Institute of General Practice, Technische Universität München, Munich, Germany.
J Eval Clin Pract. 2011 Aug;17(4):615-20. doi: 10.1111/j.1365-2753.2010.01558.x. Epub 2010 Oct 4.
Vocational trainees in general practice are often confronted with new and unusual situations. The application of the principles and techniques of evidence-based medicine (EBM) could often be appropriate in these situations. We aimed to investigate attitudes towards EBM among doctors undergoing postgraduate training in general practice in Germany. In particular, we were interested in which aspects the answers of doctors with an overall negative attitude towards EBM differed from those with a positive attitude.
A total of 153 doctors participating in courses for postgraduate medical training in general practice were asked to fill in a questionnaire on attitudes towards EBM and relevance of clinical research. Answers of doctors with a negative attitude towards EBM (negative sum in the questions asking personal judgment on EBM) were compared with those of the remaining doctors.
A total of 142 (93%) doctors returned the questionnaire and 121 responded to the questions on EBM (21 responded that they had not heard about EBM). On average, attitudes towards EBM were positive; however, nine doctors gave negative ratings. EBM-sceptics were similar regarding age, years working as doctors and working hours per week, but were more often male (P = 0.03). EBM-sceptics considered keeping up to date as important as non-sceptics but were significantly (P < 0.001) more negative regarding whether EBM is an important decision aid in one's personal work, whether it helps to identify the best clinical options and whether it constrains therapeutic freedom.
Overall, doctors specializing in general practice in Germany have a quite positive attitude towards EBM. A small minority, however, seems to consider EBM a threat to their professional autonomy.
全科医学实习医生经常会遇到新的、不常见的情况。在这些情况下，应用循证医学（EBM）的原则和技术通常是合适的。我们旨在研究德国全科医学研究生培训医生对循证医学的态度。特别是，我们对整体上对循证医学持否定态度的医生的回答与持肯定态度的医生的回答有何不同之处感兴趣。
共有 153 名参加全科医学研究生课程的医生被要求填写一份关于循证医学态度和临床研究相关性的问卷。对循证医学持否定态度的医生（在询问个人对循证医学的判断的问题中给出否定总分）的回答与其余医生的回答进行了比较。
共有 142 名（93%）医生返回了问卷，121 名医生回答了关于循证医学的问题（21 名医生表示他们没有听说过循证医学）。平均而言，医生对循证医学的态度是积极的；然而，有 9 名医生给出了否定的评价。循证医学怀疑论者在年龄、行医年限和每周工作时间方面相似，但更多的是男性（P = 0.03）。循证医学怀疑论者认为保持最新状态与非怀疑论者一样重要，但他们对循证医学是否是个人工作中的重要决策辅助工具、是否有助于确定最佳临床选择以及是否限制治疗自由的看法明显更为负面（P < 0.001）。
总体而言，德国专门从事全科医学的医生对循证医学的态度相当积极。然而，少数人似乎认为循证医学对他们的专业自主权构成威胁。
