Cheng Yu, Zou Chuan, Liu Chaojie, Jia Yu, Yang Rong, Zhang Yonggang, Han Jianjun, Lei Yi, Liao Xiaoyang
General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China.
Teaching & Research Section, General Practice Research Institute, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China.
BMC Prim Care. 2025 May 14;26(1):161. doi: 10.1186/s12875-025-02838-6.
Evidence-based medicine(EBM) is widely used across various disciplines globally. However, in general practice, we need a more person-centered approach rather than a disease-centered one. The differentiation of evidence-based general practice (EBGP) is essential. This scoping review aims to extract a potential definition of EBGP and uncover its characteristics in implementation.
We conducted a comprehensive search across three databases - PubMed, Embase, and Cochrane Library - spanning from the inception of these databases to September 24, 2023. The inclusion criteria encompassed studies focusing on EBM in general practice, involving general practitioners as study participants, and reporting any aspects related to providing evidence-based care. Our screening process involved evaluating titles, abstracts, and full texts to extract definitions and characteristics from all relevant records discussing EBGP. These identified characteristics were then categorized and thematically grouped following the guidelines outlined in the Consolidated Framework for Implementation Research (CFIR).
We initially retrieved 20,263 records from the original search. Among these, 40 records aligned with our inclusion criteria. The majority of these records took the form of reviews, qualitative studies, comments, cross-sectional surveys, or editorials. From these 40 studies, we extracted 33 unique characteristics of EBGP. Subsequently, these characteristics were thematically grouped into 19 categories, which fell under five overarching themes: evidence base, GP's role, person's role, care process, and care environment.
We propose the following definition for EBGP: Applying a combination of the best available evidence, integrated within the inner and outer contexts of general practice, person preferences, and the expertise of the general practitioner to formulate shared, person-centered decisions aimed at holistic care. This definition provides a solid foundational framework for the development of EBGP guidelines and policies.
循证医学（EBM）在全球各学科中广泛应用。然而，在全科医疗中，我们需要一种更以患者为中心的方法，而非以疾病为中心的方法。循证全科医疗（EBGP）的区分至关重要。本范围综述旨在提取EBGP的潜在定义，并揭示其在实施中的特征。
我们对三个数据库——PubMed、Embase和Cochrane图书馆——进行了全面检索，检索时间跨度从这些数据库建立之初至2023年9月24日。纳入标准包括聚焦于全科医疗中循证医学的研究、以全科医生作为研究参与者以及报告与提供循证医疗相关的任何方面。我们的筛选过程包括评估标题、摘要和全文，以从所有讨论EBGP的相关记录中提取定义和特征。然后，根据实施研究综合框架（CFIR）中概述的指南，对这些确定的特征进行分类和主题分组。
我们最初从原始检索中获得20263条记录。其中，40条记录符合我们的纳入标准。这些记录大多数采用综述、定性研究、评论、横断面调查或社论的形式。从这40项研究中，我们提取了EBGP的33个独特特征。随后，这些特征被主题分组为19个类别，这些类别归属于五个总体主题：证据基础、全科医生的角色、患者的角色、护理过程和护理环境。
我们为EBGP提出以下定义：将最佳可得证据与全科医疗的内部和外部环境、患者偏好以及全科医生的专业知识相结合，以制定旨在提供整体护理的、以患者为中心的共同决策。这一定义为EBGP指南和政策的制定提供了坚实的基础框架。
