> For the complete documentation index, see [llms.txt](https://ourfuturehealth.gitbook.io/our-future-health/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://ourfuturehealth.gitbook.io/our-future-health/data-types/clinic-measurements-data.md).
# Clinic Measurements data
The Clinic Measurements datasets contain data collected during Our Future Health in-person appointments. These appointments include measurements of basic physical characteristics, anthropometry, and circulatory function, as well as the collection of blood samples.
Historically, Point-of-Care Testing (POCT) Lipid Profiles were also collected. All measurements are quick to obtain during a short appointment, and provide greater accuracy than is typically achievable through self-reported or questionnaire data.
Two datasets are available:
* the main Clinic Measurements table - including anthropometric and circulatory measurements
* the POCT Lipid Profile table - including total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and triglycerides concentrations. Lipid profile data are no longer being collected. Information specific to POCT Lipid Profile data can be found in [POCT Lipid Profile data](/our-future-health/data-types/clinic-measurements-data/poct-lipid-profile-data.md).
Information on the invitation process, how participants book appointments, and type of appointment venues can be found in the page on [Programme design and recruitment](/our-future-health/programme/programme-design-and-recruitment.md).
Information on how appointments are conducted can be found in the [Procedure for Clinic Measurements](/our-future-health/data-types/clinic-measurements-data/procedure-for-clinic-measurements.md).
***
### The appointment process
#### What currently happens during an appointment?
Participants book their in-person appointment at a location, date, and time of their choosing. At the 15 to 20-minute appointment, we collect several health-related measurements including:
* height (1 measurement)
* weight (1 measurement)
* waist circumference (1 measurement)
* blood pressure, heart rate and rhythm (2 to 3 readings)
* blood samples (2 x 6 mL EDTA tubes)
Devices used during the appointment are:
* height measurements: Marsden HP-250P stadiometer
* weight measurements: SECA875 scales
* heart measurements: Omron M3 BP monitor or Omron HBP 1320\*
\*The primary blood pressure device used in all venues is the OMRON M3 with universal cuff. However, since September 2023, mobile venues also had the option of a blood pressure device with interchangeable cuff sizes (OMRON HBP 1320) to use with the XL cuff when deemed clinically necessary. For new providers moving forwards, we will ask suppliers to ONLY use the OMRON HBP 1320 machines with interchangeable cuff (sized S, M, L and XL).
For further details on what happens during an appointment, see [Procedure for Clinic Measurements](/our-future-health/data-types/clinic-measurements-data/procedure-for-clinic-measurements.md).
#### What types of measurements do we collect?
The components of physical health measured during an Our Future Health appointment include the following:
* Height: the distance from the bottom of the feet to the top of the head in a human body, standing erect without shoes on (in centimetres – cm).
* Body weight: the measurement of weight without shoes or heavy accessories such as mobile phones and wallets, using a weighing scale (in kilograms – kg).
* Waist circumference: measured around the middle at a point halfway between the inferior margin and the superior border of the iliac crest, just above the belly button (in centimetres – cm).
* Blood pressure: a measure of the force that the heart uses to pump blood around the body (in millimetres of mercury - mmHg)
* systolic pressure: is measured when the heart contracts
* diastolic pressure: is measured when the heart muscle rests in between contractions
* Heart rate (also known as pulse rate): the number of times the heart beats in one minute (in beats per minute - bpm).
* Heart rhythm: recorded during blood pressure measurement and classified by the device as either regular or irregular. This measurement is not intended for clinical or diagnostic use.
#### Do all participants provide every measurement?
Not all participants attend an in-person appointment. Of participants who consent, 60.6% attended a in-person appointment, and of those, 92.5% also provided a complete questionnaire. Participants from the NHSBT (NHS Blood and Transplant) route only provide blood samples and do not undergo measurements.
Participants who do attend an in-person appointment may choose to 'skip' (i.e. not provide) some or all measurements. Data fields for measurements which may be skipped are referred to here as dynamic fields. 2.0% of participants skipped one or more measurements where optional.
All participants are eligible to have two sets of readings taken for circulatory measurements. Third readings for each of blood pressure, heart rate, and heart rhythm are obtained at the end of the appointment ONLY if *at least* *one* of the following criteria is met:
* systolic blood pressure readings 1 and 2 are either both greater than or equal to 160 mmHg or both less than 90 mmHg
* heart rate readings 1 and 2 are either both greater than or equal to 100 bpm or both less than 60 bpm
* heart rhythm readings 1 and 2 are both "irregular"
Records for measurements that were not taken from a participant are recorded as NULL. If participants skip a measurement, we also record a reason why.
For comprehensive details on each dynamic field please download the clinic measurements logic file provided below. This file outlines the logic using pseudocode, including the relevant field names and measurement values.
{% file src="/files/o7rCIT8PRFEluRI6cXMt" %}
Clinic Measurements logic information
{% endfile %}
***
### What other data is collected during the appointment?
#### POCT lipid profile data
Point-of-Care Testing (POCT) lipid profile measurements were also measured during the appointment from July 2022 until December 2024. **These data are stored in a separate entity to the main Clinic measurements entity.** For more information see [POCT Lipid Profile data](/our-future-health/data-types/clinic-measurements-data/poct-lipid-profile-data.md).
#### Clinic-level identifiers
At present, there is no direct indicator available to identify the specific geographic location of appointments or to group appointments occurring within the same physical setting. However, a set of three clinic-level variables have been derived and added to the Clinic Measurements table to enable grouping of appointments occurring within the same clinic, and under similar operational conditions. All variables are pseudocoded and have been de-identified to remove any geographically identifiable information.
`CLINIC_SITE_REF`
Each clinic is assigned a unique clinic site reference. This variable captures overall between-clinic variation driven by differences such as staff, throughput, equipment, and operational conditions. It can be used alongside appointment date to approximate clinic volume and temporal variation. Mobile units are assigned a distinct clinic site reference for each location visited.
`CLINIC_PROVIDER`
We work with multiple providers who facilitate clinic operations. The `CLINIC_PROVIDER` variable can be used to group the organisation delivering the clinic. This variable reflects high-level differences in service delivery across vendors, including systematic differences in standard operating procedures (SOPs), clinical protocols, workflow design, and resource allocation, and enables assessment of variation in outcomes across providers. For information on SOPs see [Procedure for Clinic Measurements](/our-future-health/data-types/clinic-measurements-data/procedure-for-clinic-measurements.md)
`IS_MOBILE_CLINIC`
This is a boolean variable indicating whether a clinic is delivered via a mobile unit (1 = True) or a static site (0 = False). Static sites are fixed physical clinic locations, while mobile clinics are delivered in purpose-built vehicles that operate across multiple locations.
Limitations:
Mobile clinics operate across multiple geographic locations; however, identifiers do not currently track mobile units across locations or distinguish repeated visits of the same unit to the same or similar sites using a stable identifier. Clinic site references are assigned per clinic instance rather than per physical mobile unit, limiting the ability to link the same mobile unit across different locations.
Mobile units may:
* return to the same site or visit new sites
* operate across multiple geographically distinct locations
* overlap in location with other mobile units over time
In most cases, clinics do not repeatedly return to the exact same site.
Additionally, some of our mobile clinics have operated different booking models, including pre-booked appointments, walk-ins, or a combination of both at the same site. This information is not currently captured in the clinic-level identifiers, and any effects of different booking models cannot be directly accounted for in analyses. For instance, booking type may affect engagement, completion, and clinic workflow. Pre-booked participants may be informed in advance about the purpose and structure of the appointment and the measurements to be taken, which may support more consistent expectations and participation in requested measurements. In contrast, walk-in participants may have less information around the appointment and may interpret the encounter more variably, for example as a general health check or screening interaction, which may be associated with greater variability in the completion of individual measurements or, in some cases, early termination of the assessment.
#### Device metadata
Similar to location, device metadata could be a valuable attribute for various analyses. While all venues use the same devices (some information about devices is available in the [Procedure for Clinic Measurements](/our-future-health/data-types/clinic-measurements-data/procedure-for-clinic-measurements.md)), it is not currently included in the Clinic measurements data.
#### Timestamps
The release includes a field containing the appointment date and start time (rounded to the nearest hour) for each participants record (`APPOINTMENT_DATETIME`). Individual timestamps are obtained alongside each measurement that mark the time of data capture. These are not currently included in the release. For information on the timing and order of appointments, refer to [Procedure for Clinic Measurements](/our-future-health/data-types/clinic-measurements-data/procedure-for-clinic-measurements.md).
***
### Version changes and developments
#### How has the appointment process changed over time?
Since the start of recruitment to Our Future Health, several updates to both the data capture tool (Clinical Staff Application; CSA) and supplementary materials (Standard Operating Procedures; SOPs) have been made to improve various aspects of the data capture and collection process. For details on how the appointment process has changed over time see the [Change log for Clinic Measurements appointment processes](/our-future-health/data-types/clinic-measurements-data/change-log-for-clinic-measurements-appointment-processes.md).
#### How do we use major and minor versioning?
In the Clinic measurements tables, a version indicator has been added under the column `APPOINTMENT_VERSION`. Currently there are two versions, which differ in the addition of new measurements:
* version 1 ("v1") includes the original set of measurements (height, weight, waist circumference, and up to two readings for heart rate, systolic and diastolic blood pressure)
* version 2 ("v2") includes records where appointments included the additional heart rhythm and third readings for heart measurements (heart rate and rhythm, systolic and diastolic blood pressure) or second readings for POCT lipid profile in accordance with specific criteria
***
### Clinic measurements data processing and release
#### How do we process the data for each release?
We process the raw data from all participants who were in the programme on or before the cut-off date for each release. Data for participants who have fully withdrawn from Our Future Health is deleted after they request to withdraw. Any participants who have fully withdrawn from the programme since the last data release will not be included in the current data release.
To prepare the current data release, we performed minimal additional data processing. This included the following steps:
* migrating data from the CSA (Clinical Staff Application) into our platform and matching the required format and specifications for the final tables released to the TRE
* validation against predetermined criteria for data characteristics such as data type, length, measurement units, value ranges, and minimum and maximum thresholds, and consistency with the version of the appointment attended
* adding a version indicator for each record
#### How do we de-identify the Clinic Measurements data?
As well as replacing every pseudo-anonymised clinic appointment ID with `PID`, additional de-identification steps include:
* rounding of the appointment time to the nearest hour in `APPOINTMENT_DATETIME`
* redaction of direct location and provider indicators
#### What exclusions were applied to the Clinic Measurements data?
We have identified a small number of data entry errors arising from technical duplication of data due to data capture, system or processing errors. Where identified, these records have been excluded from the release.
#### How are the Clinic measurements data organised in the Trusted Research Environment (TRE)?
The data release includes 33 variables in the Clinic Measurements table across all versions of the data. In the TRE, the data is organised into a single table. Each table can be linked to another table (for example, the Participant table) using the `PID` column. Other than `PID`, variable names are unique within and between all entities.
Note that POCT lipid profile data is also available as a separate table, with a further 19 variables, alongside Clinic Measurements data. For more information see [POCT Lipid Profile data](/our-future-health/data-types/clinic-measurements-data/poct-lipid-profile-data.md).
#### How do I interpret the structured field names?
Field names are short, descriptive, and often abbreviated names used to describe the contents of a particular column. In the Clinic Measurements table, each field name consists of two main components in the following format:
\[Primary\_topic]\_\[Unique\_descriptor]
* Primary Topic: A single term (word, phrase, or abbreviation) representing a broad category that describes the overarching family of fields or refers to the main measurement. This primary topic is often consistent across multiple fields e.g. `HEIGHT`
* Unique Descriptor (optional): One or more terms, joined by underscores, that provide specific details about the field’s content. Unique descriptors are systematically organised with sequential elements, often shared among related fields, to clarify differences and relationships between elements. Examples include `HEIGHT_SKIPPED` and `HEIGHT_SKIPPED_REASON`
#### What metadata is available to help document the Clinic Measurements release?
We provide the following data files on our [Data and cohort page (external link)](https://research.ourfuturehealth.org.uk/data-and-cohort/):
* Data dictionary - which defines the raw data fields and metadata information, such as labels, descriptions, and units of measurements
* Coding file - which contains the granular details of categorical or raw coded values
If using Microsoft Excel to browse these files, for an optimal viewing experience, ensure the encoding settings are set to UTF-8.
On the [#do-all-participants-provide-every-measurement](#do-all-participants-provide-every-measurement "mention") section above we also provide a Clinic Measurements logic codebook which includes the conditions required per measurements for the field to be not null in the data table
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