Kosecoff J, Kanouse D E, Rogers W H, McCloskey L, Winslow C M, Brook R H
Department of Medicine, UCLA School of Medicine, Santa Monica.
JAMA. 1987 Nov 20;258(19):2708-13.
The effects of the National Institutes of Health Consensus Development Program on physician behavior were investigated. The medical records of 2770 patients treated in ten hospitals throughout the state of Washington were reviewed to determine if quality of care improved with respect to 12 recommendations put forth by four consensus panels concerning surgical management of primary breast cancer, the use of steroid receptors in breast cancer, cesarean childbirth, and coronary artery bypass surgery. Care was studied during 24 months before and 13 to 24 months after each consensus conference. Results showed that the conferences mostly failed to stimulate change in physician practice, despite moderate success in reaching the appropriate target audience. It was concluded that the consensus development conference is an important educational tool whose effects might be enhanced by focusing on areas of practice that need improvement and by encouraging follow-up programs at the state and local level.
研究了美国国立卫生研究院共识发展项目对医生行为的影响。回顾了华盛顿州十家医院2770名患者的病历，以确定针对四个共识小组提出的关于原发性乳腺癌手术管理、乳腺癌中类固醇受体的使用、剖宫产和冠状动脉搭桥手术的12项建议，医疗质量是否有所改善。在每次共识会议前24个月以及会议后13至24个月期间对医疗情况进行了研究。结果表明，尽管在接触到合适的目标受众方面取得了一定成功，但这些会议大多未能促使医生的医疗行为发生改变。得出的结论是，共识发展会议是一种重要的教育工具，通过关注需要改进的医疗实践领域并鼓励州和地方层面的后续项目，其效果可能会得到增强。
