When looking for real-world data, it's essential to consider the source of information. Each dataset has its strengths and weaknesses, which means that the wrong dataset used in the right situation can lead to bad decision-making.

One way to determine the quality of a dataset is to look at how it's been used in the past. If there are no publications or presentations that use the data for your specific query,, it may not be as appropriate as other sources.

However, the best way is to make use of a team of experts that are experienced in working with real-world data. They will be able to advise you on the best sources of information and how to use them effectively.


At Twist Health, we work to figure out how we can solve genuine problems for our pharmaceutical clients, provide value back into the healthcare field, and, most importantly, improve the lives of patients and HCPs worldwide.

Whether helping clients with their commercial strategy, understanding the patient journey, or developing new ways to measure outcomes, we're always looking for ways to add value.

Please contact us if you are interested in learning more about our work or collaborating with us on a project.

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