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The level of evidence utilized to answer general practitioners’ questions

The level of evidence utilized to answer general practitioners’ questions. Karen Davies. Evidence Based Medicine. Haynes et al., 1996. EBM - Levels of Evidence. Level One. Level Two. Research Objectives. To determine the highest level of evidence per question

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The level of evidence utilized to answer general practitioners’ questions

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  1. The level of evidence utilized to answer general practitioners’ questions Karen Davies

  2. Evidence Based Medicine Haynes et al., 1996

  3. EBM - Levels of Evidence Level One Level Two

  4. Research Objectives • To determine the highest level of evidence per question • To determine the number of questions not answered due to a lack of evidence • To determine the number of times a guideline was used to answer a question • To determine the type of websites used to answer questions

  5. EBM Levels Used in This Study Level One Guidelines Level Two Websites

  6. Methodology • Two national primary care answering services - ATTRACT and NLH Primary Care Answering Service • Clinical questions • Identified the type of evidence used to answer the question • Data was collected for four months, from 1st March to 30th June 2008

  7. Highest Level of Evidence • 11 of the 57 ATTRACT questions answered by level 1 or 2 in the evidence hierarchy – 19% • 74 of 724 Primary Care Answering Service questions answered by level 1 / 2 evidence – 10% • Average 11%

  8. Questions Not Answered • 2 out of 57 ATTRACT questions – 3.5% • 125 out of 724 NLH Primary Care Answering Service questions – 17% • Average 16%

  9. Guidelines Used • 24 of the 57 questions from ATTRACT - 42% • 301 of the 724 questions from NLH Primary Care Answering Service – 42%

  10. Type of Websites • 14 (18%) websites were used by ATTRACT and 116 (25%) by Primary Care Answering Service • Not for Profit • NHS (National Health Service) • Average – 17%

  11. Evidence for the Questions

  12. Questions and Their Evidence I • What evidence is there for the use of light boxes in the treatment of SAD? • Are there any alternative /complimentary therapies recommended for IBS? • Are there benefits from mindfulness therapy? • What is the evidence for the use of statin in secondary prevention in the over 80's?

  13. Questions and Their Evidence II • In a 36 year old, hysterectomy and not eligible for HRT, how do we manage osteoporosis risk? • What are the potential causes of foot numbness, spreading to both legs? • Can a tens machine be used by a patient who is 20 weeks pregnant? • Is there any evidence of an interaction between warfarin and litozin?

  14. Why Is This Research Useful? • NLH Primary Care Answering Service closed • Useful service • Guidelines may answer 40% of questions • 10% of questions were answered using level 1 or 2 evidence

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