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 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 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