Implication of evidence-based medicine in prescription guidelines taught to French medical students: current status in the cardiovascular field.
OBJECTIVE
To study how satisfactory the contents of introductory courses in cardiovascular therapeutics, given to medical students in France, are with respect to the concepts of evidence-based medicine.


METHODS
Medical school lecturers were asked to provide written course material used as part of medical school courses. Best-available evidence was classified as existent (including two therapeutic subclasses: indicated and contraindicated), and nonexistent. Four scores (from 0 to 10) were given, according to conformity with best-available evidence, and citation of randomized clinical trials (RCT), meta-analyses and therapeutic objectives.


RESULTS
Thirty-four written documents were obtained from 43 faculties. Although the score (mean +/- SEM) of conformity with best-available evidence was 5.43 +/- 0.28 for the existent best-available evidence class, the corresponding scores for the citation of RCT, meta-analyses, and therapeutic objectives were, respectively, 1 +/- 0.2, 0.16 +/- 0.07, and 2.7 +/- 0.3. The four scores were highest when the best-available evidence belonged to the indicated class, intermediate when best-available evidence was nonexistent, and lowest for the contraindicated class (P < .05). These scores were significantly higher when the printed material was intended for specialists.


CONCLUSIONS
Despite some limitations, the extent of agreement with the best-available evidence is only moderate. Pathophysiologic reasoning is largely preferred to justify the choice of therapeutics recommended to medical students.
Nony
P
P
Department of Clinical Pharmacology, Cardiovascular Hospital, Lyon, France. pn@upcl.univ-lyon1.fr
Cucherat
M
M
Boissel
J P
JP
D000704:Analysis of Variance; D002318:Cardiovascular Diseases / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000592:standards*; D004501:Education, Medical / Q000592:standards*; D019317:Evidence-Based Medicine; D005602:France; D006801:Humans; D016014:Linear Models; D015201:Meta-Analysis as Topic; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic