Exploring the general practitioners' point of view about clinical scores: a qualitative study.

Background: Clinical scores help physicians to make clinical decisions, and some are recommended by health authorities for primary care use. As an increasing number of scores are becoming available, there is a need to understand general practitioner expectations for their use in primary care. The aim of this study was to explore general practitioner opinions about using scores in general practice.

Method: This qualitative study, with a grounded theory approach, used focus groups with general practitioners recruited from their own surgeries to obtain verbatim. Two investigators performed verbatim analysis to ensure data triangulation. The verbatim was double-blind labeled for inductive categorization to conceptualize score use in general practice.

Results: Five focus groups were planned, 21 general practitioners from central France participated. Participants appreciated scores for their clinical efficacy but felt that they were difficult to use in primary care. Their opinions revolved around validity, acceptability, and feasibility. Participants have little regard for score validity, they felt many scores are difficult to accept and do not capture contextual and human elements. Participants also felt that scores are unfeasible for primary care use. There are too many, they are hard to find, and either too short or too long. They also felt that scores were complex to administer and took up time for both patient and physician. Many participants felt learned societies should choose appropriate scores.

Discussion: This study conceptualizes general practitioner opinions about score use in primary care. The participants weighed up score effectiveness with efficiency. For some participants, scores helped make decisions faster, others expressed being disappointed with the lack of patient-centeredness and limited bio-psycho-social approach.