Physicians' knowledge, attitudes and professional use of RCTs and meta-analyses: A cross-sectional survey

Abstract

Background: Familiarity with Randomized Control Trials (RCTs) and meta-analyses is essential to practice Evidence Based Medicine (EBM). The aims of this study were to describe knowledge, attitudes and professional behavior of physicians towards methods to evaluate the efficacy of health interventions, particularly meta-analysis and to find out their possible associated factors. Methods: A cross-sectional survey was carried out on a random sample of Italian physicians through a self-administered questionnaire. Results: A response rate of 70.1% was achieved (654 questionnaires). Despite satisfactory knowledge and substantial positive attitudes, Italian physicians have not integrated the use of RCTs and meta-analyses into their practice to a large extent, because they infrequently read and use RCTs and meta-analyses to make decisions in clinical practice. There is a high correlation between knowledge, attitudes and professional use of RCTs and meta-analyses. Moreover, the results of our multivariate analysis show that the probability of an appropriate professional use, that is higher for doctors who know the English language, have internet access and dedicate a proper amount of time to continuing medical education, increases significantly with a previous exposure to meta-analysis during graduate/ post-graduate training (OR 2.25, 95% CI 1.44-3.52), and with the attendance of post-graduate courses about EBM (OR 1.75, 95% CI 1.09-2.82). Finally, Italian physicians demonstrate a high level of interest in further training. Conclusions: The association between the EBM educational background of doctors and the appropriate professional use of RCTs and meta-analyses suggest that EBM training may promote a more evidence-based practice among physicians.

Are public health professionals prepared for public health genomics? A cross-sectional survey in Italy

“…Despite more positive public health attitudes, public health physicians have more gaps in their knowledge than other public health professionals (who are mainly biologists), reflecting possible deficiencies in the genetics components of current medical curricula in Italy. Compared with Italian physicians, who previously showed significant training needs in the field of efficacy, effectiveness and economic evaluation of health interventions [42,43], public health attitudes towards predictive genetic testing appear to be more positive among public health practitioners. For example, the percentage of public health professionals who agree that the selection of predictive genetic testing to be delivered to the population should be based on the principles of efficacy and cost-effectiveness are higher than those found among Italian physicians in another survey [44].…”

Evidence Based Intrapartum Care and Factors among Obstetric CareProviders, Northwest Ethiopia: An Institution Based Cross-Sectional Study,2015

“…This finding does not agree with studies in Italy, Sweden, and Cameroon. The discrepancy might be due to variation in study setting, study participants, data collection tool and procedure [15,17,29]. On the other hand, variation in terms of time might have contributed since as time advances change in practice is likely.…”

“…An institution based cross-sectional study from Cameroon found out that age; sex, profession, and experience were associated with evidence based intrapartum care [13][14][15][16]. Several studies have shown that age, sex, profession, qualification, experience, access to internet, workshop, conferences, searching for the Cochrane database, were statistical associated with evidence based practice [17][18][19].…”

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“…Ce qui ressort de cette analyse c'est que, conformément aux conclusions de Fournier et al, 2010 (cf. supra) (De Vito et al, 2009), seuls 40 % lisent souvent des essais contrôlés randomisés et 18 % des méta-analyses ; 39 % n'utilisent pas les résultats des essais contrôlés randomisés (56 % pour les méta-analyses) pour prendre des décisions dans leur pratique clinique. Une étude récente portant sur 1800 étudiants français en 6 e année de méde-cine s'est intéressée à leur utilisation de la littérature scientifique (Roupret et al, 2010).…”