Does the medical literature contain the evidence to answer the questions of primary care physicians? Preliminary findings of a study.
OBJECTIVE
To assess the quality of information retrieved in MEDLINE searches performed to answer clinical questions of primary care physicians.


METHODS
Ambulatory rural and nonrural practices.


METHODS
Active, non-academic primary care physicians; professional medical librarians, a general internist.


METHODS
Descriptive study in 3 stages: 1) Office Interviews, to record questions that arise in primary care practice; 2) Online Searches, to locate information that might answer these questions; and 3) Critical Appraisal to determine the quality of the information contained in the articles retrieved.


RESULTS
Of 74 articles judged by clinicians to be relevant to their questions, 2 were critical reviews, 14 reported results of randomized controlled trials, and 4 reported results of cohort studies. The remainder contained weaker evidence: 1 reported results of a case-control study, 6 were longitudinal case series, 13 were cross-sectional descriptions of disease, 12 were cross-sectional descriptions of diagnostic testing, and 22 were review articles which did not meet criteria for a critical review.


CONCLUSIONS
Searching the medical literature to answer the questions of primary care physicians was successful in retrieving recent, relevant information, and often provided "a clear answer" to the question, but the cost of using bibliographic retrieval was high, and fewer than a third of the articles retrieved contained high quality evidence.
Gorman
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Providence Medical Center, Portland, OR.
D003658:Decision Making, Computer-Assisted; D005194:Family Practice; D006801:Humans; D016239:MEDLINE