About this study

We want to identify who is most at risk of serious outcomes (i.e. hospital admissions, death) if they develop an infection in their airways over the 2022-23 winter period.

In November 2022, Health Data Research UK (HDR UK) and the National Institute for Health and Care Research (NIHR) announced they would fund rapid, 3-month long projects aimed at easing winter pressures on the NHS.

In total, 16 projects have been funded, with each investigating different priority topics which will help inform the NHS's compound policy and operational response to future winter health and care pressures.

Find out more about HDR UK's Winter Pressures funding call

Now the EAVE II team are extending their work beyond COVID-19 surveillance and aim to describe, characterise and predict winter respiratory accident and emergency attendances, as well as hospital and intensive care unit admissions and deaths.

More specifically, the EAVE II team are working towards:

1. Describing and characterising children and adults experiencing severe respiratory health outcomes across Scotland;
2. Identifying independent risk factors for respiratory-related A&E attendance, hospital admission, ICU admission, mechanical ventilation and death.
3. Laying the foundations for the development and validation of winter respiratory risk prediction models in children and adults.​​​​​​
4. Identifying modifiable risk factors that can potentially improve respiratory outcomes in high risk individuals.

Our study will provide key data urgently required by policymakers and NHS leaders, which will help to understand and predict what emergency care people are likely to need in the future.

Each winter NHS services come under immense pressure, in part due to the annual increase in Acute Respiratory Tract Infections (ARTIs). This increase usually begins in the autumn with the start of the new school year and then persists throughout the winter months.

However, the pressures the NHS has experienced over the ongoing 2022-23 winter period have reached unprecedented levels. This is because the usual strains are being exasperated by the ongoing COVID-19 pandemic, NHS staff absences and vacancies, and the cost of living crisis.

In addition, there are also major concerns about increases in the number of cases and severity of the respiratory syncytial virus (RSV) as it has already been reported in parts of the United States and Europe, as well as other ARTIs such as Streptococcus A.

By identifying people who are at the highest risk of serious outcomes needing, for example, hospital admission or use of a ventilator, it may be possible to intervene early to improve outcomes and reduce the pressure on our NHS.

Our team will look at individuals across the entire population of Scotland who experienced severe respiratory health outcomes between 1 September 2022 and 31 January 2023. This will include:

• Children and adults across all age groups
• People who were alive and living on 1 September 2022
• People who have primary care records prior to 1 September 2022

The 'severe outcomes' the team are looking at are:

• Hospitalisations

  • ​​​​​​A&E attendance;
  • Emergency hospital admission;
  • ICU admission;
• Deaths

We will also look at a patient's length of stay in hospital, and whether they required serious medical interventions such as oxygen therapy or mechanical ventilation.

Our analyses will focus on severe outcomes caused by SARS-CoV-2 (coronovirus), RSV, influenza, Streptococcus A and other ARTIs including co-infection (i.e. more than one infection occurring at any one time).

To do this, we will expand upon our previous work , which has supported Scotland's response to the COVID-19 pandemic by tracking it and its effects, as well as the uptake, safety effectiveness and waning of COVID-19 vaccines.

Find out more about EAVE II

This will involve use using a range of routinely collected, linked data from across Scotland including:

• A&E attendance 
• GP data (e.g. patient characteristics, acute respiratory infections, vaccination status etc.)
• Laboratory data (e.g. RT-PCR tests, multiplex tests)
• Medication data
• Mortality records
• Secondary care data (e.g. emergency and non- emergency hospital admissions, ICU)

Find out more about EAVE II data

This study will run from 1 January - 31 March 2023.

Visit the HDR UK website at: NHS Winter pressures could be addressed by research harnessing big data, machine learning and artificial intelligence - HDR UK