Perceptions and competence in evidence-based medicine: Are surgeons getting better? A questionnaire survey of members of the Dutch Orthopedic Association
Perceptions and competence in evidence-based medicine: Are surgeons getting better? A questionnaire survey of members of the Dutch Orthopedic Association
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DOI：
10.2106/jbjs.f.00633
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发表时间：
2007-01-01
影响因子：
5.3
通讯作者：
Bhandari, Mohit
中科院分区：
文献类型：
--
作者：
Poolman, Rudolf W.;Sierevelt, Inger N.;Bhandari, Mohit
背景：《美国骨关节外科杂志》(The Journal of bone and Joint Surgery，the Journal)最近开设了一个名为《循证骨科》的栏目。此外，《华尔街日报》现在使用证据等级来帮助读者进行临床决策。关于这种最近的强调是否影响了外科医生对循证医学的看法和能力，我们知之甚少。因此，我们调查了荷兰骨科医生对循证医学的认知和能力。方法：调查荷兰骨科协会成员对循证医学的态度和他们在循证医学方面的能力。结果：在611名成员中，有367名外科医生(60%)做出了回应。骨科医生对循证医学表示欢迎。实践循证医学资源被认为是从以意见为基础或以经验为基础向以证据为基础的实践转变的最佳方法。四个变量与能力量表显著正相关：(1)较年轻的年龄，特别是36岁至45岁之间(p=0.007)，(2)十年以下的经验(p=0.032)，(3)博士学位(p<；0.001)，(4)在学术或教学环境中工作(p=0.004)。大多数受访者知道《华尔街日报》的循证医学栏目(84%)和证据级别评级(65%)，20%的受访者在临床决策中使用了该杂志的循证医学摘要。这种循证医学意识的提高也反映在临床决策中频繁使用Cochrane审查(27%的受访者)。在临床决策中使用《华尔街日报》循证医学摘要或Cochrane综述的外科医生和知道但没有使用该杂志循证医学摘要或Cochrane综述的外科医生的胜任力量表得分显著高于不知道这些资源的外科医生(分别为p=0.03和p<；0.001)。最近对循证医学的重视反映在对《华尔街日报》循证医学栏目、证据水平和最大的循证医学资源：Cochrane评论的认识增加上。年轻的骨科医生对循证医学有更好的了解。开发和使用循证资源以及预先评估的摘要，如《杂志》的循证医学摘要和Cochrane评论，被认为是从以意见为基础转向以证据为基础的矫形实践的最佳方式。
Background: The Journal of Bone and Joint Surgery, American Volume (The Journal) recently initiated a section called "Evidence-Based Orthopaedics." Furthermore, a level-of-evidence rating is now used in The Journal to help readers in clinical decision-making. Little is known about whether this recent emphasis has influenced surgeons' perceptions about and competence in evidence-based medicine. Therefore, we examined perceptions and competence in evidence-based medicine among Dutch orthopaedic surgeons.Methods: Members of the Dutch Orthopaedic Association were surveyed to examine their attitudes toward evidence-based medicine and their competence in evidence-based medicine. We evaluated competences using a newly developed instrument tailored to surgical practice.Results: Of the 611 members, 367 surgeons (60%) responded. Orthopaedic surgeons welcomed evidence-based medicine. Practical evidence-based medicine resources were perceived as the best method to move from opinion-based or experience-based to evidence-based practice. Four variables were significantly and positively associated with the competence instrument: (1) a younger age, particularly between thirty-six and forty-five years (p = 0.007), (2) experience of less than ten years (p = 0.032), (3) having a PhD degree (p < 0.001), and (4) working in an academic or teaching setting (p = 0.004). The majority of the respondents were aware of The Journal's evidence-based medicine section (84%) and level-of-evidence ratings (65%), and 20% used The Journal's evidence-based medicine abstracts in clinical decision-making. This increased awareness of evidence-based medicine was also reflected in the frequent use of Cochrane reviews in clinical decision-making (27% of the respondents). Surgeons who used and those who were aware of but did not use The Journal's evidence-based medicine abstracts or Cochrane reviews in clinical decision-making had significantly higher competence instrument scores than those who were unaware of these resources (p = 0.03 and p < 0.001, respectively).Conclusions: Evidence-based medicine is welcomed by Dutch orthopaedic surgeons. The recent emphasis on evidence-based medicine is reflected in an increased awareness about The Journal's evidence-based medicine section, levels of evidence, and the largest evidence-based medicine resource: the Cochrane reviews. Younger orthopaedic surgeons had better knowledge about evidence-based medicine. The development and use of evidence-based resources as well as preappraised summaries such as The Journal's evidence-based medicine abstracts and Cochrane reviews were perceived as the best way to move from opinion-based to evidence-based orthopaedic practice.