What did we learn from the era of big data?

I would like to thank Professor de Lusignan et al for their extremely constructive and up-to-date comments about ‘Data saves lives’,¹ which may help healthcare professionals in the broader health community to achieve data-based, goal-oriented diagnostic and treatment strategies. However, as a young GP who experienced the entirety of the COVID-19 pandemic, I can’t help but question whether the data we see with our naked eyes are credible.

First, routine health data may influence treatment strategies and vaccination against COVID-19, but the data are highly biased due to differences in policies and populations (including gender, age composition, and literacy) across regions. Therefore, conclusions and strategies from extensive health data may not apply to all regions.

Second, the so-called Trusted Research Environments (TREs) proposal may exist only in the ideal. We cannot grant people’s wishes, either in terms of transparency or openness of work, because there is social stability, an economic bias, and an orientation to decision making. The criticism will probably always be there.

Third, innovation and centralisation are, in fact, in conflict with each other. The expertise of so-called expert teams is probably, in most cases, generated in centralisation. Thus, the federated TRE model may still end up being swallowed up by centralisation.

As de Lusignan et al said, ‘Top-down changes can cause unintentional disruptions and render a complex ecosystem dysfunctional.’ However, in the age of big data, if data frameworks, data quality, and trustworthy research environments are not established in a practical, truthful, and standard way, then the seemingly transparent data would be the start of the following health problem chaos of this era. As a GP in a third-world country, I look forward to applying a thriving but sensitive health data ecosystem to assist in primary care systems’ diagnosis and treatment strategies in the post-COVID-19 era.

• © British Journal of General Practice 2023