Abstract

Around half of myocardial infarction deaths still occur without a prior hospital admission. This challenges conventional surveillance, highlights the risk of selection bias inherent in hospital-based datasets. From a clinical cardiology standpoint, we will examine what large administrative datasets can and cannot tell us about the epidemiology of myocardial infarction in England. Are these data sufficiently robust to shape policy and drive meaningful change? Drawing on a real-world example from primary care in North West London, we will consider whether current data systems can move beyond describing burden to reducing it – and whether linked primary care data can move us towards a whole system perspective to close the gap between measurement and action.