ReviewJournal of clinical epidemiology2014
A review of clinical practice guidelines found that they were often based on evidence of uncertain relevance to primary care patients.
Review in Journal of clinical epidemiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 6 of them syntheses that pooled 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.
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.
Who cites it
34 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Pooled it
- Health outcomes in primary care: a 20-year evidence map of randomized controlled trials.Family practice · 2023Pooled it
- Intervention effect estimates in randomised controlled trials conducted in primary care versus secondary or tertiary care settings: a meta-epidemiological study.BMC medical research methodology · 2022Pooled it
- Pooled it
- Diagnostic accuracy of history taking, physical examination and imaging for phalangeal, metacarpal and carpal fractures: a systematic review update.BMC musculoskeletal disorders · 2020Pooled it
- Cranberries and Urinary Tract Infections: How Can the Same Evidence Lead to Conflicting Advice?Advances in nutrition (Bethesda, Md.) · 2016Pooled it
- Alcoholic versus aqueous chlorhexidine for skin antisepsis: the AVALANCHE trial.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2017Trial
- Trial
- Assessing TDApp: An AI-based clinical decision support system for ADHD treatment recommendations.Frontiers in psychiatry · 2025Article
- A scoping review of evidence-based guidance and guidelines published by general practice professional organizations.Family practice · 2024Article
- Enhancing access to primary care is critical to the future of an equitable health service: using process visualisation to understand the impact of national policy in the UK.Frontiers in health services · 2024Article
- APPRAISE-RS: Automated, updated, participatory, and personalized treatment recommender systems based on GRADE methodology.Heliyon · 2023Article
- Knowledge mobilization for primary care: Lessons learned from 40 years of the Rourke Baby Record.Canadian family physician Medecin de famille canadien · 2022Article
- Article
- The Influence of the COVID-19 Pandemic on the Clinical Application of Evidence-Based Practice in Health Science Professionals.International journal of environmental research and public health · 2022Observational
- GPs' use and understanding of the benefits and harms of treatments for long-term conditions: a qualitative interview study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021Article
- A scoping review protocol of evidence-based guidance and guidelines published by general practitioner professional organisations.HRB open research · 2021Article
- Critical appraisal of the quality of clinical practice guidelines for idiopathic pulmonary fibrosis.Annals of translational medicine · 2020Article
- Personalized Medicine, Disruptive Innovation, and "Trailblazer" Guidelines: Case Study and Theorization of an Unsuccessful Change Effort.The Milbank quarterly · 2020Article
- Guidelines and Current Assessment of Health Care Responsibility in Italy.Risk management and healthcare policy · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
objectivesPrimary care patients typically have less severe illness than those in hospital and may be overtreated if clinical guideline evidence is inappropriately generalized. We aimed to assess whether guideline recommendations for primary care were based on relevant research. STUDY DESIGN AND
settingLiterature review of all publications cited in support of National Institute for Health and Care Excellence (NICE) recommendations for primary care. The relevance to primary care of all 45 NICE clinical guidelines published in 2010 and 2011, and their recommendations, was assessed by an expert panel.
resultsTwenty-two of 45 NICE clinical guidelines published in 2010 and 2011 were relevant to primary care. These 22 guidelines contained 1,185 recommendations, of which 495 were relevant to primary care, and cited evidence from 1,573 research publications. Of these cited publications, 590 (38%, range by guideline 6-74%) were based on patients typical of primary care.
conclusionNearly two-third (62%) of publications cited to support primary care recommendations were of uncertain relevance to patients in primary care. Guideline development groups should more clearly identify which recommendations are intended for primary care and uncertainties about the relevance of the supporting evidence to primary care patients, to avoid potential overtreatment.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.