General practice research databases are increasingly used to study intended and unintended effects of treatments. However, confounding by indication remains a major problem. The randomized database study methodology has been proposed as a method to combine the strengths of observational database (generalizability) and the strength of the randomized clinical trial (RCT) design (randomization). W...

The discussion between general practitioners (GPs) and healthcare delivery organizations necessitates a common language. The presentation of the 4 types of GP’s activities, opens dialogue but can lead to possible misunderstandings between the micro- and macro-level of the healthcare system. This commentary takes 4 examples: costs reduction by P4, priority of beneficence or nonmaleficence, role ...

Clinical incident in general practice can be potentially harmful, costly and even fatal. Studies in general practice in Australia have shown that over three quarter of these incidents are preventable [Bhasale et. al. 1998]. We describe in this paper a holistic model which amalgamates three knowledge management methodologies (ontological, rulebased, and causal) and case based reasoning to provid...

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Clinical Practice Guidelines (CPGs) are being developed as a tool to promote best practice in medicine. However, the diffusion of paper guidelines has been shown to only have a limited impact. This is why computerization of CPGs has recently been suggested as a means to improve their dissemination as well as physicians' compliance. The Guideline Elements Model (GEM) has been proposed to facilit...