Flu pandemics occur when a new flu virus emerges, rapidly spreads and causes widespread disease in many communities in many continents.
Fortunately severe pandemics are rare events. When they occur, health care capacity both in the community and hospitals can be overwhelmed. When this happens doctors need to make difficult decisions about who should be admitted to hospital and who can safely be allowed to stay at home.
To do this fairly, most doctors feel that the same types of patient assessments and questions should be used across the wider community. This process is called triage. Triage tools should help doctors identify which people are most likely to benefit from treatments only available in hospital and which people can safely be managed at home.
The difficulty in designing triage tools for a future flu pandemic is that the exact nature of disease caused by a pandemic virus is generally unknown until that pandemic occurs. A further difficulty is that flu can affect children and adults quite differently. A one-size-fits-all tool is unlikely to work.
The study uses the GP's routine electronic record to capture most of the information and links to the hospital record if the patient is admitted to hospital. These records are be accessed by researchers without revealing people’s identities at the Clinical Practice Research Datalink, which is part of the Medicines and Healthcare products Regulatory Authority (MHRA).
The surgeries that participate already have long established permission to use anonymous clinical data for non-intervention studies [The General Practice Research Database: provision of anonymised data for use in observational public health].
Frequently asked questions
What’s this study really about?
The use of triage tools during surge and mass casualty events is recommended in national guidance. The need for such tools was identified again in preparation for the recent Olympic and Paralympic Games.
The evidence base for this guidance was challenged by GPs at the RCGP Pandemic Flu Summit in March 2010. GPs questioned the extent to which they as a group had been involved in the development of the tools. GPs were also concerned that there is little data supporting use of such tools in primary care.
This study aims, with your help, to develop and test these triage tools to be used in case of a pandemic. The data as collected as part of this study will be combined anonymously by the research team with data from hospital admissions in order to test the validity of the triage tool.
What does it involve for us as GPs?
A study pop-up box will appear when an eligible patient is identified during consultation. This is triggered by your entry of a relevant Read code in the patient’s electronic health record. There is no need for formal enrolment of patients.
You will be asked to record your routine assessment and decisions in a structured way using radio buttons and drop-down lists. This is very quick.
We recognise your clinical time is precious, so to avoid any double-entry of data, a summary of your entry will be presented in a friendly format ready to be cut-and-pasted back into the patient’s record. A downloadable pdf containing the same information will also be offered.
How can I participate in the study
If you are a GP working in a practice that contributes data to CPRD and would like to participate in the FLU-CATs study, please contact Dr Malcolm (Calum) Semple at firstname.lastname@example.org.
Can I test it out before I commit to the study?
Yes, you can try the entry screens on our live test site without commitment, using the links below:
What about ethics, R&D approval and consent?
The protocol has been reviewed by the NIHR, the PCRN and the Independent Scientific Advisory Committee for MHRA database research.
The information required for this study is collected as part of routine clinical care in an anonymous format.
The study is registered with the UK Clinical Research Network; see details of registration, permissions and the full protocol .