Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota.
Department of Urology, Yale University, New Haven, Connecticut.
Int J Radiat Oncol Biol Phys. 2014 Jun 1;89(2):277-83. doi: 10.1016/j.ijrobp.2014.02.001. Epub 2014 Mar 27.
To perform a national survey of radiation oncologists and urologists about the type of resources used and the level of evidence needed to change clinical practice in localized prostate cancer.
From a random sample, 1422 physicians were mailed a survey assessing the types of information used and what level of evidence could alter their clinical practice in prostate cancer. Multivariable logistic regression models were used to identify differences in physician characteristics for each outcome.
Survey response rates were similar for radiation oncologists and urologists (44% vs 46%; P=.46). Specialty-specific journals represented the most commonly used resource for informing the clinical practice for radiation oncologists (65%) and urologists (70%). Relative to radiation oncologists, urologists were less likely to report utilizing top-tier medical journals (25% vs 39%; adjusted odds ratio [OR] 0.50; P=.01) or cancer journals (22% vs 51%; adjusted OR 0.50; P<.001) but more likely to rely on clinical guidelines (46% vs 38%; adjusted OR 1.6; P=.006). Both radiation oncologists and urologists most commonly reported large randomized, clinical trials as the level of evidence to change treatment recommendations for localized prostate cancer (85% vs 77%; P=.009).
Both specialties rely on their own specialty-specific journals and view randomized, clinical trials as the level of evidence needed to change clinical practice. Our study provides a context on meaningful ways of disseminating evidence for localized prostate cancer.
对放疗医师和泌尿科医师进行一项全国性调查,了解他们在改变局限性前列腺癌临床实践时所使用的资源类型和所需证据水平。
从随机样本中,向 1422 名医生邮寄了一份调查问卷,评估他们在前列腺癌中使用的信息类型以及何种证据水平可以改变他们的临床实践。使用多变量逻辑回归模型来确定每个结果在医师特征方面的差异。
放疗医师和泌尿科医师的调查回复率相似(44%对 46%;P=.46)。专业特定期刊是为放疗医师(65%)和泌尿科医师(70%)提供临床实践信息的最常用资源。与放疗医师相比,泌尿科医师更不可能报告利用顶级医学期刊(25%对 39%;调整后的优势比[OR]0.50;P=.01)或癌症期刊(22%对 51%;调整后的 OR 0.50;P<.001),但更可能依赖临床指南(46%对 38%;调整后的 OR 1.6;P=.006)。放疗医师和泌尿科医师最常报告大型随机临床试验作为改变局限性前列腺癌治疗建议的证据水平(85%对 77%;P=.009)。
两个专业都依赖于自己的专业特定期刊,并将随机临床试验视为改变临床实践所需的证据水平。我们的研究为局部前列腺癌的证据传播提供了有意义的方法。