Shea Alisa M, DePuy Venita, Allen Joseph M, Weinfurt Kevin P
Center for Clinical and Genetic Economics, Duke Clinical Research Institute, NC 27715, USA.
Am J Med Qual. 2007 May-Jun;22(3):170-6. doi: 10.1177/1062860607300291.
The authors sought to explore the use and perceptions of clinical practice guidelines among internal medicine physicians. Through a Web-based survey, 201 board-certified internal medicine physicians rated their opinions on several statements using 7-point Likert scales. Most respondents (74.7%) felt that guidelines were suitable for at least half of their patients, although a failure to take comorbid conditions into account was a frequently cited barrier. For patients with cardiovascular disease, there was no difference between individual internists' perceptions of their own compliance with guidelines and their estimates of cardiologists' compliance (P = .14). A large majority of respondents (70.7%) believed that guideline committee member participation in industry-funded research introduces bias into guideline content (median [interquartile range], 5 [4-6]). Although most respondents felt that measuring physicians against guideline-based performance measures encourages evidence-based medicine (76.5%), opinions were split as to whether this practice distracts from patient care or compromises physician autonomy.
作者试图探讨内科医生对临床实践指南的使用情况和看法。通过一项基于网络的调查，201名获得委员会认证的内科医生使用7点李克特量表对若干陈述表达了他们的意见。大多数受访者（74.7%）认为指南至少适用于他们一半的患者，尽管未考虑合并症是一个经常被提及的障碍。对于心血管疾病患者，个体内科医生对自身遵循指南情况的认知与他们对心脏病专家遵循指南情况的估计之间没有差异（P = 0.14）。绝大多数受访者（70.7%）认为指南委员会成员参与行业资助的研究给指南内容带来了偏差（中位数[四分位间距]，5[4 - 6]）。尽管大多数受访者认为根据基于指南的绩效指标来衡量医生能促进循证医学（76.5%），但对于这种做法是否会分散对患者的治疗注意力或损害医生自主权，意见存在分歧。
