Evidence map›Paper›PMID 15514347›Full record

ArticleBMJ (Clinical research ed.)2004

Evidence based guidelines or collectively constructed "mindlines?" Ethnographic study of knowledge management in primary care.

John Gabbay, Andrée le May

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ (Clinical research ed.), 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 283 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
283citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

283 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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  11. Effectiveness of the Epley manoeuvre in posterior canal benign paroxysmal positional vertigo: a randomised clinical trial in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019
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223 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

2 authors.

John GabbayWessex Institute for Health Research and Development, Community Clinical Sciences, University of Southampton, Southampton SO16 7PX. j.gabbay@soton.ac.uk
Andrée le May

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo explore in depth how primary care clinicians (general practitioners and practice nurses) derive their individual and collective healthcare decisions.

designEthnographic study using standard methods (non-participant observation, semistructured interviews, and documentary review) over two years to collect data, which were analysed thematically.

settingTwo general practices, one in the south of England and the other in the north of England.

participantsNine doctors, three nurses, one phlebotomist, and associated medical staff in one practice provided the initial data; the emerging model was checked for transferability with general practitioners in the second practice.

resultsClinicians rarely accessed and used explicit evidence from research or other sources directly, but relied on "mindlines"--collectively reinforced, internalised, tacit guidelines. These were informed by brief reading but mainly by their own and their colleagues' experience, their interactions with each other and with opinion leaders, patients, and pharmaceutical representatives, and other sources of largely tacit knowledge. Mediated by organisational demands and constraints, mindlines were iteratively negotiated with a variety of key actors, often through a range of informal interactions in fluid "communities of practice," resulting in socially constructed "knowledge in practice."

conclusionsThese findings highlight the potential advantage of exploiting existing formal and informal networking as a key to conveying evidence to clinicians.

Indexed as

Evidence-Based MedicinePractice Guidelines as TopicEnglandFamily PracticeHealth Knowledge, Attitudes, PracticeHumansNurse PractitionersProfessional Practice

Identifiers

PMID15514347
PMCPMC524553

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.