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Clinical questions in primary care

2022-11Artigo científico Acesso aberto
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dc.contributor.authorViegas Dias, Catarina
dc.contributor.authorJasmins, Clara
dc.contributor.authorRodrigues, David
dc.contributor.authorHeleno, Bruno
dc.contributor.authorHeleno, Bruno
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.institutionComprehensive Health Research Centre (CHRC) - pólo NMS
dc.contributor.pblPLOS - Public Library of Science
dc.date.accessioned2022-11-24T22:23:18Z
dc.date.available2022-11-24T22:23:18Z
dc.date.issued2022-11
dc.descriptionFunding: The present publication was funded by Fundac¸ão Ciência e Tecnologia, IP national support through CHRC (UIDP/04923/2020).
dc.description.abstractINTRODUCTION: Clinicians raise at least one question for every two patients they see, but search for an answer to less than half of these questions, and rarely use evidence-based resources. One barrier to evidence-based practice is doubt that the search would yield an answer, and we found insufficient evidence to refute this concern. This study aims to identify what proportion of clinical questions in primary care can be answered with online evidence-based practice resources, and what proportion of these can be answered with pre-appraised evidence. MATERIALS AND METHODS: Cross-sectional study in two primary care practices. The inclusion criteria were family doctors, generalists and residents working in 2 selected practices. We collected a total of 238 questions from 19 family medicine specialists, 9 family medicine residents and 3 generalist doctors. Doctors were asked to record any clinical question that arose during 4 days of appointments. The primary outcome was the proportion of clinical questions answered with online evidence-based practice resources. The secondary outcome was the level of evidence needed to reach to find the answers (clinical summaries, systematic guidelines, systematic reviews or primary studies), according to Haynes' pre-appraised evidence pyramid model. RESULTS: 191 of the 206 valid clinical questions could be answered with online evidence-based practice resources (92.7% [95% CI 88.3%-95.9%]). Most of these questions (90.8% CI 95% 85.9%-94.4%) were successfully answered using clinical summaries (BMJ Best Practice, DynaMed or UpToDate), with a median search time of 4 minutes (range 1-16.5). CONCLUSIONS: Contrary to clinician's beliefs, the majority of clinical questions can be answered with online evidence-based practice resources, and most of them with pre-appraised evidence. This study could encourage family doctors to increase the use of clinical summaries. Furthermore, these results highlight the importance of teaching how to search for and apply pre-appraised evidence.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent524549
dc.identifier.doi10.1371/journal.pone.0277462
dc.identifier.issn1932-6203
dc.identifier.otherPURE: 47909388
dc.identifier.otherPURE UUID: 3148b866-5bc3-4048-89d0-d4f35a55259d
dc.identifier.otherScopus: 85141893759
dc.identifier.otherPubMed: 36367905
dc.identifier.otherORCID: /0000-0002-3943-1858/work/123503806
dc.identifier.otherWOS: 000926000200026
dc.identifier.urihttp://hdl.handle.net/10362/145777
dc.identifier.urlhttps://www.scopus.com/pages/publications/85141893759
dc.language.isoeng
dc.peerreviewedyes
dc.subjectGeneral
dc.titleClinical questions in primary careen
dc.title.subtitleWhere to find the answers - a cross-sectional studyen
dc.typejournal article
degois.publication.issue11
degois.publication.titlePLoS ONE
degois.publication.volume17
dspace.entity.typePublication
person.familyNameHeleno
person.givenNameBruno
person.identifier.ciencia-id8B1D-AC7D-5CB2
person.identifier.orcid0000-0002-3943-1858
person.identifier.scopus-author-id54937604600
rcaap.rightsopenAccess
relation.isAuthorOfPublication2a89b92b-0b51-4df1-911c-da2e71efae1b
relation.isAuthorOfPublication.latestForDiscovery2a89b92b-0b51-4df1-911c-da2e71efae1b

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