Article type
Year
Abstract
Background: To ascertain general practitioners (GPs) views about evidence-based medicine (EBM), perceived barriers and preferred resources to support evidence-based general practice; to assess GPs familiarity with technical terms commonly used in EBM.
Methods: We developed a self-administered questionnaire from an existing instrument.1 A random sample of GPs in Sydney, Australia completed the questionnaire at the commencement of a trial to improve preventive care.
Results: Sixty GPs (100%) participating in our trial returned the questionnaire. While 57% of respondents had a computer in their surgery, only 15% had Internet access and as few as 3% had access to the Cochrane Library at work. The most commonly cited barrier to EBM in general practice was patient demand for treatment despite lack of evidence for effectiveness (45%), followed by lack of time to read and appraise research articles (40%), lack of time to search for evidence (28%) and lack of time to discuss the implications of research findings with patients during routine consultations (25%). Fewer respondents cited insufficient skills in appraising evidence (16%), searching for evidence (12%) or communicating the implications of research to patients (5%). Preferred resources for EBM included clinical practice guidelines (rated as very useful by 55%) and journals that summarise research evidence, for example Evidence-based Medicine (52%). Systematic reviews were considered very useful by only 15% of respondents however. Unexpectedly, 30% of respondents indicated that they did not understand the term systematic review and 43% did not understand meta-analysis. Only about one quarter of respondents indicated they fully understood the terms relative risk (23%) and absolute risk (28%) and could explain these terms to others. In comparison, only 15% of respondents indicated they had the same level of understanding of number needed to treat. Even fewer respondents (12%) indicated they fully understood the term levels of evidence.
Conclusions: Barriers to EBM in Australian general practice were perceived to be related to time rather than skills. However, GPs lack of familiarity with technical terms commonly used in EBM suggests lack of training. Skills development will be important to strengthen an evidence-based approach in general practice. If methodological research supports the validity of self-assessment of understanding of EBM terms, this measure could be used to evaluate the impact of educational strategies.
Reference: 1. McColl A, Smith H, White P, Field J. General practitioners perceptions of the route to evidence based medicine: a questionnaire survey. BMJ 1998; 316: 361-5
Methods: We developed a self-administered questionnaire from an existing instrument.1 A random sample of GPs in Sydney, Australia completed the questionnaire at the commencement of a trial to improve preventive care.
Results: Sixty GPs (100%) participating in our trial returned the questionnaire. While 57% of respondents had a computer in their surgery, only 15% had Internet access and as few as 3% had access to the Cochrane Library at work. The most commonly cited barrier to EBM in general practice was patient demand for treatment despite lack of evidence for effectiveness (45%), followed by lack of time to read and appraise research articles (40%), lack of time to search for evidence (28%) and lack of time to discuss the implications of research findings with patients during routine consultations (25%). Fewer respondents cited insufficient skills in appraising evidence (16%), searching for evidence (12%) or communicating the implications of research to patients (5%). Preferred resources for EBM included clinical practice guidelines (rated as very useful by 55%) and journals that summarise research evidence, for example Evidence-based Medicine (52%). Systematic reviews were considered very useful by only 15% of respondents however. Unexpectedly, 30% of respondents indicated that they did not understand the term systematic review and 43% did not understand meta-analysis. Only about one quarter of respondents indicated they fully understood the terms relative risk (23%) and absolute risk (28%) and could explain these terms to others. In comparison, only 15% of respondents indicated they had the same level of understanding of number needed to treat. Even fewer respondents (12%) indicated they fully understood the term levels of evidence.
Conclusions: Barriers to EBM in Australian general practice were perceived to be related to time rather than skills. However, GPs lack of familiarity with technical terms commonly used in EBM suggests lack of training. Skills development will be important to strengthen an evidence-based approach in general practice. If methodological research supports the validity of self-assessment of understanding of EBM terms, this measure could be used to evaluate the impact of educational strategies.
Reference: 1. McColl A, Smith H, White P, Field J. General practitioners perceptions of the route to evidence based medicine: a questionnaire survey. BMJ 1998; 316: 361-5