Rate of Case Reporting, Physician Compliance, and Practice Volume in a Practice-Based Research Network Study

Academic physicians, with low practice volumes, may be more likely to be compliant with research protocols in general, regardless of their practice volumes. Because of the small sample size, however, this alternate hypothesis cannot be examined independently. With the exclusion of the academic physicians, relationships between the variables demonstrated the same trends, but the Spearman rank correlations were no longer significant (n = 14; patient volume vs rate: rs = -0.345; patient volume vs compliance: rs = -0.187; compliance vs rate: rs = 0.379).

This study does, however, challenge other investigators using PBRNs to revisit suitable data to determine similar patterns. Also, a simple assessment of participant compliance might prove to be an essential enhancement of future practice-based research.

Conclusions

Even encumbered with potential methodologic dilemmas, practice-based research studies may be the only way to approach many common medical issues in the context of the communities in which they occur.^1-3 For example, while selection bias in reporting of dyspepsia is clearly a problem in this example, the selection bias is still far less severe than it would be in the gastrointestinal specialty clinic of a referral center. Likewise, if nonreferred conditions are to be tracked over extensive periods of time, the use of community settings is essential, as was done with a recent longitudinal study of depression.¹³

Acknowledgments

Funding for this study was provided through a grant from the American Academy of Family Physicians. We thank the following participants of the WReN Practice-Based Research Group: R. Baldwin, E. Barr, D. Baumgardner, A. Berlage, M. Chin, D. Erickson, R. Erickson, G. Gay, M. Grajewski, D. Hahn, T. Hankey, D. Madlon-Kay, A. Marquis, E. Ott, D. Pine, and L. Radant.