Static outliers for Dr Singh M

There is substantial variation in prescribing behaviours, across various different areas of medicine. Some variation can be explained by demographic changes, or local policies or guidelines, but much of the remaining variation is less easy to explain. At OpenPrescribing we are piloting a number of data-driven approaches to identify unusual prescribing and collect feedback on this prescribing to inform development of new tools to support prescribers and organisations to audit and review prescribing.

This report has been developed to automatically identify prescribing patterns at a chemical level which are furthest away from “typical prescribing” and can be classified as an “outlier”. We calculate the number of prescriptions for each chemical in the BNF coding system using the BNF subparagraph as a denominator, for prescriptions dispensed between April 2021 and August 2021. We then calculate the mean and standard deviation for each numerator and denominator pair across all practices/CCGs/PCNs/STPs. From this we can calculate the “z-score”, which is a measure of how many standard deviations a given practice/CCG/PCN/STP is from the population mean. We then rank your “z-scores” to find the top 5 results where prescribing is an outlier for prescribing higher than its peers and those where it is an outlier for prescribing lower than its peers.

It is important to remember that this information was generated automatically and it is therefore likely that some of the behaviour is warranted. This report seeks only to collect information about where this variation may be warranted and where it might not. Our full analytical method code is openly available on GitHub here.

The DataLab is keen to hear your feedback on the results. You can do this by completing the following survey or emailing us at ebmdatalab@phc.ox.ac.uk. Please DO NOT INCLUDE IDENTIFIABLE PATIENT information in your feedback. All feedback is helpful, you can send short or detailed feedback.

Prescribing where Dr Singh M is higher than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Undecenoates 4 Antifungal preparations 14 0.29 0.00 0.01 41.82
Azilsartan medoxomil 7 Angiotensin-II receptor antagonists 627 0.01 0.00 0.00 30.30
Atenolol with calcium channel blocker 22 Beta-adrenoceptor blocking drugs 795 0.03 0.00 0.00 29.62
Antazoline 14 Other anti-inflammatory preparations 36 0.39 0.01 0.03 13.50
Chlordiazepoxide hydrochloride 7 Anxiolytics 44 0.16 0.01 0.02 9.88

Prescribing where Dr Singh M is lower than most

BNF Chemical Chemical Items BNF Subparagraph Subparagraph Items Ratio Mean std Z_Score Plots
Colecalciferol 315 Vitamin D 391 0.81 0.96 0.02 -6.36
Adcal-D3 chewable tablets tutti frutti : 54
Adcal-D3 Dissolve 1500mg/400unit effervescent tablets : 30
Adcal-D3 750mg/200unit caplets : 43
Fultium-D3 3,200unit capsules : 39
InVita D3 50,000unit capsules : 49
InVita D3 25,000unit capsules : 2
Calcichew D3 chewable tablets : 1
Calcichew D3 1000mg/800unit Once Daily chewable tablets : 1
Colecalciferol 200unit / Calcium carbonate 750mg tablets : 4
Calcichew D3 Forte chewable tablets : 4
InVita D3 800unit capsules : 4
Colecalciferol 2,400units/ml oral drops sugar free : 3
SunVit-D3 400unit tablets : 3
Fultium-D3 800unit capsules : 3
InVita D3 400unit capsules : 3
Colecalciferol 800unit capsules : 12
Adcal-D3 Lemon chewable tablets : 12
SunVit-D3 800unit tablets : 12
SunVit-D3 1,000unit tablets : 25
Calci-D 1000mg/1,000unit chewable tablets : 6
Colecalciferol 400unit / Calcium carbonate 1.5g chewable tab : 5
Valganciclovir hydrochloride 0 Cytomegalovirus infection 1 0.00 0.97 0.16 -6.12
Ivermectin 0 Topical preparation for rosacea 2 0.00 0.88 0.24 -3.72
Benzydamine hydrochloride 2 Drugs for oral ulceration and inflammation 7 0.29 0.83 0.18 -2.92
Other food for special diet preparations 5 Foods for special diets 103 0.05 0.65 0.25 -2.41