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One of the general methodological limitations of the studies included relates to estimates of consultation frequency.
Findings are limited by estimates of consultation frequency and research involving observation of consultations may improve understanding of these issues.
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Although there is some evidence on which to base estimates of GP consultation levels for gynaecological conditions (Stapley and Hamilton, 2011), it is likely that there is a wider group of women with symptoms who do not currently seek help from their GP.
8 These estimates, by week of consultation, were supplied by the RCGP Research and Surveillance Centre.
Whilst any selective non-response may affect the overall estimates of rates of consultation and prescription, it is unlikely to affect the associations found.
Patients may find the estimated schedule of consultations too onerous or simply consider the suggested level of consultations unnecessary.
While such data may accurately reflect the time course of the pandemic, it will underestimate the true incidence of infection and requires the use of a scaling factor for model parameterization reflecting an estimate of the consultation rate per infection, as described by Baguelin et al. [1].
In these studies the estimate of mean consultation length was obtained from a government report [ 54].
Total out-of-pocket health expenditure2 is estimated as the sum of consultation and prescription expenditure incurred for the first out-patient visit.
Using data from the 1991 National Survey of Morbidity in General Practice and more recent data from the North Staffordshire Primary Care Research Consortium's database of consultations, we estimate that the frequency of consultation for musculoskeletal conditions in those aged 50 years and over is 7 per 1000 registered patients per month (discounting repeat consultations within the same year).
The study also estimates the cost of consultations to administer ranibizumab/bevacizumab and monitor outcomes, which could be used in other economic evaluations.
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