Evidence map›Paper›PMID 35487581›Full record

ArticleBJGP open2022

Clinical risk in remote consultations in general practice: findings from in-COVID-19 pandemic qualitative research.

Rebecca Rosen, Sietse Wieringa, Trisha Greenhalgh, Claudia Leone, Sarah Rybczynska-Bunt, Gemma Hughes, Lucy Moore, Sara E Shaw, Joseph Wherton, Richard Byng

Open access · goldAbstract read
In one paragraph

Article in BJGP open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
47citing papers in PubMed, 2 pooled it
15.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

47 citing papers in PubMed, 2 syntheses or guidelines pooled it, 84 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Safety-netting communication during telephone consultations: an observational study using recorded consultations.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
    Observational
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  8. GP workforce sustainability to maximise effective and equitable patient care: a realist review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
    Review
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  18. Technostress, technosuffering, and relational strain: a multi-method qualitative study of how remote and digital work affects staff in UK general practice.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025
    Article
  19. Challenges to quality in contemporary, hybrid general practice a multi-site longitudinal case study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025
    Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 2 countries.

Rebecca RosenNuffield Trust, London, UK rebecca.rosen@nuffieldtrust.org.uk.
Sietse WieringaNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Trisha GreenhalghNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Claudia LeoneNuffield Trust, London, UK.
Sarah Rybczynska-BuntCommunity and Primary Care Research Group, University of Plymouth, Plymouth, UK.
Gemma HughesNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID https://orcid.org/0000-0003-2930-1125
Lucy MooreNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Sara E ShawNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Joseph WhertonNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Richard ByngCommunity and Primary Care Research Group, University of Plymouth, Plymouth, UK.
University of Oxford · GBCommunity Care · USNuffield Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe COVID-19 pandemic-related rise in remote consulting raises questions about the nature and type of risks in remote general practice.

aimTo develop an empirically based and theory-informed taxonomy of risks associated with remote consultations. DESIGN &

settingQualitative sub-study of data selected from the wider datasets of three large, multi-site, mixed-method studies of remote care in general practice before and during the COVID-19 pandemic in the UK.

methodSemi-structured interviews and focus groups, with a total of 176 clinicians and 43 patients. Data were analysed thematically, taking account of an existing framework of domains of clinical risk.

resultsThe COVID-19 pandemic brought changes to estates (for example, how waiting rooms were used), access pathways, technologies, and interpersonal interactions. Six domains of risk were evident in relation to the following: (1) practice set-up and organisation (including digital inequalities of access, technology failure, and reduced service efficiency); (2) communication and the clinical relationship (including a shift to more transactional consultations); (3) quality of clinical care (including missed diagnoses, safeguarding challenges, over-investigation, and over-treatment); (4) increased burden on the patient (for example, to self-examine and navigate between services); (5) reduced opportunities for screening and managing the social determinants of health; and (6) workforce (including increased clinician stress and fewer opportunities for learning).

conclusionNotwithstanding potential benefits, if remote consultations are to work safely, risks must be actively mitigated by measures that include digital inclusion strategies, enhanced safety-netting, and training and support for staff.

Indexed as

clinical riskfamily practicegeneral practiceremote consultationssafeguardingtelemedicine

Identifiers

PMID35487581
PMCPMC9680756
OpenAlexW4225258106

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.