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.