Evidence based general practice.

M M Suárez-Varela; A Llopis-González; J Bell; M Tallón-Guerola; A Pérez-Benajas; C Carrión-Carrión

doi:10.1023/a:1007609926935

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PubMed · 10608361

Evidence based general practice.

M M Suárez-Varela·A Llopis-González·J Bell·M Tallón-Guerola·A Pérez-Benajas·C Carrión-Carrión

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Abstract

OBJECTIVES: To estimate the proportion of interventions in general practice that are based on evidence. DESIGN: A one-year cross-sectional study involving all consultations by patients over age 15 years seen in 34 national primary health care centers. SETTING: The rural Castellon provincial district within the Valencian Community in eastern Spain, with a total population of 21,155 inhabitants. SUBJECTS: of 1990 case histories registered in the course of one year, 4800 consultations were identified; of these, 2341 (49%) distinct diagnosis-intervention pairs were identified and coded. MAIN RESULTS: The evidence basis for the diagnosis-intervention pairs in the study was derived from a computerized search of the scientific literature published in 1992-1996. The quality of the evidence was classified according to the method of Ellis et al. Within the 2341 diagnosis-intervention pairs, there was positive evidence in support of the intervention used in 55%. The evidence basis was sound for 42%, with 38% being based on Type I (clinical trials) evidence and 4% on Type II evidence. The most frequently presenting diseases involved the circulatory (18.7%), respiratory (14.9%), nervous (14.2%), musculo-skeletal (12.5%) and nutrition and metabolism and digestive systems, with 12.1% each. CONCLUSIONS: Clinical practice was clearly supported by positive evidence of all Types (I-III) in a total of 55% of interventions, and by good positive evidence of Type I or II in 42% of interventions. The percentage of evidence-based interventions in general practice serving a substantial population in rural Spain was lower than had been reported by some authors.

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Cross-Sectional Studies Diagnosis-Related Groups Evidence-Based Medicine Family Practice Health Services Research Humans Medical Audit Practice Patterns, Physicians'Primary Health Care Referral and Consultation Research Design Rural Health Services Spain Journal Article

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M M Suárez-Varela, A Llopis-González, J Bell, M Tallón-Guerola, A Pérez-Benajas, C Carrión-Carrión. 1999. Evidence based general practice.. https://doi.org/10.1023/a%3A1007609926935

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