As we mentioned earlier, part of the motivation behind developing this web page was to explore the shortcomings of this approach to risk prediction. Before discussing these drawbacks, there are two major benefits worth mentioning.
The World Wide Web paradigm facilitates access to database information and risk predictions. At the same time, the database and prediction systems remain under the control of the web page authors. Maintenance or alteration to these systems is a straightforward matter, as opposed to situations where software is supplied on portable media ( e.g. , diskette or CD-ROM).
The QAMC web page demonstrates a number of practical ways to allow large amounts of data to be ``mined'' for useful information. Simple database look-up enables clinicians to determine rates of incidence of failure to progress across over 770 000 cases. With a little extra effort, more powerful search engines could provide information on more complex queries. Further analyses, such as risk prediction, can be supplied if necessary.
Note that identifying information can easily be excluded from such database and prediction systems. ISD Scotland and other database providers have ensured that patient anonymity has been preserved at all stages of the QAMC project.
A great many databases of patient information have been, and continue to be collected. The collection of this information is often funded by public money, yet the data is seldom made publicly available. Patient confidentiality is often cited as a primary reason for this secrecy but, as the QAMC web page demonstrates, access to useful information can be provided without compromise to privacy.