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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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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container_end_page 821
container_issue 7034
container_start_page 819
container_title BMJ
container_volume 312
creator Gill, P
Dowell, A C
Neal, R D
Smith, N
Heywood, P
Wilson, A E
description 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
doi_str_mv 10.1136/bmj.312.7034.819
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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</description><edition>International edition</edition><identifier>ISSN: 0959-8138</identifier><identifier>ISSN: 0959-8146</identifier><identifier>EISSN: 1468-5833</identifier><identifier>EISSN: 1756-1833</identifier><identifier>DOI: 10.1136/bmj.312.7034.819</identifier><identifier>PMID: 8608291</identifier><identifier>CODEN: BMJOAE</identifier><language>eng</language><publisher>London: British Medical Journal Publishing Group</publisher><subject>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. 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Hygiene-occupational medicine ; Randomized Controlled Trials as Topic ; Referral and Consultation ; Studies ; Urinary tract diseases ; Urogenital system</subject><ispartof>BMJ, 1996-03, Vol.312 (7034), p.819-821</ispartof><rights>1996 BMJ Publishing Group Ltd.</rights><rights>Copyright 1996 British Medical Journal</rights><rights>1996 INIST-CNRS</rights><rights>Copyright: 1996 (c) 1996 BMJ Publishing Group Ltd.</rights><rights>Copyright British Medical Association Mar 30, 1996</rights><rights>Copyright BMJ Publishing Group Mar 30, 1996</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b598t-f285e85163d8ae189260a2590512d6eadcfe7e48bf2596544c66c87bc24ba9f33</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/29731161$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/29731161$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>112,113,230,315,786,790,891,3213,27957,27958,31034,58593,58826</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=3049131$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8608291$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gill, P</creatorcontrib><creatorcontrib>Dowell, A C</creatorcontrib><creatorcontrib>Neal, R D</creatorcontrib><creatorcontrib>Smith, N</creatorcontrib><creatorcontrib>Heywood, P</creatorcontrib><creatorcontrib>Wilson, A E</creatorcontrib><title>Evidence based general practice: a retrospective study of interventions in one training practice</title><title>BMJ</title><addtitle>BMJ</addtitle><description>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. 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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</description><subject>Allergies</subject><subject>Asthma</subject><subject>Back pain</subject><subject>Biological and medical sciences</subject><subject>Clinical trials</subject><subject>Clinical Trials as Topic</subject><subject>Decision Making</subject><subject>Eczema</subject><subject>England</subject><subject>Evaluation Studies as Topic</subject><subject>Evidence based medicine</subject><subject>Experimentation</subject><subject>Family Practice</subject><subject>Foot diseases</subject><subject>General practice</subject><subject>Health and social institutions</subject><subject>Health care</subject><subject>Health participants</subject><subject>Hormone replacement therapy</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Infections</subject><subject>Intervention</subject><subject>Medical practices</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Mortality</subject><subject>Physician-Patient Relations</subject><subject>Placebos</subject><subject>Propriety</subject><subject>Prospective Studies</subject><subject>Public health. Hygiene</subject><subject>Public health. 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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</abstract><cop>London</cop><pub>British Medical Journal Publishing Group</pub><pmid>8608291</pmid><doi>10.1136/bmj.312.7034.819</doi><tpages>3</tpages><edition>International edition</edition><oa>free_for_read</oa></addata></record>
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identifier ISSN: 0959-8138
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source Applied Social Sciences Index & Abstracts (ASSIA); JSTOR Archival Journals and Primary Sources Collection【Remote access available】; BMJ
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
title Evidence based general practice: a retrospective study of interventions in one training practice
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