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How to set up a clinical database
  1. Mark Wardle1,
  2. Martin Sadler2
  1. 1Department of Neurology, University Hospital Wales, Cardiff, UK
  2. 2Department of Neurology, Derriford Hospital, Plymouth, UK
  1. Correspondence to Dr Mark Wardle, Department of Neurology, Cardiff and Vale University Health Board, Cardiff CF14 4XW, UK; mark{at}

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What is a database?

A database is a logically integrated collection of data, organised to facilitate the efficient storage, modification and retrieval of related information.

Most neurologists already interact with databases frequently. Many such interactions are read-only, providing access to a hospital's laboratory or radiology result reporting system or a clinical document held within an electronic patient record (EPR). However, most of us increasingly use databases to view, and create data, such as electronic notes or letters or to record information as part of a wider EPR system.

Why get involved in designing a clinical database?

UK health organisations already record core demographic information about patients in a database called ‘patient administrative system’ (PAS). This typically includes name, address, date of birth, National Health Service (NHS) number, hospital identifiers as well as appointments and episodes of care. There will be separate databases to support laboratory results, radiology results and clinical documents, and such data may be combined into what looks like a single application for clinicians called a ‘portal’. Some of you will already have a hospital-wide electronic health record (EHR).

As such, why should you think about data in your neurological practice?

To support individual clinical care

Medical records are not simply a narrative record of what has happened to a patient, but when properly constructed and formatted, integrate and synthesise clinical information and support clinical practice. The record includes history and examination results, problem lists, diagnoses, management and clinical outcomes, and so the design and structure of these records is critical in supporting your clinical work. Electronic records, when properly designed by clinicians for clinicians, have the potential to transform clinical care by ensuring that important data are available at the point-of-care, and are presented in a way to support your work. For example, rather than recording a patient's weight in the paper record, an electronic record can track weight over time in a routine …

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  • ▸ Additional material is published online only. To view, please visit the journal online (

  • Competing interests MW has recently started his own software company.

  • Provenance and peer review Commissioned; externally peer reviewed. This paper was reviewed by David Nicholl, Birmingham, UK.

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