RCT's in de huisartsgeneeskunde, 1990-2010

Background Increasingly more research is being carried out in general practice, but some ailments and problems are more popular than others as research topic. This bibliometric analysis evaluated the quantity, themes, and quality of randomized controlled trials (RCTs) in general practice and whether research topics reflected clinical practice. Method RCTs with a general practice setting were identified through a systematic search of the Medline database (1990-2010). Studies that met predefined inclusion criteria were included. Publication date, country of origin, study design, journal, and impact factor were recorded. The research themes of studies were categorized using International Classification of Primary Care (ICPC) codes. Results A total of 1935 RCTs were included. The number of RCTs published annually has increased from 50 in 1991 to 170 in 2009, with most studies coming from the United States (28%), the United Kingdom (26%), and the Netherlands (10%). The median impact factor of the publications was variable, ranging from approximately 2.2 to 3.7 over the years. Most of the RCTs concerned psychiatric (code P; 28%), circulatory (code K, 13%), general (code A, 13%), endocrinological / metabolic (code T, 11%), and respiratory (code R, 10%) problems. The publication pattern did not match the morbidity seen in general practice. Notably, codes S (skin), X (female genital), W (pregnancy), F (eye) en D (digestive) were underrepresented. Conclusion Although the number of RCTs with a general practice setting has continued to increase in the past 20 years, the match between research topics and problems seen in clinical practice could be improved.