Background: As evidence based medicine has been developing rapidly in recent times, there is growing concern about what portion of medical interventions have a solid scientific foundation.
Objectives: To estimate the proportion of therapeutic interventions that is supported by scientific evidence in university based and community based primary care clinics in a district in Seoul, and to compare these proportions between the two practice settings.
Methods: A retrospective review of patient medical records was done according to the primary diagnosis and treatment. The evidence for the intervention was searched for in Medline (1966-2005) and other evidence based databases. The evidence was then classified as one of three categories 1) evidence from randomized controlled trials (RCTs); (2) convincing non-experimental evidence; and (3) interventions without substantial evidence.
Results: In the university affiliated clinics, out of 356 primary diagnosis and treatment pairs, 59.6% were supported by evidence from at least one randomized controlled trials and 19.4% were supported by convincing non-experimental evidence. In the community based clinics 47.1% out of 893 pairs and 10.5% fell into each category. As a result, the proportion of interventions in community settings that were based on evidence meeting our criteria was significantly lower than that of the university affiliated settings.
Conclusions: To facilitate evidence based practice, supportive activity should be focused on the primary care settings where medical practices are less evidence-based.