Jack Anderson: Transforming the reporting of national patient outcomes with Shiny

Описание: In June 2020, the National Disease Registration Service began reporting 30-day mortality post-Systemic Anti-Cancer Therapy (SACT) Case-Mix Adjusted Rates (CMAR) to NHS trusts in England. This work applies logistic regression to report trust-level case-mix adjusted 30-day mortality rates, which enable comparisons between trusts and with the national average. Historically, results were shared as an Excel workbook with an accompanying companion brief and FAQ document, and each report was shared in isolation from previous releases. Since April 2023, implementation of R Shiny has enabled 30-day mortality rates to be reported seamlessly on an interactive, publicly accessible dashboard. Utilising the Plotly and DT packages, dynamic funnel plots and data tables are tailored to user needs through Shiny input pickers, which reactively subset and summarise data visualisations based on user selections.

This enables NHS trust users to flexibly review their 30-day mortality outcomes against those of other trusts, their wider Cancer Alliance, and national averages, both overall and stratified by key patient demographics.

The Shiny dashboard also enables users to view current and previous CMAR reports together in one place and includes download button functionality for documentation and underlying data. With dedicated tabs for summary data, trust exclusions, and trust response statements, Shiny allows for end-to-end exploration of CMAR outcomes, making it easier for users to gain insight into clinical practice. The resulting Shiny dashboard supports clinical governance within trusts and enables clinical colleagues to better understand their patient outcomes within their wider context.