Thomas T, Fahey T, Somerset M
United Medical School, London.
Br J Gen Pract. 1998 May;48(430):1229-32.
With the expansion of academic departments, the National Research and Development initiative, and the Culyer report, United Kingdom (UK) general practice research is undergoing a period of investment and change.
To examine the content and methodological quality of UK-published general practice research, and in particular to focus on the quantity and proportion of studies that were of high methodological quality, namely randomized controlled trials (RCTs).
We manually searched three UK-published journals over a five-year period: the British Journal of General Practice (BJGP), Family Practice, and the British Medical Journal (BMJ), which has a section devoted to general practice research. Studies were classified according to the International Classification of Health Problems of Primary Health Care (ICHPPC-2).
Nearly half of published studies in UK primary care journals were concerned with either organization and administration issues in primary care or social problems (509 studies, 48%). Just over half were either qualitative studies or surveys of opinion or attitudes (528 studies, 50%). The overall number of RCTs was low (67 studies, 6%), and the proportion published has not changed over time (chi 2 for trend = 3.79, df = 1, P = 0.051). In contrast to surgical journals, nearly one-fifth of studies in general practice followed a longitudinal design (186 studies, 18%).
The content and design of published general practice research in the UK is varied and broad. The most robust methodological design should be the aim of all prospective researchers in general practice.
随着学术部门的扩张、国家研发计划以及库利尔报告的出台,英国的全科医学研究正经历着一个投资与变革的时期。
审视英国发表的全科医学研究的内容和方法学质量,尤其关注方法学质量高的研究数量及比例,即随机对照试验(RCT)。
我们在五年时间里手动检索了三本英国出版的期刊:《英国全科医学杂志》(BJGP)、《家庭医学》以及设有全科医学研究板块的《英国医学杂志》(BMJ)。研究根据《初级卫生保健国际卫生问题分类》(ICHPPC - 2)进行分类。
英国初级保健期刊上发表的研究中,近一半关注初级保健中的组织与管理问题或社会问题(509项研究,48%)。略超一半的研究为定性研究或意见或态度调查(528项研究,50%)。RCT的总数较少(67项研究,6%),且发表比例未随时间变化(趋势检验卡方值 = 3.79,自由度 = 1,P = 0.051)。与外科期刊不同,全科医学研究中近五分之一采用纵向设计(186项研究,18%)。
英国发表的全科医学研究的内容和设计多样且广泛。最可靠的方法学设计应是所有全科医学前瞻性研究者的目标。