Card Studies for Observational Research in Practice

Abstract

PURPOSE Observational studies that collect patient-level survey data at the pointof-care are often called card studies. Card studies have been used to describe clinical problems, management, and outcomes in primary care for more than 30 years. In this article we describe 2 types of card studies and the methods for conducting them. METHODSWe undertook a descriptive review of card studies conducted in 3 Colorado practice-based research networks and several other networks throughout the United States. We summarized experiences of the State Networks of Colorado Ambulatory Practices and Partners (SNOCAP). RESULTSCard studies can be designed to study specifi c 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 clinicians and patients and can be linked.CONCLUSIONS Card studies provide cross-sectional descriptive data about clinical care, knowledge and behavior, perception of care, and prevalence of conditions. Card studies remain a robust method for describing primary care. INTRODUCTIONO bservational and survey research continues to be an important source of information about primary care. Among the numerous methods available for gathering data about clinicians, patients, and their care, one method has persisted for more than 30 years and is considered by some to be the hallmark of practice-based research: the card study. A card study is a fi eld-tested method for gathering data in the location where patients receive care by those who provide the care.The card study method is designed to gather data at the point of care about such observable phenomena as disease incidence/prevalence, practice patterns, or clinical behaviors. Pioneered in the United States by the Ambulatory Sentinel Practice Network (ASPN) 30 years ago, card studies use short questionnaires that participating clinicians complete for patients with a specifi c condition. 1 The name card study derives from a weekly return card introduced by the Sentinel Stations in the Netherlands and later modifi ed by ASPN. The pocketsized card, which was designed to take fewer than 60 seconds to complete, allowed clinicians to carry it from room to room as they saw eligible patients. Although a card study is essentially a survey, it is designed to be completed as patients are seen by those who provide the care. Card studies have undergone signifi cant development by numerous researchers during the past 30 years and represent a wide array of data collection tools and methods. C A R D S T UDIES F OR OBSERVAT IONA L R ESE A RCHand otitis media. [7][8][9][10][11][12] For example, the publication of ASPN's card study on spontaneous abortion contributed to the evidence that uncomplicated spontaneous abortion could be managed safely without surgery. Using data from this study, Green et al found that card studies are as accurate as medical record review for identifying p...

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