[Implementation of evidence-based medicine in clinical practice--external offers to search for and critically assess medical literature].
Evidence-based medicine (EBM) is considered complicated and its realization in everyday medical practice causes difficulties. Therefore, in the course of the present study we made each physician of a university hospital the offer that we would undertake for them a systematic search for and critical assessment of the medical literature on a particular patient-related question they might have. One to two weeks after we had supplied our answers, the influence our answers had had on the medical decisions taken and the overall satisfaction with our offer were evaluated using standardized questionnaires.


RESULTS
A total of 34 EBM questions were asked, 31 (91%) of which had a shape that permitted an answer to be obtained. The median time required for supplying an answer was 7 hours (within a range of 3 to 32). In the course of the subsequent evaluation process it was possible to analyze 19 questionnaires (the equivalent of a response rate of 61%). In general our EBM answers were considered good, comprehensible and transparent. For 2/3 of the participants the answers supplied by us satisfied their informational requirements and could be applied satisfactorily in clinical practice.


CONCLUSIONS
The offer of external high-quality search-and-assessment of medical literature is useful, but the process is time consuming. Easier access to medical information and knowledge of how to search for and assess literature are important preconditions for the successful implementation of EBM. To achieve the latter evidence-based secondary literature and the development of evidence-based guidelines appear to be reasonable alternatives.
Euler
Ulrike
U
Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Klinikum Charité, Humboldt-Universität zu Berlin.
Juche
Aaron
A
Brüggenjürgen
Bernd
B
Kunz
Regina
R
Willich
Stefan N
SN
D019317:Evidence-Based Medicine / Q000592:standards*; D005194:Family Practice / Q000592:standards*; D005858:Germany; D006785:Hospitals, University; D006801:Humans; D010820:Physicians / Q000592:standards; D011785:Quality Assurance, Health Care; D011795:Surveys and Questionnaires