[Tests and scales: restrains to use them by general practitioners. Descriptive transversal study]

Tests, even though recommended, are only few used by general practitioners (GP's). The aim of this study was to understand the reasons of this underuse.

Descriptive transversal study, to explore knowledge, use and restrains to using ten tests related in the first 50 results of consultation in general practice. We questioned 121 GP's from Charente, selected ad random.

The oldest tests (MMS, MNA, Fagerström, mini-GDS, IPSS, depression) are known by more than half of the GP's. Only one third is familiar with more recent tests devoted to ambulatory care (TSTS, FACE, venous thromboembolic risk), which are also used less (20% at most). Systematic use of all tests mixed up, never exceeds 30% of all GP's. The principal restrain to use these tests is lack of training (53%), which seems indeed to be inefficient in this domain; 20 to 60% of GP's who know the tests, do not use them, mainly because of doubts regarding their usefulness (38%).

What really is the utility of these tests in ambulatory care? Their validity in general practice shows some gaps: their validation results seldom on studies conducted in primary care, impact studies to evaluate the benefits for patients are lacking, and tests designed for specific use by GP's are rare and lacking in validity.

Development of research in primary care in this field would be desirable in order to develop relevant, feasible and acceptable tools to help decision making in general practice.