Common protocol for validation of the QCOVID algorithm across the four UK nations

Kerr, Steven and Robertson, Chris and Nafilyan, Vahe and Lyons, Ronan A and Kee, Frank and Cardwell, Christopher R and Coupland, Carol and Lyons, Jane and Humberstone, Ben and Hippisley-Cox, Julia and Sheikh, Aziz (2022) Common protocol for validation of the QCOVID algorithm across the four UK nations. BMJ Open, 12 (6). e050994. ISSN 2044-6055 (

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Introduction: The QCOVID algorithm is a risk prediction tool for infection and subsequent hospitalisation/death due to SARS-CoV-2. At the time of writing, it is being used in important policy-making decisions by the UK and devolved governments for combatting the COVID-19 pandemic, including deliberations on shielding and vaccine prioritisation. There are four statistical validations exercises currently planned for the QCOVID algorithm, using data pertaining to England, Northern Ireland, Scotland and Wales, respectively. This paper presents a common procedure for conducting and reporting on validation exercises for the QCOVID algorithm. Methods and analysis: We will use open, retrospective cohort studies to assess the performance of the QCOVID risk prediction tool in each of the four UK nations. Linked datasets comprising of primary and secondary care records, virological testing data and death registrations will be assembled in trusted research environments in England, Scotland, Northern Ireland and Wales. We will seek to have population level coverage as far as possible within each nation. The following performance metrics will be calculated by strata: Harrell’s C, Brier Score, R2 and Royston's D. Ethics and dissemination: Approvals have been obtained from relevant ethics bodies in each UK nation. Findings will be made available to national policy-makers, presented at conferences and published in peer-reviewed journal.