Evidence map›Paper›PMID 35545391›Full record

ArticleBMJ open2022

'Low-value' clinical care in general practice: associations of low value care in GP trainees' practice, including formative and summative examination performance - protocol for cross-sectional and retrospective cohort study analyses using the QUestionable In Training Clinical Activities (QUIT-CA) index.

Parker Magin, Anna Ralston, Amanda Tapley, Elizabeth Holliday, Jean Ball, Mieke L van Driel, Andrew Davey, Linda Klein, Kristen FitzGerald, Neil Spike and 1 more

Abstract read
In one paragraph

Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

11 authors.

Parker MaginSchool of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia parker.magin@newcastle.edu.au.ORCID 0000-0001-8071-8749
Anna RalstonNSW & ACT Research and Evaluation Unit, GP Synergy Regional Training Organisation, Mayfield West, New South Wales, Australia.
Amanda TapleySchool of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.ORCID 0000-0002-1536-5518
Elizabeth HollidaySchool of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.ORCID 0000-0002-4066-6224
Jean BallClinical Research Design and Statistical Support Unit (CReDITSS), Hunter Medical Research Institute (HMRI), New Lambton, New South Wales, Australia.
Mieke L van DrielPrimary Care Clinical Unit, Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.ORCID 0000-0003-1711-9553
Andrew DaveySchool of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.ORCID 0000-0002-7547-779X
Linda KleinSchool of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.
Kristen FitzGeraldAustralian General Practice Training, General Practice Training Tasmania (GPPT), Regional Training Organisation, Hobart, Tasmania, Australia.
Neil SpikeEastern Victoria General Practice Training (EVGPT) Regional Training Organisation, Hawthorn, Victoria, Australia.
Alison FieldingNSW & ACT Research and Evaluation Unit, GP Synergy Regional Training Organisation, Mayfield West, New South Wales, Australia.ORCID 0000-0001-5884-3068

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introduction'Low value' clinical care and overuse of medical services are 'questionable' clinical activities that entail provision of medical services that are more likely to cause harm than good or whose benefit is disproportionately low compared with its cost. This study will seek to establish clinical practice associations of a non-observed work-based assessment of general practitioner (GP) trainees' (registrars') questionable practice (the QUestionable In Training Clinical Activities (QUIT-CA) index). We will also explore association of the QUIT-CA index with a formative observed work-based assessment, and will establish if registrars' QUIT-CA indexes are associated with summative examination performance. METHODS AND ANALYSIS: We will conduct three analyses, all using data from the Registrar Clinical Encounters in Training (ReCEnT) study. ReCEnT is an ongoing (from 2010) cohort study in which Australian GP registrars record details of their in-consultation clinical and educational practice. The QUIT-CA index is compiled from ReCEnT consultation data. A cross-sectional analysis, using negative binomial regression, will establish clinical practice associations of the QUIT-CA index. A cross-sectional analysis using linear regression will be used to establish associations of QUIT-CA index with formative observed in-practice assessment (the General Practice Registrar-Competency Assessment Grid). A retrospective cohort study analysis using linear regression will be used to establish associations of the QUIT-CA index with summative examination performance (Royal Australian College of General Practice fellowship examinations results). ETHICS AND DISSEMINATION: The study has ethical approval from the University of Newcastle HREC(H-2009-0323). Findings will be disseminated in peer-reviewed journal articles and conference presentations.

Indexed as

General PracticeGeneral PractitionersAustraliaCohort StudiesCross-Sectional StudiesHumansLow-Value CareRetrospective Studieseducation & training (see medical education & training)medical education & trainingprimary care

Identifiers

PMID35545391
PMCPMC9096564

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.