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Gistered with Trent practice but admitted outdoors on the area. There have been 514 pregnancies in this category more than the 4 year study period, and these have been incorporated in our evaluation. Gbolade makes great recommendations concerning record linkage. We created every single effort to obtain a distinctive patient identifying code but were unable to complete so. You’ll find three complications. Firstly, the NHS number was not around the version of your database we had access to. Secondly, the NHS quantity is recognised as not being distinctive yet. Thirdly, even if it had been around the database and had been one of a kind, we wouldn’t happen to be able to obtain ethical approval to extract such aBMJ VOLUME 321 five AUGUST 2000 bmj.comSex and age discrimination in recruitment for general practice isn’t justified by teenage pregnancy survey Editor–In the “key messages” box of their write-up on teenage pregnancy prices, MedChemExpress ML264 HippisleyCox et al conclude that general practices having a female and young doctor had drastically reduce teenage pregnancy prices and advised these responsible for recruiting employees in main care to take these conclusions into account.1 Their arguments are flawed. There are several methodological troubles. Firstly, the authors did not take into account the doctors’ inclusion in the family organizing list or their possession of family members arranging certificates and also the diploma with the Royal College of Obstetricians and Gynaecologists. Female and young physicians could possibly be additional likely to have undergone household organizing education and obtained these qualifications. These are key confounding components because the doctors’ abilities in delivering contraception have been under study. No matter if the practice ran a shared list method in allocating individuals to physicians can also be critical. Secondly, whereas teenage conceptions are defined as those in girls aged 13-15 in the Well being of your Nation targets2 and in other studies, the authors included all pregnancies in girls aged 19 or below. Thirdly, as a sizable proportion of teenage pregnancies within this study had been in girls aged 17-19 who have been likely to be in additional or greater education in the course of term time, terminations of pregnancies might have been performed outside TrentReports of urban and rural variations are contradictory Editor–In their paper on teenage pregnancies and sex and age of basic practitioners, Hippisley-Cox et al say that they identified no evidence to assistance the introduction of more family organizing clinics in rural regions since such practices currently have decrease teenage pregnancy prices.1 In table 2, they quote the incidence rate ratio for urban practice versus rural practice as 0.73. As a result they report that the rate of teenage pregnancy in urban places is only 3 quarters of that in rural regions. The other ratios in table 2–for instance, that for no less than a single female medical professional versus no female medical professional, 0.84–are clearly interpreted within this way. Is there some mistake here The subjects are described as all pregnancies of teenagers aged 13-19. As HippisleyCox et al calculate prices around the basis of all teenagers registered together with the practice, the subjects are all teenagers, not just the pregnant ones. This may possibly appear nitpicking, but we should try to get these factors suitable. The actual incidence rate ratios reported are close to 1, and so, although these components might have a relation to teenage pregnancy, it doesn’t appear to become an importantLettersstrong patient identifier without having written patient consent. This wouldn’t have already been feasible in the study executed.Julia Hippisley-Cox senior.