Opportunistic research in general practice using a low cost microcomputer based medical record system as a tool

Area of Science:

• Medical Informatics
• Clinical Research Methodology
• Public Health

Background:

• Implementing research in clinical settings presents challenges.
• Opportunistic research can leverage existing patient data.
• Computerized medical record systems offer potential for research facilitation.

Purpose of the Study:

• To evaluate the feasibility of opportunistic research using a low-cost microcomputer-based medical record system.
• To describe the process of setting up a clinical trial protocol within a teaching clinic.
• To identify and address sampling biases in opportunistic research.

Main Methods:

• Utilized a low-cost microcomputer-based medical record system in a teaching clinic.
• Conducted a clinical trial comparing breast self-examination teaching methods.
• Described research protocol development, patient sampling, and data analysis.
• Analyzed data after 1.5 years, focusing on sampling bias.

Main Results:

• Identified sampling bias: older patients with more problems and higher clinic attendance were overrepresented.
• Demonstrated that bias can be corrected by stratifying data based on attendance rates.
• Acknowledged non-compliance bias from patients and staff as a potential issue.
• Confirmed that useful results can be obtained from opportunistic research.

Conclusions:

• Computerized medical record systems simplify the implementation of opportunistic research.
• Awareness and correction of sampling biases are crucial for valid research findings.
• Opportunistic research is a viable method for generating clinical insights with limited resources.