Medical Centre

Patients are increasingly using the Internet to rate their physicians. In a study published in the Journal of Medical Internet Research , Felix Greaves and colleagues examined the usage of NHS Choices, a government website that encourages patients to rate the quality of family practices in England, and associations between web-based patient ratings and conventional measures of patient experience and clinical quality in primary care. Greaves and colleagues obtained all ratings of family practices posted on NHS Choices between October 2009 and December 2010. They then examined associations between patient ratings and family practice and population characteristics. Associations between ratings and survey measures of patient experience and clinical outcomes were also examined. They reported that 61% of the 8089 family practices in England were rated, and 69% of ratings would recommend their family practice. Practices serving younger, less deprived, and more densely populated areas we...

The number of children admitted to hospital in England for acute throat infections increased by 76 per cent between 1999 and 2010, according to new research published by Elizabeth Koshy and colleagues in the journal Archives of Disease in Childhood . The article was covered by a number of media outlets, including the BBC . Acute throat infection (ATI), which includes acute tonsillitis and acute pharyngitis, is one of the most common reasons for consulting a GP. The majority of ATIs are self-limiting and can be managed at home or by the GP, but a small proportion may require hospital admission. This study investigated admission rates for children up to age 17 with ATI alongside trends in tonsillectomy rates, between 1999 and 2010.  The study was motivated by concerns that the decline in tonsillectomy rates in recent years has led to an increase in hospital admissions for tonsillitis of increased severity. It also investigated whether performing fewer tonsillectomies is associat...

Targeted screening for cardiovascular disease (CVD) can be carried out using existing data from patient medical records. However, electronic medical records often contain missing data for which values must be estimated to produce risk scores. In a paper published in the journal Informatics in Primary Care , Andrew Dalton and colleagues compared two methods of substituting missing risk factor data: multiple imputation and the use of default National Health Survey values. They used patient-level data from patients in 70 general practices in Ealing, London and substituted missing risk factor data using the two methods. They reported that using multiple imputation, mean CVD risk scores were similar to those using default national survey values, a simple method of imputation. There were fewer patients designated as high risk (>20%) using multiple imputation, although differences were again small (10.3% compared with 11.7%; 3.0% compared with 3.4% in women). Agreement in high-risk clas...

Linkage between routinely collected hospital birth and other records offers the potential for epidemiological and public health research by developing population-level birth cohorts with lifelong follow-up. In a paper published in the Journal of Public Health , Jo Murray and colleagues from Imperial College London examined the range and completeness of birth information recorded in Hospital Episode Statistics (HES) and tested an approach for minimizing the effect of hospital-level variations by selecting hospitals with high completeness of recording (≥90%) for key fields. The authors reported that the proportion of missing data in key birth record fields such as gestational age and birth weight has been decreasing annually (from 46.2 and 43.9% in 2005/06 to 18.1 and 16.9% in 2009/10, respectively). There was however a wide variation in the completeness of recording between hospitals. The authors concluded that the completeness of recording of hospital birth information varies greatly ...