University of Manchester

Faculty of Life Sciences

PhotoGraphics Unit

The blue instruction columns are for your help

designing and will not print out on your poster

This PowerPoint 2007 and 2010 poster template produces a portrait

style poster. It is initially designed as a two column poster (although

this can be altered – see Modifying instructions below) and includes

the University Logo, Faculty Name and Faculty web address. This

template can be printed to any of the International Standard Paper

sizes (A0,A1,…etc)

The template should help design a well laid out scientific poster and

will hopefully save you time by not having to start from scratch.

The template has all the elements you need to create your poster,

and by simply dragging and dropping the individual poster elements

you can quickly and simply get a well laid out poster.

If you have any questions regarding the templates, or if you want to

get your poster printed by us please contact :

PhotoGraphics Unit on Tel: 0161 275 5258 or

Email: photographics.lifesciences@manchester.ac.uk

Modifying the Poster Layout

This PowerPoint 2007-10 template has three different column

layouts. To change to one of the different layouts, Right-click your

mouse on the background (not on the columns or title bar) and click

on “Layout” to see the different layout options.

The columns in the provided layouts are fixed and cannot be moved but advanced users can modify

any layout by going to VIEW and then SLIDE MASTER.

Using the placeholders

To add text to this template click inside a placeholder and type in or

paste your text. To move a placeholder, click on it once (to select it),

place your cursor on its frame and your cursor will change to the

symbol of your ‘mouse pointer on a cross’.

You can then, click once and drag it to its new location where you

can resize it as needed.

Additional placeholders for Titles, Text and Images can be found on

the right hand instruction column of this template.

Viewing your poster

To get an idea as to how you poster will look, you can view the

template at the size it will look like when printed. To see what you

poster will look like at A0 view the template at 100%. To view your

poster at A1 view the template at 70% (to zoom in and out go to the

VIEW menu and click on ZOOM to set your preferred magnification).

Removing Template Elements

To remove any of the Sub-Title Bars and text boxes that are already

on the template and that you don’t need, just select them with the

mouse and press the delete key.

Importing Text and Graphics from External

Sources

Text: Paste or type your text into a pre-existing placeholder or drag

in a new placeholder from the left side of the template. Move it

anywhere as needed.

Photos/Images: Drag in a picture placeholder, size it first, click in it

and insert a photo from the menu.

Tables: You can copy and paste a table from an external document

onto this poster template. To adjust the way the text fits within the

cells of a table that has been pasted, right-click on the table, click

FORMAT SHAPE then click on TEXT BOX and change the

INTERNAL MARGIN values to 0.25

Graphs: You should save graphs as image files such as jpeg, in the

programme that you created them in e.g. excel, and then insert

them into the poster using the Photo/Images instruction above. (Don’t copy and paste you graph from the programme e.g. Excel directly into the template as the graph

may not print properly)

Poster Elements

Use the sections provided below to add new elements to your

poster: Drag a placeholder onto the poster area, size it, and click in

it to edit.

Sub-Heading placeholder

Move this sub-heading placeholder onto the poster to add another

sub-heading. Use section headers to separate the sections and

topics on your poster.

Text placeholder

Move this preformatted text placeholder to the poster to add a new

body of text.

Picture placeholder

Move this graphic placeholder onto your poster, size it first, and then

click it to add a picture to the poster.

PhotoGraphics Unit – University of Manchester

1.828 Stopford Building, Oxford Road, Manchester, M13 9PT

Tel: 0161 275 5258

Email: photographics.lifesciences@manchester.ac.uk

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Funded by the National Institute for Health Research (NIHR) School for Primary Care Research.

This is a summary of independent research funded by the NIHR. The views expressed are those

of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

Background

Centre for Primary Care: www.population-health.manchester.ac.uk/primarycare

Centre for Biostatistics: www.population-health.manchester.ac.uk/biostatistics

For example, in 45 UK PCD case-control studies into diabetes:

Only 5 reported ANY clinical codes in the paper

Only 2 published lists of codes in an online appendix

Only 1 Provided a full set of code lists for the study

So, in 44 out of 45 studies, given the original paper, there is no

way of independently assessing the validity of how diseases,

exposures, treatments or outcomes were defined or of

replicating the research.

1. Shephard et al. Family Practice 2011; 28:4

2. Brookhart et al. Medical Care 2010; 48:6

3. Jordon et al. Family Practice 2004; 21:4.

4. Smeeth et al. Family Practice 2006; 23:5

• All historical code-lists

published on

clinicalcodes.org are freely

downloadable

• The repository will host the

full set of Read codes from

all versions of the Quality

and Outcomes Framework

(QOF) from 2004 – 2012

• Other clinical codes (e.g.

SNOMED, ICD-10) can

also be deposited

• Can also be used to host

database-specific coding

information (e.g. CPRD

consultation types)

• Codes from other

Electronic medical record

database studies can also

be hosted

The repository would be most effective if…

• Deposition of all clinical codes was a prerequisite for publication of all

future PCD studies

• Funding bodies included deposition as a pre-condition for funding

• Authors of historical PCD studies were encouraged to deposit their

codes post-publication

We are working to automate up/download via an API

Challenges

Improving validity and reproducibility

of primary care database studies:

An online clinical codes repository

University of Manchester Centre for Primary Care / Centre for Biostatistics

David A. Springate, Evangelos Kontopantelis, David Reeves and Ivan Olier

Knowledge of the clinical codes used in a PCD study is critical to

determining its validity because…

1. The ways in which populations, diseases, exposures, treatments and

outcomes are defined through code lists can have a large impact on the

results

2. If a code list for a study is unavailable, that study is impossible to

properly validate or replicate

However, there is currently no…

• Obligation on researchers to publish clinical codes lists by journals or

research councils

• Centralised repository to hold archived clinical code lists

This means that the vast majority of published PCD studies do not

publish their clinical codes and so are impossible to properly validate.

The problem

We are developing an online repository where researchers can freely

deposit their lists of clinical codes at the time of publication in a

standardised way, along with links to the original paper and meta-data on

the codes used.

www.ClinicalCodes.org

• Clinical codes can be held to scrutiny and peer-review in the same way

as any other research methods

• Replication of previously published studies (e.g. in different databases) is

facilitated

• Access to historical code-lists allows researchers and clinicians to make

incremental improvements to disease (and other) definitions, building on

and avoiding unnecessary replication of previous work

• Clinical code lists can become a resource for future research in their own

right (e.g. tracking disease definitions through time)

Advantages

david.springate@manchester.ac.uk

www.clinicalcodes.org – online from July 2013

@medcodes – follow us to keep up with updates to the repository

Contact and references

• Large Primary Care Databases (eg CPRD, Qresearch, THIN) are

increasingly used to address a wide range of research questions1

• Much research has been done into establishing the validity of statistical

analysis of PCD data, e.g. the role of confounding variables2, GP

recording quality3 and selection bias4

• BUT PCDs also rely on clinical codes (such as Read codes) to provide

standardised means for medical professionals to record clinical

information. The validity of PCD studies depends upon the validity of the

clinical codes used to define the population of interest, their disease

conditions, exposures, treatments and outcomes

New primary care

database (PCD) studies

are being published at an

exponential rate