实施基于证据的临床指南的障碍：早期采用者的调查。
Barriers to implementing evidence-based clinical guidelines: a survey of early adopters.
机构信息
Center for Dental Informatics, Department of Dental Public Health and Information Management, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA 15261, USA.
出版信息
J Evid Based Dent Pract. 2010 Dec;10(4):195-206. doi: 10.1016/j.jebdp.2010.05.013.
OBJECTIVE
The purpose of this study was to identify barriers that early-adopting dentists perceive as common and challenging when implementing recommendations from evidence-based (EB) clinical guidelines.
METHOD
This is a cross-sectional study. Dentists who attended the 2008 Evidence-based Dentistry Champion Conference were eligible for inclusion. Forty-three dentists (34%) responded to a 22-item questionnaire administered online. Two investigators independently coded and categorized responses to open-ended items. Descriptive statistics were computed to assess the frequency of barriers and perceived challenges.
RESULTS
The most common barriers to implementation were difficulty in changing current practice model, resistance and criticism from colleagues, and lack of trust in evidence or research. Barriers perceived as serious problems had to do with lack of up-to-date evidence, lack of clear answers to clinical questions, and contradictory information in the scientific literature.
CONCLUSIONS
Knowledge of barriers will help improve translation of biomedical research for dentists. Information in guidelines needs to be current, clear, and simplified for use at chairside; dentists' fears need to be addressed.
目的
本研究旨在确定早期采用者在实施基于证据（EB）的临床指南建议时所认为的常见且具有挑战性的障碍。
方法
这是一项横断面研究。参加 2008 年循证牙科冠军会议的牙医有资格入选。43 名牙医（34%）对在线进行的 22 项问卷调查做出了回应。两位调查员对开放式问题的回答进行了独立编码和分类。计算了描述性统计数据来评估障碍和感知挑战的频率。
结果
实施的最常见障碍是改变当前实践模式困难、同事的抵制和批评，以及对证据或研究的信任缺失。被认为是严重问题的障碍与缺乏最新证据、临床问题缺乏明确答案以及科学文献中的矛盾信息有关。
结论
了解障碍将有助于提高牙医对生物医学研究的转化。指南中的信息需要是最新的、清晰的，并简化为在椅旁使用；还需要解决牙医的恐惧。
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