The 'One in a Million' study: creating a database of UK primary care consultations

Abstract

Background: Around 1 million primary care consultations happen in England every day. Despite this, much of what happens in these visits remains a 'black box'.

Aim: To create an archive of videotaped consultations and linked data based on a large sample of routine face-to-face doctor-patient consultations with consent for use in future research and training.

Design and setting: Cross-sectional study in 12 general practices in the west of England, UK.

Method: Up to two GPs from each practice took part in the study. Over 1 to 2 days, consecutive patients were approached until up to 20 eligible patients for each GP consented to be videotaped. Eligible patients were aged ≥18 years, consulting on their own behalf, fluent in English, and with capacity to consent. GP questionnaires were self-administered. Patient questionnaires were self-administered immediately pre-consultation and post-consultation, and GPs filled in a checklist after each recording. A follow-up questionnaire was sent to patients after 10 days, and data about subsequent related consultations were collected from medical records 3 months later.

Results: Of the 485 patients approached, 421 (86.8%) were eligible. Of the eligible patients, 334 (79.3%) consented to participate and 327 consultations with 23 GPs were successfully taped (307 video, 20 audio-only). Most patients (n = 300, 89.8%) consented to use by other researchers, subject to specific ethical approval.

Conclusion: Most patients were willing to allow their consultations to be videotaped, and, with very few exceptions, to allow recordings and linked data to be stored in a data repository for future use for research and training.

Keywords: data sharing; databases, factual; general practice; office visits; physicians; physician–patient relations; primary health care.

Figure 1.

Flow diagram of patient recruitment and response rates.