DEVELOPMENT OF A PRACTICE-BASED RESEARCH-PROGRAM

Objective: To establish an infrastructure to collect accurate data fro m ambulatory settings. Design: The program was developed through an it erative model governed by a process of formative evaluation. The three iterations were a needs assessment, feasibility study and pilot proje ct. Necessary program components were identified as infrastructure, pr actitioner-researcher partnership, centralized data management and sta ndardized quality assurance measures. Setting and Participants: Volunt eer chiropractors and their staff collected data on patients in their practices in ambulatory settings in the U.S. and Canada. Outcome Measu res: Evaluative measures were counts of participants, patients and com pleted forms. Standardized, validated and reliable measures collected by patient self-report were used to assess treatment outcomes. These i ncluded the SF-36 or SF-12 Health Survey, the Pain Disability Index, a nd the Global Well-Being Scale. For characteristics for which appropri ate standardized instruments were not available, questionnaires were d esigned and and pilot-tested before use. Results: Information was gath ered on practice and patient characteristics and treatment outcomes, b ut for this report, only those data concerning process evaluation are reported. Through the three program iterations, 65 DCs collected data on 1360 patients, 663 of whom were new patients. Follow-up data record ed by doctors were obtained for more than 70% of patients; a maximum o f 50% of patient-completed follow-up forms were collected in the three iterations. Conclusions: This program is capable of providing data fo r descriptive epidemiology of ambulatory patients, and, with continued effort to maximize follow-up, may have utility in providing insight i nto utilization patterns and patient outcomes.