Providing evidence‐based answers to clinical questions A pilot information service for general practitioners

Abstract

Objective To pilot a clinical information service for general practitioners. Methods A representative sample of 31 GPs was invited to submit clinical questions to a local academic department of general practice. Their views on the service and the usefulness of the information were obtained by telephone interview. Results Over one month, nine GPs (29% of the sample, 45% of those stating an interest), submitted 20 enquiries comprising 45 discrete clinical questions. The median time to search for evidence, appraise it and write answers to each enquiry was 2.5 hours (range, 1.0–7.4 hours). The median interval between receipt of questions and dispatch of answers was 3 days (range, 1–12 days). Conclusions The GPs found the answers useful in clinical decision making; in four out of 20 cases patient management was altered.

A comparative case study of two models of a clinical informaticist service

“…4 12 – 15 Clinical questions were considered to arise from a doctor's (or nurse's) thoughts during a consultation. Hence, this group oriented their informaticist service towards individual doctors (and nurse practitioners) rather than practices or teams.…”

“…One small Australian study ran for a month and drew 20 questions from nine general practitioners; no general conclusions about the transferability of the service could be drawn 15. Preliminary data from the Welsh ATTRACT study showed that a fast (6 hour turnaround) questioning service using a pragmatic search protocol and fronted by a librarian informaticist was popular and led to (or supported) changes in practice in about half the cases; the general practitioners in this study did not seem to be concerned that the informaticist was not clinically qualified 20.…”

A clinical informaticist to support primary care decision making

“…Participants submitted questions on a short request form adapted from a form developed by Hayward et al 14 If additional information was required to formulate the question, this was discussed with the questioner (n=8).…”

“…A 1 month pilot study of a similar service in Australia has been reported, 14 and the ATTRACT project recently evaluated an answering service provided by a non-clinician based on a rapid appraisal process. 15 We are unaware of any published reports of a GP led answering service in the UK.…”

Implementation of evidence based medicine in primary care

“…Durch den Wissenszuwachs kann zumindest für den nächsten Patienten mit einem ähnlich gelagerten Problem eine Verbesserung der Behandlung angenommen werden. Alle bisherigen Projekte [2][3][4][5][6] wurden zeitlich limitiert und auf ein ausgewähltes € Arztekollektiv beschränkt durchgeführt und nach einer Laufzeit von maximal 2 Jahren wieder eingestellt.…”