Series: The research agenda for general practice/family medicine and primary health care in Europe. Part 4. Results: Specific problem solving skills

Figures & data

Table I. Research topics related to ‘specific problem solving skills’.

Diagnosis	Therapy	Specific approaches of problem solving	Educational research
• Studies on diagnostic reasoning in an unselected primary care setting, starting from complaints	• Continuity between health and disease, when to start or stop treating	• GP decision making, shared decision making, prioritization (overlap with person-centred care)	• Education of students and trainees
• Diagnostic/predictive values of history taking, simple clinical examination or sophisticated diagnostic test	• RCTs in typical primary care populations, regarding effectiveness and efficiency	• Quality management, guidelines (overlap with primary care management)	• Continuing medical education/professional development
• Step-wise or incremental diagnostic approach, incl. red-flag issues	• Safety issues, risk-benefit-assessments in unselected populations	• Chronic disease management, multi-morbidity, long term care	• Evaluation of methods to teach clinical problem solving competencies skills in primary care with regards to effectiveness and sustainability
• Severity scores and their practical and clinical consequences	• Non-pharmacological treatment (i.e. counselling, physiotherapy, complementary medicine)	• Clinical skills (i.e. communication, examination, counselling, family orientation)	• Instrumental research on methods to measure clinical and problem solving competencies
	• Compliance/adherence issues, acceptability, patient priorities (overlap with patient-centeredness, comprehensive care)	• Home visits
		• Dealing with complexity and uncertainty, watchful waiting, tentative treatment whithout a confirmed diagnosis
		• Problems related to specific patient groups or gender
		• Special or local interests in GP/PC
		• Genetics/genomics

Table II. Search strategies: Specific problem solving skills.

Diagnosis	Therapy	Chronic care
• ‘diagnosis’ [MeSH] AND ‘primary care’ [MeSH] OR ‘family practice’ [MeSH]	• specific disease MeSH term AND ‘therapeutics’ [Maj MeSH] OR ‘drug therapy’ [MeSH]	• specific disease mesh term AND ‘long-term care’ [MeSH] AND ‘family practice’ [MeSH]
• specific disease MeSH term AND ‘epidemiology’ [MeSH]	• specific disease MeSH term AND ‘drug therapy’ [MeSH]
• specific disease MeSH term AND ‘decision making’ [MeSH]	• specific disease MeSH term AND ‘complementary therapies’ [MeSH]
• ‘diagnostic errors’ [MeSH]
• ‘false-negative reactions’ [MeSH]
• ‘false-positive reactions’ [MeSH]
• ‘observer variation’ [MeSH]
• ‘watchful waiting’ (general term)
Rehabilitation	Quality of care	(Shared) decision making
• specific disease MeSH term AND ‘rehabilitation’ [MeSH] AND ‘primary health care’ [MeSH]	• specific disease mesh term AND ‘quality assurance, health care’ [MeSH] AND ‘family practice’ [MeSH]	• ‘physician-patient relations’ [MeSH] AND ‘family practice’ [MeSH]: gives a very wide and unspecific approach
		• ‘decision making’ [MeSH] with and without family practice’ [MeSH] (‘shared decision making’ is no MeSH term)
Health services research	Genetics	Educational research
• ‘problem solving’ [MeSH] with all sub-headings AND ‘health services’ AND (‘family practice’ OR ‘family physician’)	• genetics [MeSH] AND ‘family practice’ [MeSH], limits: human	• ‘education, medical’ [MeSH] AND ‘problem solving’ [MeSH] AND ((‘family practice’ [TIAB] NOT Medline [SB]) OR ‘family practice’ [MeSH] OR general practice [Text Word]) OR ((‘primary health care’ [TIAB] NOT Medline [SB]) OR ‘primary health care’ [MeSH] OR primary care [Text Word])
• combined with ‘quality management’ [MeSH]	• ‘genetics’ [MeSH] AND ‘primary health care’ [MeSH]
• ‘primary care’ [MeSH] AND ‘disease management’ [MeSH] AND ‘health services’ [MeSH]
• combined with ‘collaborative care management’, ‘rehabilitation’, ‘patient-centred care’, ‘frequent attenders’, ‘promoting healthy life style’, ‘continuity of health care’

Figure 1. Topics of RCTs and clinical trials labelled with ‘family practice’ PubMed 2003–2008.