AimTo assess the reliability and accuracy of medical advice, over a range of types of websites, found using the Google search engine, thus simulating a patient's experience. Design Advice was sought for fi ve common paediatric questions using the Google search engine. The fi rst 100 results of each question were classifi ed as either being consistent or inconsistent with current recommendations or as 'no answer given'. Record of the type of site and its visibility was noted. Results 39% of the 500 sites searched gave correct information; 11% were incorrect and 49% failed to answer the question. Where an answer was available, 78% of sites gave the correct information. The accuracy of information varied depending on the topic and ranged from 51% (mumps, measles and rubella and autism) to 100% (breast feeding with mastitis

Guidelines are a common and important tool in providing high-quality health care. The National Institute for Health and Clinical Excellence (NICE) guidelines are now being used to set standards for assessing the quality of care in UK general practice, and so the evidence behind them needs to be relevant to primary care. AimTo assess the extent to which guideline recommendations aimed at primary care are based on research conducted in a primary care setting. Design of studyPurposeful selection of a sample of NICE guidelines for conditions commonly seen in general practice, with identification of the evidence underpinning recommendations that are relevant to primary care. MethodThree recent NICE guidelines were selected: chronic obstructive pulmonary disease (COPD), hypertension, and respiratory tract infection in adults and children. Publications referenced as evidence for each individual primary care relevant recommendation were classified as to whether or not they were based in primary care relevant settings. ResultsIn the three guidelines assessed, 160 studies were used to derive the 115 recommendations that were relevant to, or aimed at primary care. A wide variation was found in the proportion of studies that recruited patients from a setting relevant to primary care (range 26% to 80%). ConclusionIn this sample of three NICE guidelines, a significant proportion of studies underlying the primary care relevant recommendations were derived from studies that were not conducted in that setting. In producing guidelines for a primary care audience, the guideline development groups should include explicit information about the setting of studies underpinning the recommendations.

We compared the information contained in traditional 'To Take Out (TTO)' discharge prescriptions and dictated letters with the information in discharge summaries from an online system. We also investigated the satisfaction of general practitioners (GPs) with the two types of discharge communication. One group of 30 patients were discharged using traditional TTOs and dictated letters and a second group of 30 patients was discharged using the computer generated summary. The summaries were assessed against the 17 criteria of the Scottish Intercollegiate Guidelines Network. The number of criteria met in the conventional summaries was 10.5 (SD 4.3); the number of criteria met in the computer-generated summaries was 14 (SD 1.2), which was significantly higher (Po0.002). Twelve of the 30 traditional TTOs (40%) were considered illegible. The response rate to the questionnaire was 86%. Eighty-three percent of responding GPs preferred computer generated discharge summaries. The computer generated discharge summaries largely satisfied the guidelines and were enthusiastically received by the GPs surveyed.