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Healthy Skepticism Library item: 2083

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

 

Publication type: Journal Article

McColl A, Smith H, White P, Field J.
General practitioner's perceptions of the route to evidence based medicine: a questionnaire survey.
BMJ 1998 Jan 31; 316:(7128):361-5
http://bmj.bmjjournals.com/cgi/content/full/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.

Keywords:
MeSH Terms: Attitude of Health Personnel* Awareness Evidence-Based Medicine* Family Practice* Great Britain Humans Perception Questionnaires Research Support, Non-U.S. Gov't

 

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909