How helpful is NHS Direct? The caller’s perspective

Statistician's report by Julie Morris
 

This paper describes a simple survey of callers to three NHS Direct sites. More details of the sampling process and response rates need to be given. In addition, the presentation of results could be improved. The comments of the specialist referee cover many of the same points.
 

Design and Methods:

  1. Which weekdays were covered?
  2. A response rate of 71% is given, but 0.71 x 1050 callers = 746 respondents not 719 as quoted in the text.
  3. Was there a similar response rate for each of the three NHS Direct sites?

    4.  
Statistical Analysis and Presentation of Results:
  1. A large percentage of respondents made written comments (579 in all), but less than a third of these (relating to ‘reassurance’) are reported in the paper. What areas do the other comments cover?
  2. Was there a similar pattern of responses from each of the three sites?
  3. 95% confidence intervals should be provided for some of the more important results eg. the percentage who found the advice ‘helpful’.
  4. It would be of interest to see whether ‘type of advice’ (contact A&E, GP immediately etc) was associated with the perceived helpfulness of the advice.
  5. An estimate of the minimum percentage of callers finding the advice ‘helpful’, calculated assuming the non-respondents found the advice unhelpful, would be a useful addition.

    6.  
CHECKLIST FOR STATISTICAL REVIEW OF PAPERS FOR THE BMJ

“Unclear” and “No” answers to be addressed by authors
when revising their papers – in particular any marked with *

Design Features

1.  Was the objective of the study sufficiently described?

Yes
2.  Was an appropriate study design used to achieve the objective?
Yes
3.  Was there a satisfactory statement given of source of  subjects?
No *
4.  Was a pre-study calculation of required sample size reported?
No


Conduct of study

5.  Was a satisfactory response rate achieved?

Unclear *


Analysis and Presentation

6.  Was there a statement adequately describing or referencing all statistical procedures used?

Yes
7.  Were the statistical analyses used appropriate?
Yes
8.  Was the presentation of statistical material satisfactory?
No *
9.  Were confidence intervals given for the main results?
No
10. Was the conclusion drawn from the statistical analyses justified?
Yes


Abstract

11. Does the Abstract give a fair summary of the paper?

N/A


Recommendation on Paper

12. Is the paper of acceptable statistical standard for publication?

No
13. If ‘No’ to Question 12 could it become acceptable with suitable revision?
Yes