Tierney William M, Oppenheimer Caitlin C, Hudson Brenda L, Benz Jennifer, Finn Amy, Hickner John M, Lanier David, Gaylin Daniel S
Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis, Ind, USA.
Ann Fam Med. 2007 May-Jun;5(3):242-50. doi: 10.1370/afm.699.
Increasing numbers of primary care practice-based research networks (PBRNs) are being developed in the United States to perform research relevant to everyday practice. To assess the current status and potential value of this resource, we surveyed US primary care PBRNs in operation from late 2003 to early 2004.
We performed a Web-based survey and structured interviews with PBRN directors and administrative officers, assessing PBRNs' history, size, location, organization, resources, operations, and productivity (funding obtained, studies performed, and articles published).
Of 111 primary care PBRNs identified, 89 (80%) responded to the survey. The 86 (77%) meeting the criteria for primary care PBRNs contained 1,871 practices, 12,957 physicians (mean 152 per PBRN, median 100), and 14.7 million patients (mean 229,880 per PBRN, median 105,000). Minority and underinsured patients were overrepresented. The average PBRN was young (4.4 +/- 5.7 years): one-half had performed 3 or fewer studies. Three-quarters were affiliated with universities. Common research foci included prevention, diabetes, cardiovascular risk factors, and mental health. Respondent PBRNs had published more than 600 articles in peer-reviewed journals. PBRNs studying questions posed by outside researchers had more federal funding (84% vs 27%, P=.006). PBRNs citing funding as a weakness relied more on local resources to fund research projects (70% vs 40%, P=.036).
American primary care PBRNs are mainly young, diverse, and pursuing a variety of research foci. Most have university links and provide a dynamic town-gown relationship that could be a vital national resource for improving primary care, translating research into practice, and meeting the National Institutes of Health Roadmap goals. PBRNs merit further attention from both private and public funding agencies and researchers interested in studying the delivery of primary care.
美国正在建立越来越多基于初级保健实践的研究网络（PBRN），以开展与日常实践相关的研究。为评估这一资源的现状和潜在价值，我们于2003年末至2004年初对美国正在运营的初级保健PBRN进行了调查。
我们通过网络调查以及与PBRN主任和行政官员进行结构化访谈，评估了PBRN的历史、规模、地点、组织、资源、运营和生产力（获得的资金、开展的研究以及发表的文章）。
在确定的111个初级保健PBRN中，89个（80%）回复了调查。符合初级保健PBRN标准的86个（77%）包含1871个诊所、12957名医生（每个PBRN平均152名，中位数100名）以及1470万名患者（每个PBRN平均229880名，中位数105000名）。少数族裔和未参保患者的比例过高。PBRN的平均成立时间较短（4.4±5.7年）：一半的PBRN开展的研究不超过3项。四分之三的PBRN与大学有关联。常见的研究重点包括预防、糖尿病、心血管危险因素和心理健康。参与调查的PBRN已在同行评审期刊上发表了600多篇文章。研究外部研究人员提出问题的PBRN获得的联邦资金更多（84%对27%，P = 0.006）。将资金视为薄弱环节的PBRN更多地依靠当地资源为研究项目提供资金（70%对40%，P = 0.036）。
美国的初级保健PBRN主要成立时间短、种类多样，且研究重点各异。大多数与大学有联系，并提供了一种活跃的产学研关系，这可能成为改善初级保健、将研究转化为实践以及实现美国国立卫生研究院路线图目标的重要国家资源。PBRN值得私人和公共资助机构以及对研究初级保健服务感兴趣的研究人员给予进一步关注。
