These ‘GPEAs or ” General Practice evidence appraisals’ have been prepared by trainees on the Oxford VTS scheme, with assistance from Academic GPs from the Department of Primary Care Health Sciences at the University of Oxford.
How GPEAs works:
During their ST1/2 GP attachment trainees work in pairs to produce a ‘GPEA’. All trainees have an introductory 2 hour teaching session – a recap on how to construct a question in PICO format, literature searching (with ‘live’ practice session with a University Librarian), and critical appraisal. Following this session trainees decide on a clinical question they’d like to find an evidence based answer for, and each pair of trainees is matched with an academic GP mentor for help as needed during the project. 2-3 months later the groups present to each other during a learning set session.
What’s been done already?
The page below lists all completed GPEA projects. Use them to look at clinical bottom lines, to see how others went about their work, and to avoid future duplication of topics. Links to the presentations made by each group are contained below the summary tables.
For all enquires related to the GPEA projects please contact either gail.hayward@phc.ox.ac.uk or rebecca.fisher@phc.ox.ac.uk
Which route for Abx for otitis externa?
Treatment of otitis externa in General Practice: Should we use oral or topical antibiotics?
Abi Moore and Yasmin Ball
PICO
P = In patients with uncomplicated OE
I = Is oral antibiotic therapy +/- topical adjunct
C = Better than topical antibiotic therapy +/- topical steroid
O = At improving symptoms or clinical resolution
Clinical bottom line
Limited evidence suggests there is no clinical or patient-perceived benefit in treating uncomplicated OE with both topical and oral antibiotics + topical steroid compared to topical antibiotics + topical steroid
Olive Oil for Ear Wax?
Use of Olive Oil for ear wax
Nick Jones and Kat Young
PICO
P = Adults (>18 yrs) presenting with symptomatic ear wax
I = Use of olive oil drops
C = Use of alternative ear wax solvent or no treatment
O = Removal of ear wax, with or without syringing
Clinical bottom line
There is no evidence that olive oil offers a significant benefit over other topical treatments for ear wax but given its safety and cost is a reasonable first line treatment, particularly if used in conjunction with subsequent syringing
Which topical treatment for otitis externa?
Which topical treatment for otitis externa?
Marie Chowdhury
PICO
P = In patients presenting to primary care with otitis externa.
I = Are topical combination antibiotic/steroid drops
C = Better than topical antibiotic drops alone
O = At reducing symptoms
Clinical bottom line
There is no evidence that antibiotic/steroid drops have a better cure rate or prevent recurrence better than antibiotic drops.
Chloramphenicol for conjunctivitis?
Chloramphenicol for conjunctivitis?
Tim Robson and Liz Morris
PICO
P = In adults with acute infective conjunctivitis
I = Is use of chloramphenicol treatment better than
C= No treatment/placebo
O = At reducing severity or duration of symptoms.
Clinical bottom line
In poor quality data, there is a small statistical benefit (of uncertain clinical significance) of antibiotics versus placebo in acute infective conjunctivitis
So…
Watch & wait is probably reasonable