Evidence-based psychiatry--do psychiatrists want it and can they do it?
Lawrie SM., Scott AI., Sharpe M.
OBJECTIVE: To examine (a) psychiatrists' attitudes to evidence-based psychiatry, (b) whether psychiatrists have identifiable clinical information needs, (c) if such information is practically obtainable, and (d) how psychiatrists respond to the information obtained. DESIGN: We surveyed senior psychiatrists to enquire about their attitudes and to request up to three clinical questions they would like answered. We attempted to find evidence to answer the five most frequently asked questions using recommended strategies and timed how long it took us. We fed our answers back to those who had asked one of these questions and asked if they found the answers useful. SETTING: Specialist registrars, senior registrars and consultants in south-east Scotland. RESULTS: Ninety three (76%) of those surveyed returned usable questionnaires. Respondents thought that only 40% of their practice is evidence-based. They reported that 'insufficient time' was the biggest barrier to implementing evidence-based psychiatry. The most frequently asked questions concerned the treatment of major psychiatric disorders. It took us--three experienced researchers, trained in critical appraisal, with excellent local facilities--between 15-60 minutes to answer each question. Most of those who had asked the questions (15/22) thought they would not have been able to answer them and stated that such a 'question answering service' as piloted here would be valuable. CONCLUSIONS: An evidence-based psychiatry appears to be desirable and possible, but impractical for the individual clinician. There is a need for short accessible evidence-based summaries of optimal treatment in psychiatry