Development of a research agenda for general practice based on knowledge gaps identified in Dutch guidelines and input from 48 stakeholders.

Background: Several funding organizations using different agendas support research in general practice. Topic selection and prioritization are often not coordinated, which may lead to duplication and research waste.

Objectives: To develop systematically a national research agenda for general practice involving general practitioners, researchers, patients and other relevant stakeholders in healthcare.

Do specialized centers and specialists produce better outcomes for patients with chronic diseases than primary care generalists? A systematic review.

Purpose: Although specialized centers are generally accepted for treatment of relatively uncommon diseases, such as cystic fibrosis, statements regarding the amount of expertise or minimum number of patients treated are increasingly included in guidelines for the treatment of other chronic diseases such as rheumatoid arthritis and diabetes mellitus.

Data Sources: Medline and Embase from 1987 through March 2008 were searched.

Study Selection: Studies reporting the effect of treatment in a specialized or high-volume center or by subspecialists on a clinically relevant outcome.

Guideline development.

During the last decade many countries have become increasingly interested in the development and use of evidence-based practice guidelines, recognising that guidelines are key tools to improve the quality and appropriateness of health care. They are considered to be the ideal mediator for bridging the gap between the growing stream of research findings and actual clinical practice. Systematic reviews of guideline evaluations have shown that clinical practice guidelines can be an effective means of both changing the process of healthcare delivery and improving outcomes.