Evidence based general practice: a retrospective study of interventions in one training practice

Abstract Objectives: To estimate the proportion of interventions in general practice that are based on evidence from clinical trials and to assess the appropriateness of such an evaluation. Design: Retrospective review of case notes. Setting: One suburban training general practice. Subjects: 122 con...

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Bibliographic Details
Published in:BMJ 1996-03, Vol.312 (7034), p.819-821
Main Authors: Gill, P, Dowell, A C, Neal, R D, Smith, N, Heywood, P, Wilson, A E
Format: Article
Language:English
Subjects:
Allergies
Asthma
Back pain
Biological and medical sciences
Clinical trials
Clinical Trials as Topic
Decision Making
Eczema
England
Evaluation Studies as Topic
Evidence based medicine
Experimentation
Family Practice
Foot diseases
General practice
Health and social institutions
Health care
Health participants
Hormone replacement therapy
Hospitals
Humans
Hypertension
Infections
Intervention
Medical practices
Medical research
Medical sciences
Medicine
Mortality
Physician-Patient Relations
Placebos
Propriety
Prospective Studies
Public health. Hygiene
Public health. Hygiene-occupational medicine
Randomized Controlled Trials as Topic
Referral and Consultation
Studies
Urinary tract diseases
Urogenital system
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Summary:Abstract Objectives: To estimate the proportion of interventions in general practice that are based on evidence from clinical trials and to assess the appropriateness of such an evaluation. Design: Retrospective review of case notes. Setting: One suburban training general practice. Subjects: 122 consecutive doctor-patient consultations over two days. Main outcome measures: Proportions of interventions based on randomised controlled trials (from literature search with Medline, pharmaceutical databases, and standard textbooks), on convincing non-experimental evidence, and without substantial evidence. Results: 21 of the 122 consultations recorded were excluded due to insufficient data; 31 of the interventions were based on randomised controlled trial evidence and 51 based on convincing non-experimental evidence. Hence 82/101 (81%) of interventions were based on evidence meeting our criteria. Conclusions: Most interventions within general practice are based on evidence from clinical trials, but the methods used in such trials may not be the most appropriate to apply to this setting. Key messages Key messages 81% of general practice can be described as evidence based using this method of assessment Evidence derived from different methodologies may be important for the assessment of the evidence base of general practice
ISSN:0959-8138
0959-8146
1468-5833
1756-1833
DOI:10.1136/bmj.312.7034.819