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General practitioners' perceptions of the route to evidence based medicine: a questionnaire survey

BMJ 1998; 316 doi: (Published 31 January 1998) Cite this as: BMJ 1998;316:361
  1. Alastair McColl, lecturer in public health medicinea,
  2. Helen Smith, senior lecturer in primary carea,
  3. Peter White, general practitioner tutorb,
  4. Jenny Field, senior lecturer in primary carec
  1. a Wessex Primary Care Research Network, Primary Medical Care, University of Southampton, Aldermoor Health Centre, Southampton SO16 5ST
  2. b Nightingale Surgery, Great Well Drive, Romsey, Hampshire SO51 7QN
  3. c Primary Medical Care, University of Southampton
  1. Correspondence to: Dr Alastair McColl
  • Accepted 28 November 1997


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.

Key messages

  • Despite considerable variation in 302 general practitioners' attitudes to the promotion of evidence based medicine, most were welcoming and agreed that it improved patient care

  • There was a low level of awareness of extracting journals, review publications, and databases relevant to evidence based medicine, and the major perceived barrier to its practice was lack of personal time

  • In their surgery only 20% of general practitioners had access to Medline or other bibliographic databases and 17% had access to the world wide web

  • Most had some understanding of the technical terms used in evidence based medicine, but less than a third felt able to explain to others the meaning of these terms

  • Respondents thought that the best way to move from opinion based practice towards evidence based medicine was by using evidence based guidelines or protocols developed by colleagues


    • Accepted 28 November 1997
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