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全科医生对循证医学途径的认知:一项问卷调查

General practitioner's perceptions of the route to evidence based medicine: a questionnaire survey.

作者信息

McColl A, Smith H, White P, Field J

机构信息

Wessex Primary Care Research Network, University of Southampton, Aldermoor Health Centre.

出版信息

BMJ. 1998 Jan 31;316(7128):361-5. doi: 10.1136/bmj.316.7128.361.

Abstract

OBJECTIVES

To determine the attitude of general practitioners towards evidence based medicine and their related educational needs.

DESIGN

A questionnaire study of general practitioners.

SETTING

General practice in the former Wessex region, England.

SUBJECTS

Randomly selected sample of 25% of all general practitioners (452), of whom 302 replied.

MAIN OUTCOME MEASURES

Respondents' attitude towards evidence based medicine, ability to access and interpret evidence, perceived barriers to practising evidence based medicine, and best method of moving from opinion based to evidence based medicine.

RESULTS

Respondents mainly welcomed evidence based medicine and agreed that its practice improves patient care. They had a low level of awareness of extracting journals, review publications, and databases (only 40% knew of the Cochrane Database of Systematic Reviews), and, even if aware, many did not use them. In their surgeries 20% had access to bibliographic databases and 17% to the world wide web. Most had some understanding of the technical terms used. The major perceived barrier to practising evidence based medicine was lack of personal time. Respondents thought the most appropriate way to move towards evidence based general practice was by using evidence based guidelines or proposals developed by colleagues.

CONCLUSION

Promoting and improving access to summaries of evidence, rather than teaching all general practitioners literature searching and critical appraisal, would be the more appropriate method of encouraging evidence based general practice. General practitioners who are skilled in accessing and interpreting evidence should be encouraged to develop local evidence based guidelines and advice.

摘要

目的

确定全科医生对循证医学的态度及其相关教育需求。

设计

对全科医生进行问卷调查研究。

地点

英国前韦塞克斯地区的全科医疗。

对象

从所有全科医生中随机抽取25%的样本(452人),其中302人进行了回复。

主要观察指标

受访者对循证医学的态度、获取和解读证据的能力、循证医学实践的感知障碍,以及从基于意见的医学转向循证医学的最佳方法。

结果

受访者主要欢迎循证医学,并认同其实践可改善患者护理。他们对提取期刊、综述出版物和数据库的认知水平较低(只有40%知道Cochrane系统评价数据库),而且即使知晓,许多人也未使用。在他们的诊所中,20%可以访问书目数据库,17%可以访问万维网。大多数人对所使用的技术术语有一定理解。循证医学实践的主要感知障碍是缺乏个人时间。受访者认为转向循证全科医疗的最合适方法是使用同事制定的循证指南或建议。

结论

促进和改善证据摘要的获取,而不是教授所有全科医生文献检索和批判性评价,将是鼓励循证全科医疗的更合适方法。应鼓励擅长获取和解读证据的全科医生制定当地的循证指南和建议。

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