The International Classification of Primary Care (ICPC) has, since its introduction in 1987, been quite successful. Now in its second revised version, it has been translated in 22 languages, accepted by the World Health Organization (WHO) as a member of the Family of International Classifications, and is being widely used both in routine daily practice and in research. In this contribution, it is explained that ICPC was designed as a theoretical classification, and that it has especially great potential when used (1) supported by the ICPC2/ICD10 Thesaurus, (2) in sufficiently large studies to allow all classes to be observed often enough to provide reliable data, and (3) in studies based on data on episodes of care, rather than encounter data only. Under these conditions, the likelihood ratios of symptoms given a diagnosis, and of co-morbidity become available, which define the clinical content of family practice.

Introduction: Diagnostic error is a major threat to patient safety in the context of family

The 591h meeting of the European General Practice Research Network' (EGPRN, formerly EGPRW) was held in delightful surroundings and wonderful weather on the Mediterranean island of GOZO, Malta, in October 2004. The theme of the meeting 'Research using electronic patient records in general practice' had prompted preliminary workshops on the principles underlying routine record construction for research, and on the use of the International Classification of Primary Care (ICPC) for practice-based research.2 The meeting attracted several high-quality contributions which have prompted this opportunity to take stock and consider prospects for the use of electronic records as a research instrument. Keynote speeches took for granted the demise of the paper record: there were practices in almost all countries represented that were now paperless, though no estimates were available on the numbers or proportions of general practitioners (GPs) concerned. It was suggested that a paperless electronic medical record (EMR) would cost less to maintain than a paper-based equivalent because of the great savings to be obtained by automated transfer of information and the elimination of manual filing systems. Nonetheless, correct filing procedures are essential if the filing capacity of the computer is to be exploited for patient management, regardless of secondary research-oriented objectives. The primary purpose of the record is to provide a faithful and accurate description of the interaction be-Douglas M Fleming general practitioner and director