Overview of archived data

‘One in a Million’ was a prospective observational study that has created a unique initial dataset of recorded consultations plus linked survey and electronic patient records data that can be shared for future research and teaching purposes

Data were collected in and around the City of Bristol between July 2014 - April 2015 from 327 unselected adult patients (18-96 years of age) consulting with 23 GPs in 12 different general practices across areas of high and low deprivation. 89.8% (n=300) consented to data access by ‘other researchers, subject to specific ethical approval’ and 89.5% (n=299) consented to data access by ‘approved researchers and university teachers’ for the development of medical and research training materials

In addition to consultation recordings and verbatim transcripts, the dataset comprises a wide range of measures at practice level, GP level, patient level and visit level.

What measures have been collected?

TimelineMeasures
Pre-data collection

Practice data
GP demographics and survey

Immediately pre-consultation

Patient demogrphics and survey

 Index consultation Length of consultation
Problems presented
Issues discussed
Drug treatments recommended
 Immediately post consultation Patient survey
GP checklist
 Follow up at 10 days Patient survey
 At 3 months  Patient record data

   At practice level

  • Information was collected for each participating practice including geographical location, urban/rural classification, patient list size, area related deprivation score, dates on which data was collected, QOF achievement, staffing, score on doctor-patient communication items on GP-Patient Survey, volume of appointments and prescribing rate in the month of data collection.
  • Recruitment data including numbers of sessions attended for data collection, numbers of appointments, DNAs, ineligible patients and reasons for ineligibility, patients missed, number of eligible patients, patients declined, patients consented, camera error, patients who withdrew, patients enrolled, practice consent rate, and numbers of video recordings vs audio-only

At GP level

  • GPs completed a survey on the first day of data collection including demographic information (year of qualification, time working at the practice, gender, age, employment status, working hours, whether they were an accredited trainer, prior experience of being video recorded, country of birth, ethnic group, main language), Job Satisfaction and Job Stress scales9 and items about Work-Related Burnout10
  • GPs completed a post-appointment checklist for each recorded consultation reporting on post-visit experiences1, perception of decision-making4, familiarity with the patient, clinical certainty over treatment plan and confidence in the patient to follow it. The mode of recording is included here.

At patient level

  • Pre-appointment survey including demographic information (gender, age, home owner, educational attainment, marital status, living arrangements, employment status, country of birth, ethic group, main language), reason for the visit, visit status, problem duration, pre-visit expectations1, control preferences scale2, perceived influence over consultation outcome1, and questions about perceived physical and mental health status using the EQ-5D3
  • Post-appointment survey including post-visit experiences1, patient perception of decision-making4, satisfaction with visit, the Patient-Doctor Depth-of-Relationship Scale5 and the Patient Enablement Index6
  • Follow-up survey 10 days after the index recording containing questions about recall and adherence to GP-initiated prescription drug and self-care treatment recommendations using an investigator-adapted version of the Brief Medication Questionnaire7, plus the Beliefs about Medicines Questionnaire8 and the EQ-5D3
  • Information written by GPs relating to the index visit and any related subsequent events 3 months post index consultation (re-consulting, home or out-of-hours visit, emergency department visit, unplanned hospital admission) will be extracted from the medical records.
  • Patient consents for future use and mode of recording

At visit level

  • Type and number of health problems discussed11
  • Consultation length
  • Medicines discussed.

 For more information on how to access the data for your research, please click here


References

  1. Bowling A, Rowe G, Lambert N, Waddington M, Mahtani KR, Kenten C, Howe A, Francis SA. The measurement of patients' expectations for health care: a review and psychometric testing of a measure of patients' expectations. Health Technol Assess. 2012 Jul;16(30):i-xii, 1-509.
  2. Degner LF, Kristjanson LJ, Bowman D, et al. Information needs and decisional preferences in women with breast cancer. JAMA 277:1485-1492, 1997.
  3. Herdman M, Gudex C, Lloyd A et al. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L) Qual. Life Res. 2011;20(10):1727–1736.
  4. Janz NK, Wren PA, Copeland LA, Lowery JC, Goldfarb SL, Wilkins EG. Patient-Physician Concordance: Preferences, Perceptions, and Factors Influencing the Breast Cancer Surgical Decision. JCO Aug 1, 2004:3091-3098.
  5. Ridd M J, Lewis G, Peters T J, Salisbury C. Patient-Doctor Depth-of-Relationship Scale: Development and Validation. The Annals of Family Medicine 2011; 9(6): 538-545.
  6. Howie JG, Heaney DJ, Maxwell M et al. A comparison of a patient enablement instrument (PEI) against two established satisfaction scales as an outcome measure of primary care consultations. Fam. Pract. 1998;15:165-171.
  7. Svarstad B, Chewning B A, Sleath B L, Claesson C. The brief medication questionnaire: a tool for screening patient adherence and barriers to adherence. Patient Education and Counselling. 1999; 37: 113-24.
  8. Horne R, Weinman J. Patients’ beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. J Psychosom Res 1999;47:555–67.
  9. Sutherland VJ, Cooper CL. Job stress, satisfaction, and mental health among general practitioners before and after introduction of new contract. BMJ 1992;304:1545-8.
  10. Kristensen TS, Borritz M, Villadsen E, Christensen KB. The Copenhagen Burnout Inventory: A new tool for the assessment of burnout. Work & Stress 2005;19(3).
  11. Procter S, Stewart K, Reeves D, Bowen L, Purdy S, Ridd M, Salisbury C. Complex consultations in primary care: a tool for assessing the range of health problems and issues addressed in general practice consultations. BMC Family Practice 2014, 15:105.