Article Figures & Data
Tables
Question Who Completed Survey Cards No. of Practices No. of Clinicians No. of Cards Distributed DMII = type 2 diabetes mellitus; HbA1c = glycated hemoglobin; NA = not available; PBRN = practice-based research network: SNOCAP = State Networks of Colorado Ambulatory Practices and Partners. a Questions initiated by PBRN practicing clinician. Condition-specfic card study What factors influence changes in type 2 diabetes treatment?14,15 Clinicians: card attached to all HbA1c laboratory results 19 88 483 What factors influence changes in blood pressure treatment in type 2 diabetes?16,a Clinicians: card attached to all DMII patient visits 26 NA 778 To determine the adherence to Institute for Safe Medication Practices recommendations regarding sample provision in primary care17 Site visit Clinicians and patients: when sample medications given out 17 NA 585 (clinician) 27 (patient) What are the primary reasons a pharmacy calls to clarify a prescription?18 Nurses: after every pharmacy prescription clarification call 22 NA 567 What types of medical errors occur in ambulatory primary care?19,20 Practice clinicians, nurses, or staff: anonymous or confidential cards 33 475 708 What are the presenting features of acanothosis nigricans? Physicians: using a personal digital assistant (PDA) 2 20 311 Prevalence card study What is the impact of patient medication requests on the clinical encounter?21,a Clinicians: card placed on every chart at time of visit 22 168 1,647 What factors influence referral for Mental Health services? a Clinicians: card placed on every chart at time of visit 30 170 1,693 Description of clinical information missing at the time of visit22,a Clinicians: card placed on every chart at time of visit 32 253 1,614 What factors are associated with colorectal cancer screening in rural primary care? Clinicians Nurses/staff Patients 21 46 63 570 (patient) What factors are associated with colorectal cancer screening in rural primary care? Clinicians Nurses/staff Patients 42 94 118 851 (patient) What is the prevalence of underinsurance in ambulatory primary care?23,a Patients: card given to every patient on day 1 37 NA 1,133 Description of ambulatory care patients and encounters24,25 Clinicians: card for every other patient until 100 completed 7 NA 2,773 Description of smoking identification and cessation activities Site visit Staff and clinicians Patients 7 NA 465 (clinician) 627 (patient) What are the current practices for screening women of reproductive age for alcohol abuse? Clinicians and nurses: clinician- and patient-linked cards Funded, in development
Additional Files
Supplemental Appendixes & Figures
Supplemental Appendix 1. Linked Data in Card Studies; Supplemental Figure 1. Practice-level data in a PBRN.; Supplemental Figure 2. Linking practice, clinician, and patient data in observational survey research.; Supplemental Figure 3. Linking physician and patient study cards.; Supplemental Figure 4. A novel approach to link patient and clinician data.; Supplemental Appendix 2. IRB and HIPAA for Card Studies;
Files in this Data Supplement:
- Supplemental data: Appendixes & Figures - PDF file, 8 pages, 254 KB
The Article in Brief
Card Studies For Observational Research in Practice
John M. Westfall , and colleagues
Background The card study is a method for gathering data about primary care clinicians, patients, and their care. It is a type of brief survey completed by clinicians as they see patients. This article describes the research questions a card study can address, types of card studies, resources required, issues of human subjects protection and implementation, and future considerations for card study research.
What This Study Found Card studies can be designed to study specific conditions or care (clinicians complete a card when they encounter patients who meet inclusion criteria) and to determine trends and prevalence of conditions (clinicians complete a card on all patients seen during a period). Data can be collected from both clinicians and patients and linked.
Implications
- Card studies remain a robust research tool for primary care practice-based research networks because they are inexpensive, flexible, standardized, customizable, and easy to develop and use.
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