Pracitcal everyday science – data collection in routine care

Data collection in our own practices is very basic daily repetitious work. It is every day a small effort, then waiting and, much later, getting results.

The Dutch project began 6 years ago. There were:

• an ECH standard,

• a good computer program, a combination of a practice administration program and a registration tool: HARP,

• the understanding that we should work together,

• support by the national society VHAN,

• a grant by VSM and a pharmacy (Hahnemann Pharmacy),

• support by the DHU, sharing the main aspects of their ISH-10 project.

So all members (400) of the VHAN received a free copy, and 20 members (now 25) started to work with HARP. After 6 years, 60.000 consultations have been monitored.

What do we register?

• Name?: no names, the data are anonymous but retraceable by the participating doctor,

• Data of birth/age,

• Gender,

• Diagnosis in ICPC-coding,

• Quality of life (Euroqol measure),

• The remedy, including dose, etc.

Result; measured by the Glasgow Homeopathic Hospital Outcome Scale (GHHOS).

The idea was and is that the more we ask, the less doctors will participate or will be able to keep participating.

Apart from or in addition to this bare backbone, extra projects can be superimposed, as we are doing now, with a likelihood ratio project and, starting soon, an adverse reactions project.

Is this research?

You might call this an uncontrolled multicentred prospective documentation approach study. It is more proto-research, defining and exploring areas for possible future research, getting suggestions of the therapeutic effectiveness and efficiency of our education program.

The information from the study is rudimentary rather than in-depth, though it can help in finding the more interesting cases within our own databases.

There are, as a result of the latest collection of data, a lot of interesting things to be seen and this will be shown at the congress. These include:

• age and gender patterns,

• diagnoses as reason for encounter,

• quality of life changes (in effect: ameliorations) per diagnosis or per remedy,

• result per remedy and per diagnosis: Which diagnoses can we treat well, which do we have difficulties with? Which remedies do we prescribe with success, which not?

• remedies effective per diagnosis.

Apart from this we can try to validate our parameters like GHHOS and Euroqol.

Future plans:

• More participants,

• Easy feedback and a simplified program, even for cyber-novices,

• To use the results for adjusting and benchmarking our continuous education programme,

• Projects like L/R project and adverse events registration,

• Advertising our good results to profile homeopathy as a viable first-choice treatment,

• (Restricting patients with poor treatment prognoses),

• Joining international projects.

Motto for data collection:

A little bit of work every day, improves your work and keeps the critics away.

Keywords:

Prospective documentation in general practice, clinical research.

Schlüsselwörter:

Prospektive Falldokumentation in Arztpraxen, klinische Forschung.

Korrespondierender Autor: Dr. Dick Koster, Th. Mansholtstraat 5a, NL-2331 JE Leiden, Netherlands

E-Mail: [e-mail]