Do the public share practitioners' views about the best evidence?

Abstract

Objective: To investigate whether general practitioners (GPs) and patients agree on what constitutes the best evidence for the effectiveness of treatments.

Methods: GPs and members of the public aged 18-83 read five scenarios describing comparisons between hypothetical treatments for common ailments. Each scenario reported that one treatment was the more effective, as determined by randomised controlled trial (RCT), audit of treatment outcomes from many doctors' patients, a single doctor's clinical experience, a friend's experience, or a web-based sales site. Participants rated how confident they would be that the treatment reported to be more effective would work for them.

Results: All participants had least confidence in the web-based sales site, more confidence in a friend's experience and more still in one doctor's experience. For doctor's experience, audit and RCT, amongst the public there were some differences by age but, importantly, only GPs had most confidence in evidence from an RCT.

Conclusion: GPs may treat evidence from RCTs as the gold standard while members of the public (their patients) may not afford it that same respect.

Practice implications: GPs engaged in shared decision-making should be alert to possible differences from their patients in the weight given to different types of evidence.