Date Published: November 13, 2009
Publisher: Public Library of Science
Author(s): Lidziya Vanahel Ulvenes, Olaf Aasland, Magne Nylenna, Ivar Sønbø Kristiansen, German Malaga. http://doi.org/10.1371/journal.pone.0007828
Abstract: To answer five research questions: Do Norwegian physicians know about the three important aspects of EBM? Do they use EBM methods in their clinical practice? What are their attitudes towards EBM? Has EBM in their opinion changed medical practice during the last 10 years? Do they use EBM based information sources?
Partial Text: Even though the use of systematic research has deep roots in the history of medicine, the concept “evidence based medicine” (EBM) was first introduced in 1991 by Gordon Guyatt . In 1996 Sackett described EBM as “the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients” and practicing evidence based medicine means “integrating individual clinical expertise with best available external clinical evidence from systematic research” and “the […] compassionate use of individual patients’ predicaments, rights and preferences in making decisions about their care” . By definition, Sackett states that EBM is the integration of three important aspects: current best evidence, clinical expertise and patients’ values.
Data for this study stems from the so called Reference Panel of the Norwegian Physician Survey, approximately 1400 doctors of all specialties and work situations who receive a postal questionnaire from The Research Institute of The Norwegian Medical Association every other year. The questionnaires contain both questions that are repeated every time, and questions that change from one round to the next, often to meet the need of external collaborators. In 2006, a 15-page questionnaire was sent to the 1,400 professionally active panel members. It included seven composite questions about EBM with a total of 27 items. These items were sent to several colleagues in Norway and the UK for pilot testing. Most of these 27 items were formulated as statements about which respondents could indicate their position on a five point Likert scale from 1 (completely disagree) to 5 (completely agree).
In total 976 out of the 1,400 physicians (70%) returned a questionnaire, of which 10 were unusable. Among non-respondents, 50 explicitly stated that they did not wish to participate while 374 did not return the questionnaire despite one reminder. The respondents were quite representative of all Norwegian doctors with regard to gender, age and specialty, with slightly more psychiatrists and slightly less public health specialists (Table 1).
The results of this study indicate that Norwegian physicians have positive attitudes to EBM although their knowledge of all of its three main components (research evidence, physician expertise and patient values) is limited. They do not consider EBM to be an important factor for change in medical practice, and few have attended EBM courses or use the Cochrane database.