Analysis of questions asked by family physicians regarding patient care (Reprinted from BMJ, vol 319, pg 358-361, 1999)

Objectives To characterize the information needs of family physicians by co llecting the questions they asked about patient care during consultations a nd to classify these in ways that would be useful to developers of knowledg e bases. Design An observational study in which investigators visited physi cians for two half-days and collected their questions. Taxonomies were deve loped to characterize the clinical topic and generic type of information so ught far each question. Setting Eastern Iowa. Participants Random sample of 103 family physicians, Main outcome measures Number of questions posed, pu rsued, and answered; topic and generic type of information sought for each question; rime spent pursuing answers; and information resources used. Resu lts Participants asked a total of 1,101 questions. Questions about drug pre scribing, obstetrics and gynecology, and adult infectious disease were most common, comprising 36% of the total. The taxonomy of generic questions inc luded 69 categories; the three most common types, comprising 24% of all que stions, were "What is the cause of symptom X?" "What is the dose of drug X? " and "How should I manage disease or finding X?" Answers to most questions (n = 702 [64%]) were not immediately pursued, but of those Pursued, most ( n = 318 [80%]) were answered. Physicians spent an average of less than 2 mi nutes pursuing an answer, and they used readily available print and human r esources. Only two questions led to a formal literature search. Conclusions Family physicians in this study did not pursue answers to most of their qu estions. Questions about patient care can be organized into a limited numbe r of generic types, which could help guide the efforts of knowledge-base de velopers.