Abstract
BackgroundAcademic infrastructures and networks for clinical research in primary care receive little funding in Germany. We aimed to provide an overview of the quantity, topics, methods and findings of randomised controlled trials published by German university departments of general practice.MethodsWe searched Scopus (last search done in April 2015), publication lists of institutes and references of included articles. We included randomised trials published between January 2000 and December 2014 with a first or last author affiliated with a German university department of general practice or family medicine. Risk of bias was assessed with the Cochrane tool, and study findings were quantified using standardised mean differences (SMDs).ResultsThirty-three trials met the inclusion criteria. Seventeen were cluster-randomised trials, with a majority investigating interventions aimed at improving processes compared with usual care. Sample sizes varied between 6 and 606 clusters and 168 and 7807 participants. The most frequent methodological problem was risk of selection bias due to recruitment of individuals after randomisation of clusters. Effects of interventions over usual care were mostly small (SMD <0.3). Sixteen trials randomising individual participants addressed a variety of treatment and educational interventions. Sample sizes varied between 20 and 1620 participants. The methodological quality of the trials was highly variable. Again, effects of experimental interventions over controls were mostly small.ConclusionsDespite limited funding, German university institutes of general practice or family medicine are increasingly performing randomised trials. Cluster-randomised trials on practice improvement are a focus, but problems with allocation concealment are frequent.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1328-y) contains supplementary material, which is available to authorized users.
Highlights
Academic infrastructures and networks for clinical research in primary care receive little funding in Germany
Being considered the gold standard for clinical research, high-quality randomised controlled trial (RCT) led by general practitioners (GPs) are of crucial importance to enhance the still limited acceptance of general practice/ family medicine as an academic discipline at German universities [2]
128 were excluded because neither the first nor the last author was associated with a GP department, the studies were not randomised trials, or the authors reported additional information related to a randomised trial included which was not directly related to the main results
Summary
Academic infrastructures and networks for clinical research in primary care receive little funding in Germany. We aimed to provide an overview of the quantity, topics, methods and findings of randomised controlled trials published by German university departments of general practice. A group of researchers from German academic departments of general practice published an analysis of obstacles in clinical trials [5]. Sustained funding for research-oriented practice networks is almost inexistent [5] Despite these difficult circumstances, researchers in German university departments of general practice or family medicine have performed a number of randomised trials in recent years. Our aim in this article is to provide a descriptive overview of the current status of research productivity by performing a systematic review of the amount, topics, methods, quality and findings of randomised trials carried out by German university departments of general practice
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