Correa Ana, Hinton William, McGovern Andrew, van Vlymen Jeremy, Yonova Ivelina, Jones Simon, de Lusignan Simon
Department of Clinical and Experimental Medicine, University of Surrey, Guildford, UK Royal College of General Practitioners, London, UK.
Department of Clinical and Experimental Medicine, University of Surrey, Guildford, UK.
BMJ Open. 2016 Apr 20;6(4):e011092. doi: 10.1136/bmjopen-2016-011092.
The Royal College of General Practitioners Research and Surveillance Centre (RCGP RSC) is one of the longest established primary care sentinel networks. In 2015, it established a new data and analysis hub at the University of Surrey. This paper evaluates the representativeness of the RCGP RSC network against the English population.
The cohort includes 1 042 063 patients registered in 107 participating general practitioner (GP) practices. We compared the RCGP RSC data with English national data in the following areas: demographics; geographical distribution; chronic disease prevalence, management and completeness of data recording; and prescribing and vaccine uptake. We also assessed practices within the network participating in a national swabbing programme.
We found a small over-representation of people in the 25-44 age band, under-representation of white ethnicity, and of less deprived people. Geographical focus is in London, with less practices in the southwest and east of England. We found differences in the prevalence of diabetes (national: 6.4%, RCPG RSC: 5.8%), learning disabilities (national: 0.44%, RCPG RSC: 0.40%), obesity (national: 9.2%, RCPG RSC: 8.0%), pulmonary disease (national: 1.8%, RCPG RSC: 1.6%), and cardiovascular diseases (national: 1.1%, RCPG RSC: 1.2%). Data completeness in risk factors for diabetic population is high (77-99%). We found differences in prescribing rates and costs for infections (national: 5.58%, RCPG RSC: 7.12%), and for nutrition and blood conditions (national: 6.26%, RCPG RSC: 4.50%). Differences in vaccine uptake were seen in patients aged 2 years (national: 38.5%, RCPG RSC: 32.8%). Owing to large numbers, most differences were significant (p<0.00015).
The RCGP RSC is a representative network, having only small differences with the national population, which have now been quantified and can be assessed for clinical relevance for specific studies. This network is a rich source for research into routine practice.
皇家全科医师学院研究与监测中心(RCGP RSC)是历史最悠久的基层医疗哨点网络之一。2015年,它在萨里大学建立了一个新的数据与分析中心。本文评估了RCGP RSC网络相对于英国人口的代表性。
该队列包括在107家参与研究的全科医生(GP)诊所注册的1042063名患者。我们在以下方面将RCGP RSC的数据与英国国家数据进行了比较:人口统计学;地理分布;慢性病患病率、管理及数据记录完整性;以及处方开具和疫苗接种情况。我们还评估了参与一项全国拭子采样计划的网络内诊所。
我们发现25 - 44岁年龄组的人群在该队列中略多,白人种族、贫困程度较低的人群在队列中的占比略少。地理上主要集中在伦敦,英格兰西南部和东部的诊所较少。我们发现糖尿病(全国:6.4%,RCGP RSC:5.8%)、学习障碍(全国:0.44%,RCGP RSC:0.40%)、肥胖症(全国:9.2%,RCGP RSC:8.0%)、肺部疾病(全国:1.8%,RCGP RSC:1.6%)以及心血管疾病(全国:1.1%,RCGP RSC:1.2%)的患病率存在差异。糖尿病患者人群危险因素的数据完整性较高(77 - 99%)。我们发现感染方面的处方开具率和费用存在差异(全国:5.58%,RCGP RSC:7.12%),营养和血液疾病方面也存在差异(全国:6.26%,RCGP RSC:4.50%)。2岁患者的疫苗接种率存在差异(全国:38.5%,RCGP RSC:32.8%)。由于样本数量庞大,大多数差异具有统计学意义(p<0.00015)。
RCGP RSC是一个具有代表性的网络,与全国人口仅有微小差异,现在这些差异已被量化,并且可以针对特定研究评估其临床相关性。该网络是研究常规医疗实践的丰富资源。