CRISP Reporting Checklist Helps Advance Primary Care Research

Comprehensive generalist medical care (family medicine general practice and primary care) is a global enterprise devoted to providing patient-centered evidence-based care to patients families and communities. It has its own caring perspective clinical methods and foundation of knowledge. With WONCA support, primary care research is growing to inform clinical primary care and primary healthcare at the foundation of our healthcare systems.

Reporting Research

The new CRISP (Consensus Reporting Items for Studies in Primary Care) Checklist is a tool for planning reporting and applying primary care research. The CRISP Checklist was built by and for primary care to meet the needs of our clinical practitioners academic investigators patients and communities.

Across biomedical and health sciences there is growing recognition of the need to improve the information investigators deliver in their research reports. This need has led to the development of research reporting guidelines. Well-known examples include CONSORT for reporting randomized clinical trials and PRISMA for systematic reviews. The EQUATOR Network catalogs over 450 research reporting guidelines but none address the needs of family medicine/general practice.

Early CRISP studies documented that family physicians and general practitioners frequently read original research reports but usually find them inadequate to apply the study findings to patient care in their practice settings. The CRISP initiative set out to fill that gap.

CRISP Process

A rigorous five-year program of research and development engaged diverse voices across 29 nations. This work was conducted by the international CRISP Working Group including Drs. Paul Glasziou Pallavi Prathivadi and Grant Russell (Australia); Aaron Orkin (Canada); Tim olde Hartman and Chris van Weel (Netherlands); and Joanne Reeve (UK).

CRISP pioneered a new approach to developing research reporting guidelines based on the values of family medicine/general practice. Rather than relying on a small group of expert methodologists CRISP regarded the experts as the users of research. CRISP actively engaged the worldwide primary care community including practicing clinicians researchers patients community representatives educators policymakers journal editors and reviewers. All nominated items needed in research reports and a Delphi study identified the essential elements and refined the final CRISP Checklist.

CRISP Checklist

The CRISP checklist identifies 24 items in ten themes to include in research reports. Each item is on the list because it was identified by our worldwide community producers and users of primary care research. The CRISP Checklist and full CRISP Statement were published in the Annals of Family Medicine in 2023 along with a full explanation and examples for each item.

Overall the CRISP Checklist suggests richer context in research reports. Readers need to understand the context of the researchers patients populations health problems clinical encounters patient care teams study interventions and research measures. The breadth depth and wide variety of practice settings in primary care mean that research reports need context to help readers understand the studies and how they might apply to their own practice settings and healthcare systems.

The CRISP Checklist is a tool for investigators and authors to improve the dissemination and application of their research. It is flexible to accommodate the variety of research methods study designs patient populations topics and systems of care. Not all items apply to all study reports. Authors and editors will still make final decisions on content and form.

The WONCA Executive endorsed the CRISP Checklist in August 2023.

NAPCRG - the North American Primary Care Research Group – has also endorsed the Checklist. The CRISP Checklist is now registered with the EQUATOR Network.

The Checklist and all materials can be downloaded from the CRISP website.

CRISP Dissemination and Use

The CRISP checklist is included in the “Information for Authors” along with other major research report guidelines by a growing number of journals around the world. A network of colleagues is translating the Checklist to serve researchers working in a variety of languages.

The CRISP Checklist can apply to all primary care research. This includes research done by primary care investigators and studies by others in primary care settings patients and problems and all studies intended to influence the practice and organization of primary care. CRISP can be a tool to help others understand the complexities of family medicine/general practice the information we need and the research we do.

CRISP users have reported the Checklist helps them craft their research reports and can also help in reviewing and editing reports planning studies and teaching research methods with a focus on primary care.

The Working Group considers the CRISP Checklist to be a living document ready for application testing and improvement. We welcome all comments and suggestions.

William R. Phillips MD MPH FAAFP
University of Washington Seattle WA. USA

Liz Sturgiss BMed PhD FRACGP MPH MForensMed FHEA
Monash University Melbourne Victoria Australia