PubMed HealthSearch

PubMed · 8443486

Developing a research and development strategy for primary care.

Abstract

General practice research has been a minority activity and underfunded in the past. The creation of the purchaser and provider split, the introduction of medical audit, and the new research and development strategy for the NHS provide an opportunity to focus research on the health needs of the population. FHSAs, with the regional health authority, should develop a local strategy for research and development and appoint a lead officer, who may be the medical adviser. When negotiating contracts FHSAs need to back up their arguments with research evidence. NHS development research should cover quality, distribution, accessibility, outcome, and effectiveness. FHSAs should play a part in disseminating knowledge in the interests of achieving an effective and high quality service. GPs should be encouraged to participate in research by relaxing the regulations of compulsory hours of patient service and by creating a practice development allowance.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

A Harris. 1993-01-16. Developing a research and development strategy for primary care.. https://doi.org/10.1136/bmj.306.6871.189

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

The accuracy of diagnoses as reported in families with cancer: a retrospective study.

Assessment of risk of developing hereditary cancer and subsequent clinical surveillance is largely based on family history. It is considered standard practice to confirm as many diagnoses as possible in cancer families. Our aim was (1) to assess inaccuracies in reporting of cancers by families, (2) to assess the need for confirmation of diagnosis, and (3) to estimate how many families would have been entered unnecessarily or excluded from screening. A retrospective study of 595 case notes was performed in two centres. Methods of confirmation included information from the cancer registries, death certificates, hospital notes, and histopathological records. Accuracy varied by site of cancer and by the closeness of the relationship to the affected person. Reported abdominal malignancies were inaccurate in 20%, whereas 5% of reported breast cancers were inaccurate. In two families the family history of cancer proved fictitious. Management was altered in 231213 (11%) families following cancer confirmation. The results of the study favour verification of cancer diagnoses particularly if decisions regarding surveillance or prophylactic surgery are based on the family history.

Family Health

Modelling the cause of dependency with application to filaria infection.

A preliminary data set is analysed containing filaria specific IgG4 and IgE levels and the presence of microfilariae of 196 people from families of a village in Indonesia. Since filaria infected people may not be microfilaria positive, a filaria infection can easily be missed. First, the probabilities of a filaria infection are estimated from the IgG4 levels and the presence of microfilariae using the EM algorithm. By dichotomizing these probabilities, infection status is estimated for each person. Then for IgG4, IgE and infection status, the correlations between observations are modelled. Three causes for a correlation are considered, namely genetic, intra-uterine or environmental effects. The correlation structure of the genetic and the intra-uterine effects are quite similar and consequently it may be difficult to disentangle them. Empirical variograms are plotted and the various variance components are estimated by maximizing the log-likelihood. For infection status an environmental effect is found and for IgG4 and IgE levels genetic effects are found.

Family Health