The practice of evidence-based medicine in an acute medical ward: retrospective study.
OBJECTIVE
To review the practice of evidence-based medicine with respect to drug treatment given to medical in-patients.


METHODS
Retrospective study.


METHODS
Teaching hospital, Hong Kong.


METHODS
Medical records of 129 consecutive patients who were admitted to the acute adult general medical ward from 1 September 1998 to 30 September 1998 were reviewed.


METHODS
Primary diagnoses, drug treatments prescribed, and the level of evidence (based on a literature search of randomised controlled trials and relevant studies) that supported the treatment given.


RESULTS
For the 129 patients studied, 91 drug interventions had been prescribed on 312 occasions. Treatment that was supported by randomised controlled trials was prescribed in 162 (52.9%) cases. In 121 (38.8%) cases, patients were given standard and commonly used drugs that were not supported by evidence from clinical trials, and in 29 (9.3%) cases, the treatments given had no substantial supporting evidence. The management of some frequently encountered medical conditions was not based on trial data, because the relevant studies had not been conducted.


CONCLUSIONS
Basing treatment on comparative efficacy results is a worthwhile goal, but there are limitations in conducting literature searches to identify relevant trials and studies. Evidence-based medical practice is not applicable in a large number of commonly encountered conditions.
Hui
A C
AC
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Mak
J
J
Wong
S M
SM
Fu
M
M
Wong
K S
KS
Kay
R
R
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003695:Delivery of Health Care; D004358:Drug Therapy; D019317:Evidence-Based Medicine; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D016032:Randomized Controlled Trials as Topic / Q000592:standards; D012189:Retrospective Studies; D016896:Treatment Outcome