The purpose of the project was to coordinate activities in the field of sentinel practices with GPs in the EC-member countries (COST-countries included). The ultimate goal was to establish a real European network of sentinel practices.
Activities in the field of sentinel practices have been coordinated with general practitioners (GP) in order to establish a real European network of sentinel practices. An international surveillance on measles, mumps, human immunodeficiency virus (HIV) antibody tests and influenza like illness was started and a 1 month descriptive study on laboratory tests in general practice was carried out.
The sentinel networks are now established, but their heterogeneity is considerable. It was decided to continue the international data collection on measles, as an indicator to control impact of vaccination policy, using diagnostic guidelines along the lines of the International Classification of Health Problems in Primary Care (ICHPPC-2-defined).
Participants of the networks should seek serological confirmation, in view of the unreliability of the clinical diagnosis. The vaccination status of the cases should be documented by a medical record or a vaccination card. Incidence of measles can be expressed as the number of new cases per GP per week or per year, but it was convened that only full time equivalent GPs should be accepted. When using GPs as denominators, to study trends of incidence of a health problem over time, it should be convened that participating GPs provide during short separate periods of time their number of encounters by age groups and gender. In the international data collection on HIV tests in general practice, the numerator was all patients for whom an HIV test was prescribed in general practice but the categories of reason(s) for testing were not the same in all networks. The standard tables on this matter were thus a compromise enabling global comparisons of the reason(s) for testing between the networks. As for the denominator, the same problems were encountered as for the international data collection on measles and mumps.
For the surveillance of influenza like illness diagnostic guidelines along the lines of the International Classification o f Health Problems in Primary Care (ICHPPC-2-defined) should be used.
The following objectives were defined to be met in the course of the project.
The first and main objective was to encourage and assist in the development of sentinel networks in as many member countries as possible, with as least 30 participants routinely recording information about a small number of carefully chosen conditions, and respecting some discipline and basic rules in relation to, eg quality of data gathering, regular transmission of data to a central facility, and regular feedback of information to the participants. The second objective was to start international recording of conditions in which there was a specific international interest, with the collaboration of already existing networks.
Elements hampering the comparison of data collected internationally had to be defined and possible solutions for a further harmonization of the data recording and thus towards a real European network of sentinel practices had to be discussed.