{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T18:22:41Z","timestamp":1780424561178,"version":"3.54.1"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:00:00Z","timestamp":1757548800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>For research with electronic health records in the outpatient setting, obtaining Broad Consent (BC) is increasingly important. However, the presence of potential selection bias in this context remains unclear. Since 2020, the BeoNet-Halle outpatient database collects patient data from participating general and specialty ambulatory practices\u2019 management systems in Germany, whereby data is obtained anonymously or pseudonymously <jats:italic>via<\/jats:italic> BC. For clarity, anonymized datasets are routinely extracted for descriptive analyzes, whereas pseudonymized datasets are available only when patients provide BC (details in Methods and Ethics). The primary objective of this study is to compare health related parameters between patients who provided BC and the general practice population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a single-center, cross-sectional study. From February 2021 to May 2023, patients were asked by a general practitioner or a specially trained member of the joint practice to provide BC. Within the yearly contact group of 2022, we compared patients who provided BC with the reference population (RP) of patients with at least one physician\u2013patient contact during that period in a joint practice including eight eneral ractitioners. Data pertaining to health, morbidity, and health utilization were extracted from the BeoNet-Halle database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 5,034 patients were analyzed (BC-group: 439 vs. RP group: 4,595). Sex was similar distributed between the groups. In the BC group, patients were slightly older (56.2 vs. 54.1 years), had more physician contacts (15.0 vs. 9.2) and more often at least one chronic condition (76.1 vs. 51.6%) than patients from RP group. Patients were more likely to be referred to at least one other specialist (74.0 vs. 44.4%) and to get at least one drug prescription (89.5 vs. 69.6%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Differences between BC and the reference population (older age, higher multimorbidity, more contacts, referrals, and drug use) indicate selection processes at the point of consent. Given the single-practice design and descriptive analysis, generalizability beyond similar German group practices is limited and requires validation in multi-site studies.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1450274","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T05:26:25Z","timestamp":1757568385000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Health disparities and selection bias in obtaining broad consent in a general practitioner setting"],"prefix":"10.3389","volume":"12","author":[{"given":"Christine","family":"Br\u00fctting","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantin","family":"Moser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Heise","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Bauch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Frese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1186\/s12875-022-01945-y","article-title":"The use of routine data from primary care practices in Germany to analyze the impact of the outbreak of SARS-CoV-2 on the utilization of primary care services for patients with type 2 diabetes mellitus.","volume":"23","author":"Strumann","year":"2022","journal-title":"BMC Prim Care."},{"key":"B2","doi-asserted-by":"publisher","first-page":"S91","DOI":"10.1055\/a-1099-0789","article-title":"Sonderheft Methodische Aspekte der Sekund\u00e4rdatenanalyse [Special issue methodological aspects of secondary data analysis].","volume":"82","author":"Swart","year":"2020","journal-title":"Gesundheitswesen."},{"key":"B3","doi-asserted-by":"publisher","first-page":"e37665","DOI":"10.2196\/37665","article-title":"Patients\u2019 willingness to provide their clinical data for research purposes and acceptance of different consent models: findings from a representative survey of patients with cancer.","volume":"24","author":"K\u00f6ngeter","year":"2022","journal-title":"J Med Internet Res."},{"key":"B4","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s12910-021-00622-6","article-title":"Normative framework of informed consent in clinical research in Germany, Poland, and Russia.","volume":"22","author":"Orzechowski","year":"2021","journal-title":"BMC Med Ethics"},{"key":"B5","first-page":"34232120","article-title":"Germany: health system review.","volume":"22","author":"Bl\u00fcmel","year":"2020","journal-title":"Health Syst Transit."},{"key":"B6","year":"2017","journal-title":"Bundesdatenschutzgesetz (BDSG) in der Fassung der Bekanntmachung vom 30. 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