Evidence map›Paper›PMID 8280213›Full record

Trial reportBMJ (Clinical research ed.)1993

Do clinical guidelines improve general practice management and referral of infertile couples?

C Emslie, J Grimshaw, A Templeton

Abstract readClinical TrialRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 1993. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 8 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

34 citing papers in PubMed, 8 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. A systematic review of the effect of primary care-based service innovations on quality and patterns of referral to specialist secondary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2003
    Pooled it
  7. Recommendations for future studies: a systematic review of educational interventions in primary care settings.The British journal of general practice : the journal of the Royal College of General Practitioners · 1999
    Pooled it
  8. Pooled it
  9. Trial
  10. Open Access Tubal aSsessment for the initial management of infertility in general practice (the OATS trial): a pragmatic cluster randomised controlled trial.The British journal of general practice : the journal of the Royal College of General Practitioners · 2009
    Trial
  11. Trial
  12. Trial
  13. Effectiveness of an educational strategy to improve family physicians' detection and management of depression: a randomized controlled trial.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 1999
    Trial
  14. Trial
  15. Reassured or fobbed off? Perspectives on infertility consultations in primary care: a qualitative study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2012
    Article
  16. Article
  17. Mono-disciplinary or multidisciplinary back pain guidelines? How can we achieve a common message in primary care?European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2006
    Article
  18. Article
  19. Article
  20. Implementing national guidelines at local level.BMJ (Clinical research ed.) · 2001
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors.

C EmslieDepartment of Obstetrics and Gynaecology, University of Aberdeen.
J Grimshaw
A Templeton

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate guidelines for general practice management and referral of infertile couples. Guidelines were implemented with a disease specific reminder at the time of consultation (the guidelines were embedded within a structured infertility management sheet for each couple).

designPragmatic randomised controlled trial. Participating practices were randomised to a group that received the guidelines and a control group.

setting82 general practices in Grampian region. SUBJECTS: 100 couples referred by general practitioners receiving the guideline and 100 couples referred by control general practitioners.

main outcome measuresWhether the general practitioner had taken a full sexual history and examined and investigated both partners appropriately.

resultsCharacteristics of patients referred by study and control general practitioners did not differ significantly at baseline. Compliance with the guidelines increased for all targeted activities. General practitioners in the study group were more likely to take a sexual history (for example, couples' use of fertile period, 85% v 69%, p < 0.01); examine both partners (female partner, 68% v 52%, p < 0.05; male partner 39% v 13%, p < 0.01); and investigate both partners (day 21 progesterone, 72% v 41%, p < 0.001; semen analysis, 51% v 41%, p > 0.05). Improvements were greater when general practitioners used the disease specific reminder.

conclusionReceiving guidelines led to improvements in the process of care of infertile couples within general practice. This effect was enhanced when the guidelines were embedded in a structured infertility management sheet for each couple.

Indexed as

Practice Guidelines as TopicAdolescentAdultFamily PracticeFemaleHumansInfertilityMaleMedical History TakingMiddle AgedPhysical ExaminationPractice Patterns, Physicians'Referral and ConsultationUnited Kingdom

Identifiers

PMID8280213
PMCPMC1678278

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.