First Do No Harm: a guide to choosing wisely in general practice

Development of First Do No Harm

Development process

Development process

The First do no harm Expert Steering Group was formed by GP and consumer representatives with extensive experience in evidence-based healthcare. Following the formation of the Expert Steering Group, a public survey was undertaken in June 2020 to identify which topics would be most helpful for both GPs and consumers. Survey respondents were asked to prioritise a provided short list of topics, with a free-text option to allow all respondents to suggest topics. 

The Expert Steering Group reviewed the results of the survey, and chose an initial set of 10 topics, using the following principles:

  • the topic’s relevance to general practice and to GPs
  • whether the topic can cause harm to patients and/or provides little benefit
  • whether the topic contributes to excessive demand for scarce resources
  • whether the topic is something that GPs and/or patients face regularly and need guidance on
  • whether the topic requires support for GPs and/or patients to have a constructive, evidence-based conversation about it. 

The Royal Australian College of General Practitioners (RACGP) Knowledge Management team conducted a literature review of the identified topics. The scope included guidelines, systematic reviews and meta-analyses. The databases and sources searched included PubMed/Medline, EBSCOhost, Google, DynaMed and Trip database. Initial time periods searched were from 2016–21. 

The Expert Steering Group provided 2022 RACGP Future Leaders and Future Leader alumni an opportunity to draft the topics as the initial medical author and/or review the topics. The medical authors for each topic reviewed the relevant clinical content from the provided literature reviews, summarising the evidence in a prescribed template. Reviewers then appraised the draft, providing feedback and suggestions for improvement. The draft topic templates and associated evidence were then reviewed by the Expert Steering Group, before being rewritten and edited.

Consultation drafts were sent to identified internal and external stakeholders through a targeted consultation process in September and October 2022. Health consumers were sourced through the Consumers Health Forum to provide reviews of the consumer guides.

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