Temte J L, Beasley J W
University of Wisconsin, Department of Family Medicine, 777 South Mills St, Madison, WI 53715, USA.
J Fam Pract. 2001 Nov;50(11):977.
Practice-based research is one method for answering questions about common problems that are seen infrequently in referral centers. We explored the potential limitations of this method.
This was a prospective observational cohort study of participants in a practice-based research network who submitted data on 231 patients with dyspepsia from a total of 45,337 patient encounters over a 53-week period. Reporting of individual cases involved use of a relatively high-burden data instrument. Outcome measures were compared using rank correlation.
We included 18 physicians in a Wisconsin research network study on initial management of dyspepsia in primary care settings.
The outcomes we measured were the rate of dyspepsia visits, average weekly patient volume, and self-reported compliance to the study protocol for each physician.
A significant negative correlation existed between physician patient volume and the reported rate of dyspepsia visits. Self?reported compliance with the protocol was negatively correlated to patient volume and positively correlated to the reported rate of dyspepsia visits.
Practice volume may influence the results in practice-based research. Investigators using practice-base research networks need to consider the complexity of their protocols and should be cognizant of compliance-sensitive measures.
基于实践的研究是回答有关转诊中心不常见的常见问题的一种方法。我们探讨了这种方法的潜在局限性。
这是一项对基于实践的研究网络中的参与者进行的前瞻性观察队列研究,这些参与者在53周内从总共45337次患者诊疗中提交了231例消化不良患者的数据。单个病例的报告涉及使用负担相对较重的数据工具。使用等级相关性比较结果指标。
我们纳入了威斯康星州一个研究网络中18名医生,该研究网络针对初级保健机构中消化不良的初始管理。
我们测量的结果是每位医生的消化不良就诊率、每周平均患者量以及自我报告的对研究方案的依从性。
医生的患者量与报告的消化不良就诊率之间存在显著负相关。自我报告的对方案的依从性与患者量呈负相关,与报告的消化不良就诊率呈正相关。
实践量可能会影响基于实践的研究结果。使用基于实践的研究网络的研究人员需要考虑其方案的复杂性,并应认识到对依从性敏感的指标。