PRP129: Opportunities to improve primary care research reports to meet needs of researchers, clinicians, patients and policymakers

William Phillips, MD, MPH, FAAFP; Elizabeth Sturgiss, MD, PhD, BMed, MPH, FRACGP; Grant Russell, PhD, MBBS, FRACGP MFM; Tim olde Hartman, MD, PhD; Aaron Orkin, MD, MPH, MSc, CCFP(EM) FRCPC; Joanne Reeve, PhD, MBBS, MBChB, MPH; Angela Yang; Liesbeth Hunik, MSc; Paul Glasziou; Chris van Weel, MD, PhD


Context: CRISP - Consensus Reporting Items for Studies in Primary Care (CRISP) - is an international, multidisciplinary initiative to identify opportunities to improve the reporting of research in primary care (PC). Previous CRISP research documents user difficulty using reports of PC research, particularly in synthesizing findings across studies, applying to policy and transferring to practice. Objective: To identify opportunities to improve the reporting of PC research. Study Design: Two online surveys with targeted, convenience and snowball sampling. Setting: International, multidisciplinary PC research and clinician communities. Population studied: General survey of PC research users: researchers, practitioners, educators, policymakers, patients, and communities. Additional focused survey of clinicians working half-time or more in PC practice. Outcome Measures: Open text comments on reports of PC research regarding special needs in PC, common problems, and potential areas for improvement. Results: Total of 580 respondents across both surveys. General survey of PC research community yielded 286 respondents from 23 nations (USA 40%, Australia 16%, Canada 8%, UK 5%, Netherlands 4%); females 54%; physicians 60% (with 92% being FPs); investigators 26%, clinicians 16% and patients 7%; with full range of research experience. Focused survey of practitioners yielded 294 respondents with a similarly broad distribution, 85% physicians (88% (154) FPs, 9% (15) internal medicine). Free-text answers detailed concerns about special needs and challenges for PC research in categories of planning studies, context of research, research methods, dissemination, implications, implementation, research training, and ethical issues. The greatest needs were for better reporting of the context of clinical care and setting, practical details of interventions, complex nature of relationships (both clinician-patient and teams), transferability, and impact in the great variety of PC practice settings. Conclusions: Opportunities exist to make PC research more valuable for its many users by improving the ways it is reported. CRISP - Consensus Reporting Items for Studies in Primary Care - is working to develop guidelines to help improve the reporting of PC research.
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Paul James 11/21/2020

Bill, Thank you for sharing this work. It identifies the important issue of "context." In research, this goes by the terms generalizability (application to specific situations" or External Validity. You may enjoy the commentary on this I recently wrote in Family Medicine Journal.

Bill Phillips 11/21/2020

Thanks, Paul. The generalizability of conclusions, transferability of findings and implementation of interventions are more challenging in the complex world of primary care by the diversity of practice settings, patient populations, community environments, etc. Primary care readers also want to know the context in more depth than is traditionally reported in much biomedical research. They want to know more about: illnesses versus disease and diagnoses; relationships between clinicians and patients and among teams; adaptations made in study protocols and clinical interventions; practical details necessary for implementation in the real world of their own practices with their own patients. Traditionally, many researchers do not understand these nuances or report this information. Often this highly valued information is left out of research reports. We hope to understand, identify and prioritize the needs of PC researchers and readers to help improve the usefulness of our research reports. You expand on some of these same concerns in the excellent article your wrote with Chip Mainous: James PA, Mainous III AG. The Challenge of External Validity: Why Specialties Interpret Evidence Differently. Fam Med. 2020;52(8):548-50. doi: 10.22454/FamMed.2020.476348.

Bill Phillips 11/22/2020

If any NAPCRG friends are interested in participating in our upcoming Delphi study to prioritize the essential content of PC research reports, please contact me – Bill Phillips -

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