J Am Board Fam Med
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Letter Comparative Study
Comparison of point of care and laboratory HbA1c analysis: a MetroNet study.
Evaluating new technology in clinical practice is an important component of translating research into practice. We considered the feasibility of using a Clinical Laboratory Improvement Amendments (CLIA)-waived point of care (POC) glycohemoglobin (HbA1c) methodology in busy family medicine centers by comparing the results of POC HbA1c and laboratory analysis results. ⋯ Before adopting a POC methodology, practices are encouraged to review its feasibility in the context of the office routine, and also to conduct periodic comparisons of the accuracy of POC test results compared with those from laboratory analysis.
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Continuing growth of the research spectrum of practice-based research networks (PBRNs) creates a need (1) for new approaches to training clinicians in research protocols and (2) to standardize clinician data collection. Each existing training method has shortcomings when used in geographically dispersed PBRNs. We describe here the use and costs of Internet-based training in support of a research protocol across a PBRN consortium. ⋯ The Internet can be an effective and feasible alternative method for training clinicians in support of PBRN research.
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Practice-based research network (PBRN) study investigators must interface with multiple Institutional Review Boards (IRBs), many of which are unfamiliar with PBRN research. ⋯ IRB requirements not directly responsive to federal regulations can add significant costs, frustrations, and burdens to PBRN studies. Non-federally mandated IRB requirements should be based on an identified need with evidence to support the solution.
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The development of a pan-Canadian network of primary care research networks for studying issues in primary care has been the vision of Canadian primary care researchers for many years. With the opportunity for funding from the Public Health Agency of Canada and the support of the College of Family Physicians of Canada, we have planned and developed a project to assess the feasibility of a network of networks of family medicine practices that exclusively use electronic medical records. ⋯ This article reports on the 7-month first phase of the feasibility project of 7 regional networks in Canada to develop a business plan, including governance, mission, and vision; develop memorandum of agreements with the regional networks and their respective universities; develop and obtain approval of research ethics board applications; develop methods for data extraction, a Canadian Primary Care Sentinel Surveillance Network database, and initial assessment of the types of data that can be extracted; and recruitment of 10 practices at each network that use electronic medical records. The project will continue in phase 2 of the feasibility testing until April 2010.
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Maternal medical care (prenatal and postpartum) involves a set of clinical interventions addressing risk factors associated with important maternal and infant outcomes. Programs to increase the rate of delivery of these interventions in clinical practice have not been widely implemented. ⋯ A practice-based research network of family medicine residency practices focused on CQI outcomes was successful in increasing the delivery of some maternal care interventions.