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Visits to pediatric practice-based research network offices are representative of national pediatric outpatient visits

Practice-based research networks (PBRNs), in which multiple primary care practices study similar clinical problems, have become an important feature of primary care research. The generalizability of PBRN patient samples has been called into question. However, a new study found no significant differences among the top five practitioner visit diagnoses between the Pediatric Research in Office Settings (PROS) and National Ambulatory Medical Care Survey (NAMCS) data. Thus, the PROS patient population is reasonably representative of patients who are seen in U.S. ambulatory office-based pediatric primary care practices, concludes Eric J. Slora, Ph.D., of the American Academy of Pediatrics.

Dr. Slora and colleagues collected the PROS data of 1,706 pediatric patient visits from the offices of 57 randomly selected network practitioners in 2002. They compared this data to data from the same period of 948 randomly selected pediatric patient visits in the offices of the 33 primary care pediatric practitioners who had participated in the NAMCS. Patient gender, ethnicity, and socioeconomic status, as well as visit characteristics, were similar for both the PROS and NAMCS patients. However, PROS children were about 1 year older and were comprised of a significantly lower proportion of black patients than their NAMCS counterparts.

The top six reasons for visits mentioned by parents of both groups were remarkably similar in rank order and proportions. However, there were overall differences, mostly attributable to a larger number of the "other" category in the PROS cases. Despite the benefit of PROS "real world" settings and large data samples, the PROS network will need to remain vigilant for biases that might limit the applicability of study conclusions, caution the researchers. Their study was supported in part by the Agency for Healthcare Research and Quality (HS13512).

See "Patient visits to a national practice-based research network: Comparing pediatric research in office settings with the National Ambulatory Medical Care Survey," by Dr. Slora, Kathleen A. Thoma, M.A., Richard C. Wasserman, M.D., M.P.H., and others, in the August 2006 Pediatrics 118(2), pp. e228-e234.

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