DEcision rule for severe Symptoms and Complications of Acute Red Throat in Everyday practice (DESCARTE)

Lead Research Organisation: University of Southampton
Department Name: Community Clinical Sciences

Abstract

This study will engage hundreds of practices, and thousands of patients and their families directly in the research process. It will potentially provide very practical evidence for both health professionals and the general public about who is at risk - and who is not at risk - for one of the commonest conditions experienced in the general population. Applying this evidence in clinical practice could then potentially make a difference in the management for millions of people, and help in the understanding of both rare outcomes, risk management, and the importance of preserving the precious resource of antibiotics. In the UK alone the clinical rule can potentially be used in 6 million face to face consultations a year , and a similar number of consultation with NHS direct each year for URTIs ? and thus provide an excellent vehicle for the public understanding of and engagement with science.

Technical Summary

Setting. This study is based around high volume simplified data collection among a cohort of 600 GPs recruited mainly by postal invitation through existing research Networks at 6 sites.
Methods. Each GP will collect data from 30 patients (18,000 patients in total): baseline clinical data will be collected using a very simple structured proforma. Complications or deterioration of illness will be documented from GP records and from patient report. Prolonged or severe symptoms will be documented among a subsample of patients completing a symptom diary.
From this data set we will develop a clinical prediction rule - to predict a group at high risk of complications - and pilot the rule.
If a rule is found to be predictive the next step will be a subsequent study (i.e. a separate application) to both confirm the predictive value of the rule in a new data set and trial the use of the rule

Publications

10 25 50
 
Description NIHR Programme Grant RP-PG-0407-10098 Primary care Infection Management for Everyday practice (PRIME)
Amount £1,999,000 (GBP)
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 09/2008 
End 04/2015
 
Description Inter-University collaboration in NIHR Programme funding 
Organisation University of Bristol
Department School of Social and Community Medicine
Country United Kingdom 
Sector Academic/University 
PI Contribution As PI I have lead an NIHR Programme application for the management of RTIs in adults (in the same area building on the experience of recruitment and data collection in this study), and am co PI in another successfull Programme grant to address the issues in Children
Impact Two successful NIHR Programme Grants
Start Year 2008