Related Experiment Video
Updated: Sep 6, 2025
06:28
E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
8.4K
Can primary care research be conducted more efficiently using routinely reported practice-level data: a cluster
Peter S Blair1, Jenny Ingram2, Clare Clement3
1Centre for Academic Child Health, University of Bristol, Bristol, UK p.s.blair@bris.ac.uk.
BMJ Open
|July 1, 2022
Summary
This study shows that using routinely collected data for primary outcomes in primary care trials is feasible in England. This efficient design, avoiding individual patient recruitment, can improve the infrastructure for future research.
Area of Science:
- Primary Care Research
- Clinical Trials Methodology
- Health Services Research
Background:
- Conducting randomized controlled trials (RCTs) in primary care presents challenges, including selection bias from time-limited consultations and high costs associated with accessing patient records.
- Investigating efficient trial designs is crucial for improving the feasibility and scalability of primary care research.
Purpose of the Study:
- To assess the barriers and facilitators of an efficient randomized controlled trial (RCT) design in primary care.
- To evaluate the viability of using aggregate, routinely collected data for primary outcomes in a primary care setting.
Main Methods:
- An RCT was designed to reduce antibiotic prescribing for children with acute cough and respiratory tract infections (RTIs) using a practice-level, clinician-focused intervention.
- Aggregate data on antibiotic dispensing and hospital admissions for RTIs were used as coprimary outcomes, eliminating the need for individual patient recruitment.
- Data were collected from general practitioner practices and interviews were conducted with stakeholders from Clinical Research Networks (CRNs) and Clinical Commissioning Groups (CCGs).
Main Results:
- The study successfully recruited 294 out of 310 intended practices (95%), representing a substantial proportion of the child population.
- Data collection for coprimary outcomes achieved nearly 100% completeness.
- Engagement with CRNs was straightforward, but variability was observed in CCG engagement; practice IT system updates and familiarity posed minor challenges requiring extended support.
Conclusions:
- The infrastructure for conducting primary care trials using routinely collected data for primary outcomes is viable in England.
- This efficient trial design, leveraging aggregate data, should be promoted to enhance primary care research where appropriate.
Related Concept Videos
01:20Study Designs in Epidemiology
397
Epidemiological study designs are fundamental tools for investigating the distribution, determinants, and control of health conditions in populations. They help researchers understand the relationships between exposures and outcomes, and they broadly fall into two categories: "observational" and "experimental" studies.
Observational studies are those where the researcher does not intervene but rather observes natural variations. They include cross-sectional, cohort, and...
Observational studies are those where the researcher does not intervene but rather observes natural variations. They include cross-sectional, cohort, and...
397
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
169
Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
169
01:16Clinical Trials
7.2K
Clinical trials are prospective experimental studies conducted on humans to determine the safety and efficacy of treatments, drugs, diet methods, and medical devices. Using statistics in clinical trials enables researchers to derive reasonable and accurate conclusions from the collected data, allowing them to make wise decisions in uncertain situations. In medical research, statistical methods are crucial for preventing errors and bias.
There are four phases in a clinical trial. A phase one...
There are four phases in a clinical trial. A phase one...
7.2K
01:30Primary Healthcare Services
1.5K
Primary care promotes wellness and prevents disease. This care includes health promotion, education, protection (such as immunizations), early disease screening, and environmental considerations. Settings providing this type of healthcare include physician offices, public health clinics, school nursing, and community health nursing.
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
1.5K
01:12Hazard Ratio
238
The hazard ratio (HR) is a widely used measure in clinical trials to compare the risk of events, such as death or disease recurrence, between two groups over time. It reflects the ratio of hazard rates—the instantaneous risk of the event occurring—between a treatment group and a control group. This measure provides valuable insights into the relative effectiveness of a treatment by assessing how the risk of an event differs between the two groups.
For example, in a clinical trial...
For example, in a clinical trial...
238
01:11Clinical Trials: Overview
3.3K
Clinical development focuses on how the drug will interact with the human body and encompasses four key phases of clinical trials, each serving a specific purpose in assessing the safety and effectiveness of new drugs. These phases overlap and build upon one another. Phase I involves a small group of healthy volunteers (typically 20-80 individuals) or, in cases where significant toxicity is expected, patients with the targeted disease, such as cancer or AIDS. The volunteers are tested for...
3.3K