A review of an online medical reference for general medicine practitioners revealed a dearth of high-quality, evidence-based data to support clinical decisions in the primary care setting, according to a study published in the journal Evidence-Based Medicine.
For the study, researchers analyzed 721 chapters in Essential Evidence, an online reference guide for generalists. Each chapter represents a certain treatment area and contains care recommendations. Among the 3,251 recommendations compiled in the database, approximately 18 percent were supported by high-quality, patient-oriented evidence. In total, only 51 percent of the recommendations were supported by patient-centered care outcomes like morbidity, mortality, quality of life or symptom reduction.
Recommendations in the areas of pregnancy and childbirth, cardiovascular health and psychiatry were most likely to be based on high-quality, research-based evidence. Hematological, musculoskeletal and rheumatological, and poisoning and toxicity topics displayed the lowest percentage of high-quality evidence.
"The research done in the primary care setting, which is where most outpatients are seen, is woefully underfunded," said Mark Ebell, MD, a professor of epidemiology at Athens-based University of Georgia's college of public health and lead author of the study. "[T]hat's part of the reason why there's such a large number of recommendations that are not based on the highest level of evidence … You would want your care to be guided by studies that have demonstrated that what the physician recommends will help you live better or longer. We should all want that kind of information to guide care."
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