Assessing the extent of evidence-based therapeutic intervention in a university based family medicine outpatient clinic

Aim : The purpose of the present study was to estimate the proportion of therapeutic interventions which are supported by scientific evidence in a university based family medicine outpatient clinic. Methods : A retrospective review of patient medical records was done to assess the primary diagnosis and treatment option. A Medline review from 1966 to 2001, standard textbooks and evidence-based medicine online databases including American College of Physician journal club and Cochrane database of systematic reviews were searched to assess the evidence for the chosen intervention. The evidence was then classified as one of three categories developed by the Oxford Center for Evidence-Based Medicine: (i) evidence from randomized controlled trials (RCT); (ii) convicing non experimental evidence; (iii) and interventions without substantial evidence. Results : Of the 356 primary diagnosis and treatment pairs, 59.6% were supported by evidence from at least one RCT. A total of 19.4% were supported by convincing non experimental evidence, and 75 (21%) were classified as intervention without substantial evidence. As a result, 79.0% of interventions (281/356) met our criteria to be evidenced-based. Conclusions : Approximately 60% of the interventions in a university based family medicine outpatient practice were supported by evidence from at least one RCT. Although this result is limited to one tertiary hospital outpatient care setting, it could serve as a baseline reference for future assessments of evidence-based family practice. © 2003 Blackwell Publishing Asia and Wonca