Bibliometric analysis of primary care research, childhood obesity, the importance of understanding small area data and diabetes

Abstract

The Editorial and two substantial papers, in this issue with their associated commentaries, look at how informatics has an important role to play in raising the quality of lower limb care in diabetes.We collect data about the circulation and sensation in the foot in diabetes because people with diabetes are at increased risk of infections, leg ulcers and ultimately gangrene and amputation. Unfortunately, amputation rates in diabetes are rising in theUKand somethingneeds tobe done. How we might manage the relevant data better is discussed in depth within this issue. This issue of Informatics in Primary Care includes a bibliometric analysis of data from Australian general practices. Large indexed repositories of research papers and abstracts – such as PubMed/Medline (www.ncbi. nlm.nih.gov/pubmed) make the world’s biomedical research readily searchable. Such databases also allow monitoring of published output. The paper explores 5%of papers emanating fromprimary care onmedical informatics. Trends, previously impossible to document, are now readily observable with important comparisons made between UK, Australian and New Zealand primary care research output. Publications have increased 15-fold in Australia, 5-fold in New Zealand, but less than 4-fold in the UK over the same period, with some flattening off in the increase since 2000. Shaikh et al, provide us with another reminder that passive reminders do not have as large an effect as an intervention. They report how displaying body mass index (BMI; Box 1) does not significantly affect outcomes though there are some useful smaller changes in recording, interventions and recording of important background information. These are similar to the findings from the study by Crawford et al, and further evidence that passive supply of data may not be enough to promote utilisation in the way that was intended. Although, the information provided was used in both studies. The systematic review by Police et al, looks at the last five years adoption of health information technology (HIT) across the USA. This shows how the reported levels of adoption remain low: 9–29% of practices have implemented electronic health record (EHR). They classify the benefits and barriers; which fit well with the view of your Editor that for IT to be implemented four things need to tilted in favour of its adoption: (1) The organisational interaction; (2) The individual clinician’s motivation and skills; (3) The technology must be usable; and (4) It must be appropriate for conducting the clinical task (Table 1). Finally, we publish a paper on using routine data to compare the demographics of two ‘small areas’ – an English northern and London locality. The ‘small area’ or locality is important because superficially these two areas both have similar levels of deprivation. However, their demographic pattern and levels of mental health problems are very different. Commissioning or providing care for localities requires careful analysis of the population demographics – including ethnicity and deprivation – as these are known predictors of health needs. Comments, as ever, are very welcome to: Editor IPC@gmail.com