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      The Preterm Clinical Network (PCN) Database: a web-based systematic method of collecting data on the care of women at risk of preterm birth

      research-article
      , , , , the UK Preterm Clinical Network
      BMC Pregnancy and Childbirth
      BioMed Central
      Preterm birth, Clinical databases, Clinical registries, Clinical networks, Clinical audit

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          Abstract

          Background

          Despite much research effort, there is a paucity of conclusive evidence in the field of preterm birth prediction and prevention. The methods of monitoring and prevention strategies offered to women at risk vary considerably around the UK and depend on local maternity care provision. It is becoming increasingly recognised that this experience and knowledge, if captured on a larger scale, could be a utilized as a valuable source of evidence for others. The UK Preterm Clinical Network (UKPCN) was established with the aim of improving care and outcomes for women at risk of preterm birth through the sharing of a wealth of experience and knowledge, as well as the building of clinical and research collaboration. The design and development of a bespoke internet-based database was fundamental to achieving this aim.

          Method

          Following consultation with UKPCN members and agreement on a minimal dataset, the Preterm Clinical Network (PCN) Database was constructed to collect data from women at risk of preterm birth and their children. Information Governance and research ethics committee approval was given for the storage of historical as well as prospectively collected data. Collaborating centres have instant access to their own records, while use of pooled data is governed by the PCN Database Access Committee. Applications are welcomed from UKPCN members and other established research groups. The results of investigations using the data are expected to provide insights into the effectiveness of current surveillance practices and preterm birth interventions on a national and international scale, as well as the generation of ideas for innovation and research. To date, 31 sites are registered as Data Collection Centres, four of which are outside the UK.

          Conclusion

          This paper outlines the aims of the PCN Database along with the development process undertaken from the initial idea to live launch.

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          Most cited references9

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          Core outcome sets in women's and newborn health: a systematic review

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            A Core Outcome Set for Evaluation of Interventions to Prevent Preterm Birth.

            To develop a consensus on a set of key clinical outcomes for the evaluation of preventive interventions for preterm birth in asymptomatic pregnant women.
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              Harnessing experience: exploring the gap between evidence-based medicine and clinical practice.

              There is mounting evidence of a gap between Evidence-based Medicine (EBM) and physician clinical practice, in part because EBM is averaged global evidence gathered from exogenous populations which may not be relevant to local circumstances. Local endogenous evidence, collected in particular and 'real world' patient populations may be more relevant, convincing and timely for clinical practice. Evidence Farming (EF) is a concept to provide such local evidence through the systematic collection of clinical experience to guide more effective practice. We report on the findings of a pilot study of 29 individual and three focus group (n = 10) interviews exploring physicians' evaluations how they use multiple sources of information in clinical decision making and their thoughts on EF. Physicians recognize a gap in translating EBM to practice. Physicians reported that when making clinical decisions, they more often rely on clinical experience, the opinions of colleagues and EBM summarizing electronic clinical resources rather than refer directly to EBM literature. Confidence in making decisions based on clinical experience increases over time, yet few physicians reported having systems for tracking their clinical experience in designing treatment plans and patient outcomes. Most physicians saw EF as a promising way to track experience, thereby making scientific evidence more relevant to their own clinical practices. Clinical experience is relatively neglected by the EBM movement, but if that experience were systematically gathered through an approach such as EF, it would meet a need left unfulfilled by EBM.
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                Author and article information

                Contributors
                jenny.carter@kcl.ac.uk
                rachel.tribe@kcl.ac.uk
                jane.sandall@kcl.ac.uk
                andrew.shennan@kcl.ac.uk
                Journal
                BMC Pregnancy Childbirth
                BMC Pregnancy Childbirth
                BMC Pregnancy and Childbirth
                BioMed Central (London )
                1471-2393
                17 August 2018
                17 August 2018
                2018
                : 18
                : 335
                Affiliations
                ISNI 0000 0001 2322 6764, GRID grid.13097.3c, Department of Women and Children’s Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, , King’s College London, ; London, UK
                Author information
                http://orcid.org/0000-0003-2550-6465
                Article
                1967
                10.1186/s12884-018-1967-y
                6098573
                30119660
                56b0d7ba-9638-43f4-9989-2fc1ceb75e60
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 20 November 2017
                : 6 August 2018
                Categories
                Database
                Custom metadata
                © The Author(s) 2018

                Obstetrics & Gynecology
                preterm birth,clinical databases,clinical registries,clinical networks,clinical audit

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