PBRN Characterization & Automated NAMCS Patient Report

我们最初的计划拨款支持了执业医师研究协会（RAPP）的扩展，并显示了通过互联网和计算机电话访谈自动收集患者数据的可行性。为了响应RFA HS-01-004的两个部分，这个竞争性的延续应用程序建立在这些活动的基础上，通过提出网络定义调查和电子数据收集方法的试点测试。计划在新扩大的网络中对儿科医生进行网络定义调查。根据2001年10月AHRQ PBRN会议的决定，将鼓励彩虹办公室临床研究网络的所有171个成员，利用1999- 2000年全国门诊医疗（NAMCS）调查和NAMCS类似程序，收集30次门诊就诊的医生报告数据。彩虹办公室临床研究网络是RAPP正在扩大的大学医院卫生系统的一个附属机构。根据先前的研究，预计有30%的医生参与。NAMCS调查将与彩虹网络中正在进行的网络表征活动相结合。数据将用于回答网络临床医生提出的特定问题，并报告给集中的AHRQ存储库。在申请的第二部分，两种自动收集患者报告数据的新技术将在我们的姐妹PBRN，东北俄亥俄网络（NEON）中进行评估。NEON是第一个使用NAMCS方法描述其患者群体的PBRN。现在，10年后，30名NEON家庭医生同意使用1999-2000年NAMCS调查对30名连续门诊患者重复这一特征。每位患者还将被要求描述访问的特征，使用他们选择的两种技术：基于网络的NAMCS版本或计算机化的NAMCS电话访谈。在整个样本和患者亚组中比较患者对这些技术的偏好，并使用kappa统计来评估患者报告和医生报告访问内容的一致性。此外，具体的网络临床医生的问题，关于一致性的医生和病人的感知原因访问和访问诊断将进行评估。拟议的延续项目将利用RAPP网络的基础设施和经验，1)增强和表征作为初始计划拨款努力的一部分开发的新网络，2)通过与经验丰富的附属网络合作，评估旨在减轻网络临床医生和实践人员数据收集负担的新技术，扩大AHRQ PBRN倡议的影响。

Our initial planning grant has supported expansion of the Research Association of Practicing Physicians (RAPP) and shown the feasibility of automated collection of patient data by intemet and computerized telephone interview. This competing continuation application builds on these activities, in response to both portions of RFA HS-01-004, by proposing a network-defining survey and a pilot test of electronic data collection methods. A network-defining survey is planned among pediatricians in the newly expanded network. All 171 members of the Rainbow Office-Based Clinical Research Network, a subsidiary of the University Hospital Health System with which RAPP is expanding, will be encouraged to collect physician-report data on 30 outpatient visits, using the 1999- 2000 National Ambulatory Medical Care (NAMCS) survey and NAMCS-like procedures, as decided upon at the October, 2001 AHRQ PBRN meeting. Based on prior studies, participation by 30% of physicians is anticipated. The NAMCS survey will be integrated with ongoing network characterization activities in the Rainbow Network. Data will be used to answer specific questions proposed by network clinicians, as well as being reported to the centralized AHRQ repository. In the second portion of the application, two new technologies for automated collection of patient report data will be evaluated in our sister PBRN, the NorthEast Ohio Network (NEON). NEON was the first PBRN to characterize its patient population using the NAMCS methodology. Now, 10 years later, 30 NEON family physicians have agreed to repeat this characterization of 30 consecutive outpatient visits using the 1999-2000 NAMCS survey. Each patient will also be asked to characterize the visit, using their choice of two technologies: a web- based version of the NAMCS or a computerized telephone interview of the NAMCS. Patient preference for these technologies will be compared for the entire sample and for patient subgroups, and the concordance of patient report and physician report of visit content will be assessed with the kappa statistic. In addition, specific network clinician questions about the concordance of physician and patient perception of reason for visit and visit diagnoses will be assessed. The proposed continuation project will use the infrastructure and experience of the RAPP network to 1) enhance and characterize a new network developed as part of the initial planning grant efforts, and 2) expand the impact of the AHRQ PBRN initiative through collaboration with an experienced affiliated network to assess new technologies designed to decrease the burden of data collection b bus network clinicians and practice staff.