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Validity of patient satisfaction surveys questioned

By Ingrid Torjesen

Patient satisfaction surveys used to determine almost £9,000 of an average practice's income have not been properly validated, researchers conclude.

It was ‘not clear the questionnaires measure satisfaction at all', a team of GPs and academics concluded in September's British Journal of General Practice.

A trawl through peer-reviewed journals found only one paper assessing the validity and reliability of the Improving Practices Questionnaire – and this could not support its conclusions with data.

Not a single paper was uncovered assessing the General Practice Assessment Questionnaire, although there were three papers assessing an earlier version, the GPAS. These found it had acceptable reliability but evidence for its validity was weak.

Study leader Dr Matthew Hankins, a senior research fellow at Brighton and Sussex Medical School, said the evidence base for the patient satisfaction data was ‘suboptimal' and certainly not as good as for the clinical indicators.

‘Attempts to develop validated measures haven't gone far enough to warrant their use nationally and in repeated cohorts for the QOF,' he said.

He added that he would be concerned if the data were used to compare practices in league tables because sampling was not random and methodology not uniform.

Dr Richard Vautrey, deputy chair of the GPC, said the committee agreed ‘wholeheartedly' with the researchers' conclusions that any changes to the QOF had to be based on sound evidence.

‘That is a lesson that must be learned particularly by the Department of Health,' he said.

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