Evidence Based General Practice

• Published in: European journal of epidemiology Vol. 15; no. 9; pp. 815 - 819
• Main Authors: M. M. Morales Suárez-Varela, Llopis-González, A., Bell, J., Tallón-Guerola, M., Pérez-Benajas, A., Carrión-Carrión, C.
• Format: Journal Article
• Language: English
• Published: Dordrecht Kluwer Academic Publishers 01.10.1999; Springer; Springer Nature B.V
• Subjects: Biological and medical sciences; Cross-Sectional Studies; Diabetes; Diagnosis-Related Groups - classification; Diagnosis-Related Groups - statistics & numerical data; Digestive system diseases; Evidence-Based Medicine; Family Practice - standards; Family Practice - statistics & numerical data; General practice; Health care; Health participants; Health Services Research; Hematologic diseases; Humans; Intervention; Medical Audit; Medical sciences; Nervous system diseases; Occupational disorders; Practice Patterns, Physicians' - standards; Practice Patterns, Physicians' - statistics & numerical data; Primary health care; Primary Health Care - standards; Primary Health Care - statistics & numerical data; Public health. Hygiene; Public health. Hygiene-occupational medicine; Referral and Consultation - standards; Referral and Consultation - statistics & numerical data; Research Design - standards; Respiratory diseases; Rural Health Services - standards; Rural Health Services - statistics & numerical data; Rural populations; Skin diseases; Spain; Europe; Spain; Human; Medicine; Evaluation; Health staff; Professional practice; Physician; Public health
• ISSN: 0393-2990; 1573-7284
• DOI: 10.1023/a:1007609926935

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 Castellón 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.