The Bristol archive project
General practice accounts for over 85% of all NHS doctor–patient encounters. However our understanding of what happens during these encounters is limited because of a relative lack of research in situ. This has been attributed to perceived difficulties in recording routine primary care consultations, including obtaining ethical permissions, recruiting participants and organising data collection, safe transfer, and storage. Most consultations research has been based on patient interviews, surveys, or medical records, which provide a limited and potentially biased account of what actually occurs. In contrast, some of the earliest and most influential studies in the history of general practice research were based on the study of directly observed or recorded consultations. Since then, although other researchers have collected recordings of UK primary care consultations, most of these have relied on audio-only recordings and have not been collected with data sharing in mind.
The aim of the Bristol Archive Project was to create a set of high-quality video-recorded GP–patient consultations, plus linked practice, GP, and patient data, with consent for reuse for the purpose of future research and teaching.
We wanted the dataset to be useful to as a wide a range of researchers as possible. We surveyed key people in UK academic primary care, asking them what sort of information and measures would be most useful to collect for a range of different projects. This informed our plan for data collection as shown in the oval shapes in the diagram above.
The video recordings were collected in and around Bristol in 12 different GP practices – six in areas of high deprivation and six in areas of low deprivation. We recruited up to two GPs in each practice and filmed willing adult patients who had an appointment to see these GPs over two agreed data collection days. In addition to capturing basic data on patient, GP, and practice characteristics, we asked patients to fill out three surveys: one immediately before they went in to see the GP, one immediately after they came out, and a follow-up survey ten days later. The GPs also filled out a survey for us at the start of our data collection, and a brief checklist after each recording. We also collected data entered in the electronic health records for the index visit, and noted any further related visits that patients made up to three months later. Information about our data collection methods and the data characteristics can be found in our data paper.
The resulting dataset was named the ‘One in a Million primary care consultation archive’ because we know that around one million patients visit a GP every day in England and our dataset represents a snapshot of those encounters.
Read more about the creation of the archive in our 'Spotlight on Data' blog post.