Rate of case reporting, physician compliance, and practice volume in a practice-based research network study.

ABSTRACT

OBJECTIVE: 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. STUDY DESIGN: 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. POPULATION We included 18 physicians in a Wisconsin research network study on initial management of dyspepsia in primary care settings. OUTCOMES MEASURED 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. RESULTS: 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. CONCLUSIONS: 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.