Abstract:
BACKGROUND:General Practitioners (GPs) employ strategies to identify and retrieve medical evidence for clinical decision making which take workload and time constraints into account. Optimal Foraging Theory (OFT) initially developed to study animal foraging for food is used to explore the information searching behaviour of General Practitioners. This study is the first to apply foraging theory within this context.Study objectives were: 1. To identify the sequence and steps deployed in identifiying and retrieving evidence for clinical decision making. 2. To utilise Optimal Foraging Theory to assess the effectiveness and efficiency of General Practitioner information searching. METHODS:GPs from the Wellington region of New Zealand were asked to document in a pre-formatted logbook the steps and outcomes of an information search linked to their clinical decision making, and fill in a questionnaire about their personal, practice and information-searching backgrounds. RESULTS:A total of 115/155 eligible GPs returned a background questionnaire, and 71 completed their information search logbook. GPs spent an average of 17.7 minutes addressing their search for clinical information. Their preferred information sources were discussions with colleagues (38% of sources) and books (22%). These were the two most profitable information foraging sources (15.9 min and 9.5 min search time per answer, compared to 34.3 minutes in databases). GPs nearly always accessed another source when unsuccessful (95% after 1st source), and frequently when successful (43% after 2nd source). Use of multiple sources accounted for 41% of searches, and increased search success from 70% to 89%. CONCLUSIONS:By consulting in foraging terms the most 'profitable' sources of information (colleagues, books), rapidly switching sources when unsuccessful, and frequently double checking, GPs achieve an efficient trade-off between maximizing search success and information reliability, and minimizing searching time. As predicted by foraging theory, GPs trade time-consuming evidence-based (electronic) information sources for sources with a higher information reward per unit time searched. Evidence-based practice must accommodate these 'real world' foraging pressures, and Internet resources should evolve to deliver information as effectively as traditional methods of information gathering.
journal_name
BMC Fam Practjournal_title
BMC family practiceauthors
Dwairy M,Dowell AC,Stahl JCdoi
10.1186/1471-2296-12-90subject
Has Abstractpub_date
2011-08-23 00:00:00pages
90issn
1471-2296pii
1471-2296-12-90journal_volume
12pub_type
杂志文章abstract:BACKGROUND:Hypertension prevalence is high in China, while patients' levels of hypertension awareness, treatment and control are low. General practitioners' knowledge and training relating to hypertension prevention may be an important related factor. We aimed to investigate general practitioners' knowledge of hyperten...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-14-16
更新日期:2013-01-28 00:00:00
abstract:BACKGROUND:A cluster randomised trial was conducted to determine the effectiveness of locally adapted practice guidelines and education about paediatric asthma management, delivered to general practitioners (GPs) in small group interactive workshops. METHODS:Twenty-nine practices were randomly allocated to one of thre...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-9-22
更新日期:2008-04-20 00:00:00
abstract:BACKGROUND:There are a substantial number of instruments for primary-care clinicians to assess physical-activity (PA). However, there are few studies that have explored the views of clinicians regarding comparative acceptability and ease of use. A better understanding of how clinicians perceive instruments could help o...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-016-0536-6
更新日期:2016-09-22 00:00:00
abstract:BACKGROUND:Upper respiratory tract infections (URTI) are common. The etiologic factor is usually viral, but many physicians prescribe antibiotics. We aimed to evaluate parents' expectations of and knowledge about the role of antibiotics in childhood URTI. METHODS:The study was conducted in thirteen primary care pediat...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-4-20
更新日期:2003-12-30 00:00:00
abstract:BACKGROUND:Symptoms of cancer may be interpreted differently by different patients before the diagnosis. This study investigated symptom attributions in Danish patients with colorectal cancer and the potential associations with symptom type, socio-demographic characteristics and patient interval. METHODS:Data were col...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0315-9
更新日期:2015-09-03 00:00:00
abstract:BACKGROUND:Physical activity (PA) counselling is an effective approach to promote PA in primary health care (PHC). Barriers to PA counselling in PHC include time constraints, lack of knowledge and skills of providers, and systemic barriers. Using electronic health (eHealth) has the potential to promote PA. This scoping...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01304-9
更新日期:2020-11-06 00:00:00
abstract:BACKGROUND:Low patient satisfaction with the quality of out-of-hours primary care (OOH-PC) has been linked with several individual and organizational factors. However, findings have been ambiguous and may not apply to the Danish out-of-hours (OOH) setting in which general practitioners (GPs) perform the initial telepho...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-017-0681-6
更新日期:2018-01-11 00:00:00
abstract:BACKGROUND:General practitioners' (GPs') feelings of burnout or dissatisfaction may affect their patient care negatively, but it is unknown if these negative feelings also affect their mental health care. GPs' available time, together with specific communication tools, are important conditions for providing mental heal...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-10-60
更新日期:2009-08-26 00:00:00
abstract:BACKGROUND:Specialised diabetes teams, specifically certified nurse and dietitian diabetes educator teams, are being integrated part-time into primary care to provide better care and support for Canadians living with diabetes. This practice model is being implemented throughout Canada in an effort to increase patient a...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-016-0407-1
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Clinical guidelines exhort clinicians to encourage patients to improve their health behaviours. However, most offer little support on how to have these conversations in practice. Clinicians fear that health behaviour change talk will create interactional difficulties and discomfort for both clinician and pat...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-019-0992-x
更新日期:2019-08-03 00:00:00
abstract:BACKGROUND:Policy makers in Africa are ambivalent about the need for family physicians to strengthen district health services. Evidence on the impact of family physicians is therefore needed. The aim was to develop a tool to evaluate the impact of family physicians on district health services according to the six expec...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-014-0204-7
更新日期:2014-12-12 00:00:00
abstract:BACKGROUND:In medical malpractice litigations in recent years in Japan, it is notable that the growing number of medical litigation cases includes the issue of a doctor's explanation to the patient as a pivotal point. The objective of this study was to identify factors of physicians' communication skills with patients,...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-9-43
更新日期:2008-07-25 00:00:00
abstract:BACKGROUND:The vast majority of patients with diabetes have multiple chronic conditions, increasing complexity of care; however, clinical practice guidelines, interventions, and public reporting metrics do not adequately address the interaction of these multiple conditions. To advance the understanding of diabetes clin...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0253-6
更新日期:2015-03-28 00:00:00
abstract:BACKGROUND:Identification of perinatal mental health problems and effective care for women who experience them are important considering the potentially serious impact that they may have on the wellbeing of the woman, her baby, family and wider society. General practitioners (GPs) play a central role in identifying and...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-018-0884-5
更新日期:2018-12-13 00:00:00
abstract:BACKGROUND:Distress is an expected emotional response to a negative life event. Experiences common in later life may trigger distress such as bereavement or loss of physical mobility. Distress is considered to be distinct to anxiety and/or depression and is not diagnostically labelled as a mental health problem. Older ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01152-7
更新日期:2020-05-04 00:00:00
abstract:BACKGROUND:Antibiotics are being overprescribed in ambulant care, especially for respiratory tract infections (RTIs). Gaining insight into the actual reasons for prescribing remains important for the design of effective strategies to optimise antibiotic prescribing. We aimed to determine items of importance for the ant...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-3-16
更新日期:2002-09-09 00:00:00
abstract:BACKGROUND:In order to proceed from a paper based registration to a surveillance system that is based on extraction of electronic health records (EHR), knowledge is needed on the number and representativeness of sentinel GPs using a government-certified EHR system and the quality of EHR data for research, expressed in ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-11-50
更新日期:2010-06-25 00:00:00
abstract:BACKGROUND:There are caregivers who see their quality of life (QoL) impaired due to the demands of their caregiving tasks, while others manage to adapt and overcome the crises successfully. The influence of the family function in the main caregiver's situation has not been the subject of much evaluation. The aim of thi...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-12-19
更新日期:2011-04-15 00:00:00
abstract:BACKGROUND:Variation in prescription of antibiotics in primary care can indicate poor clinical practice that contributes to the increase of resistant strains. General Practitioners (GPs), as a professional group, are expected to have a fairly homogeneous prescribing style. In this paper, we describe variation in prescr...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-015-0224-y
更新日期:2015-01-29 00:00:00
abstract:BACKGROUND:Nursing in Australian general practice has grown rapidly over the last decade in response to government initiatives to strengthen primary care. There are limited data about how this expansion has impacted on the nursing role, scope of practice and workforce characteristics. This study aimed to describe the c...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-15-52
更新日期:2014-03-25 00:00:00
abstract:BACKGROUND:Sleep problems are common, affecting over a third of adults in the United Kingdom and leading to reduced productivity and impaired health-related quality of life. Many of those whose lives are affected seek medical help from primary care. Drug treatment is ineffective long term. Psychological methods for man...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-10-9
更新日期:2009-01-26 00:00:00
abstract:BACKGROUND:The general practitioner (GP) can play an important role in promoting a healthy lifestyle, which is especially relevant in people with an elevated risk of cardiovascular diseases due to hypertension. Therefore, the aim of this study was to determine the frequency and content of lifestyle counseling about wei...
journal_title:BMC family practice
pub_type: 杂志文章,多中心研究
doi:10.1186/1471-2296-9-58
更新日期:2008-10-14 00:00:00
abstract:BACKGROUND:Patients' expectations can influence antibiotic prescription by primary healthcare physicians. We assessed knowledge, attitude and practices towards antibiotic use for upper respiratory tract infections (URTIs), and whether knowledge is associated with increased expectations for antibiotics among patients vi...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-016-0547-3
更新日期:2016-11-03 00:00:00
abstract:BACKGROUND:Doctors and nurses are two natural partners in the healthcare team, but they usually differ in their perspectives on how to work for increased health. These professions may also have different beliefs about medicines, a factor important for adherence to medicines. The aim was to explore general beliefs about...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/1471-2296-10-35
更新日期:2009-05-18 00:00:00
abstract:BACKGROUND:The average delay in diagnosis for patients with axial spondyloarthritis (axSpA) is 7 to 10 years. Factors that contribute to this delay are multifactorial and include the lack of diagnostic criteria (although classification criteria exist) for axSpA and the difficulty in distinguishing inflammatory back pai...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-020-01274-y
更新日期:2020-09-29 00:00:00
abstract:BACKGROUND:Except for the established risk factors, presence of target organ damage has an important role in the treatment of hypertensive subjects. The aim of the present study was to estimate the prevalence of target organ damage in primary care subjects. METHODS:This multi-centre, cross-sectional survey of 115 prim...
journal_title:BMC family practice
pub_type: 杂志文章,多中心研究
doi:10.1186/1471-2296-12-75
更新日期:2011-07-14 00:00:00
abstract:BACKGROUND:People with long term conditions (LTCs) make most of the daily decisions and carry out the activities which affect their health and quality of life. Only a fraction of each contact with a health care professional (HCP) is spent supporting this. This paper describes how care and support planning (CSP) and an ...
journal_title:BMC family practice
pub_type: 杂志文章
doi:10.1186/s12875-019-1042-4
更新日期:2019-11-08 00:00:00
abstract:BACKGROUND:Inappropriate use of antidepressants (AD), defined as either continuation in the absence of a proper indication or continuation despite the lack of therapeutic efficacy, applies to approximately half of all long term AD users. METHODS/DESIGN:We have designed a cluster randomized controlled clinical trial to...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-14-6
更新日期:2013-01-08 00:00:00
abstract:BACKGROUND:The prevention of type 2 diabetes is a recognised health care priority globally. Within the United Kingdom, there is a lack of research investigating optimal methods of translating diabetes prevention programmes, based on the promotion of a healthy lifestyle, into routine primary care. This study aims to est...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2296-13-46
更新日期:2012-05-29 00:00:00
abstract:BACKGROUND:Cluster randomized controlled trials are often used in research in primary care but creates challenges regarding biases and confounders. We recently presented a study on low back pain from primary care in Norway with equal effects in the intervention and the control group. In order to understand the specific...
journal_title:BMC family practice
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12875-018-0759-9
更新日期:2018-05-22 00:00:00