Experiments/General Practice Based Incidence Study

Source Paper

Study of infectious intestinal disease in England: rates in the community, presenting to general practice, and reported to national surveillance

J. G Wheeler, D. Sethi, J. M Cowden, P. G Wall, L. C Rodrigues et al.

BMJ • 1999

DOI PMC

General Practice Based Incidence Study

behavioralhuman

Objective: To establish the incidence and aetiology of infectious intestinal disease in the community and presenting to general practitioners, with comparison to national laboratory-based surveillance

Materials & Equipment Checklist

2 items

Gather these items before starting the experiment. Check off items as you prepare.

Equipment2

General Practice Facilities

Amazon

Laboratory Facilities

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Protocol Steps

Study Design and Setting Establishment

Established population-based community cohort incidence study across 70 general practices in England

Note: Multi-component study design including community surveillance, general practice-based incidence studies, and case linkage to national laboratory surveillance

View evidence from paper

“Design Population based community cohort incidence study, general practice based incidence studies, and case linkage to national laboratory surveillance. Setting 70 general practices throughout England.”

Community Cohort Selection

Randomly selected 9776 patients from the 459,975 patients served by the 70 general practices for community surveillance

Note: Community surveillance component of the study

View evidence from paper

“Participants 459 975 patients served by the practices. Community surveillance of 9776 randomly selected patients.”

Case Identification in Community

Identified cases of infectious intestinal disease in the community cohort through surveillance

Note: 781 cases were identified in the community cohort

View evidence from paper

“781 cases were identified in the community cohort, giving an incidence of 19.4/100 person years”

General Practice Case Identification

Identified cases of infectious intestinal disease presenting to general practitioners across the 70 practices

Note: 8770 cases presented to general practice

View evidence from paper

“8770 cases presented to general practice (3.3/100 person years (2.94 to 3.75)).”

Laboratory Investigation

Sent stool samples for laboratory investigation and microbiological analysis to identify causative organisms

Note: Samples analyzed for bacterial and viral pathogens including salmonella, campylobacter, rotavirus, and small round structured viruses

View evidence from paper

“6.2 stools sent for laboratory investigation, 23 cases presenting to general practice, and 136 community cases.”

National Surveillance Linkage

Linked identified cases to national laboratory-based surveillance system for comparison of reporting rates

Note: One case was reported to national surveillance for every 1.4 laboratory identifications

View evidence from paper

“One case was reported to national surveillance for every 1.4 laboratory identifications, 6.2 stools sent for laboratory investigation, 23 cases presenting to general practice, and 136 community cases.”

Pathogen-Specific Analysis

Analyzed reporting ratios for different microorganisms to national surveillance

Note: Bacterial pathogens showed lower community-to-surveillance ratios than viral pathogens

View evidence from paper

“The ratio of cases in the community to cases reaching national surveillance was lower for bacterial pathogens (salmonella 3.2:1, campylobacter 7.6:1) than for viruses (rotavirus 35:1, small round structured viruses 1562:1).”