| Failure to adopt beneficial therapies caused by bias in medical evidence evaluation. | |
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MedLine Citation:
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PMID: 17099195 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Although it is known that many evidence-based therapies are underutilized, the causes of the research-practice gap are not well understood. The authors sought to determine if there is a bias in the evaluation of new evidence that leads to low rates of adoption of beneficial therapies compared to abandonment of harmful ones. METHODS: Two case vignettes describing hypothetical clinical trials were administered to 2 independent samples of pulmonary and critical care practitioners. Each vignette was presented in 2 different ways; in one version, the results of the hypothetical trial showed that a treatment was harmful, and in the other version, the same treatment was shown to be beneficial. Prospective respondents from each sample were randomized to receive 1 version of each vignette (intersubject design). The main outcome was respondent's willingness to apply the results of the hypothetical trial to patient care. RESULTS: There were 174 participants for trial 1 and 138 participants for trial 2 (enrollment rates of 44.2% and 41.8%, respectively). For trial 1, respondents were 2.3 times less likely to change clinical practice based on results indicating benefit as opposed to harm (33.3% v. 76.5%; P < 0.0001). Similarly, for trial 2, respondents were 2.57 times less likely to change practice when trial results showed that early use was beneficial as opposed to showing that early use was harmful (37.1% v. 95.3%; P < 0.0001). CONCLUSIONS: When evaluating clinical trials, physicians demonstrate less willingness to adopt beneficial therapies than to abandon harmful ones. This difference may contribute to the research-practice gap. |
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Authors:
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Scott K Aberegg; Hal Arkes; Peter B Terry |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Medical decision making : an international journal of the Society for Medical Decision Making Volume: 26 ISSN: 0272-989X ISO Abbreviation: Med Decis Making Publication Date: 2006 Nov-Dec |
Date Detail:
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Created Date: 2006-11-13 Completed Date: 2007-02-28 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 8109073 Medline TA: Med Decis Making Country: United States |
Other Details:
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Languages: eng Pagination: 575-82 Citation Subset: IM |
Affiliation:
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Johns Hopkins Medical Institutions,Department of Medicine, Division of Pulmonary and Critical CareMedicine, Baltimore, MD, USA. scottaberegg@gmail.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Attitude of Health Personnel* Critical Care Decision Support Techniques* Diffusion of Innovation* Ethics, Medical Evidence-Based Medicine Guideline Adherence* Harm Reduction Humans Prospective Studies Pulmonary Medicine Randomized Controlled Trials as Topic Treatment Failure Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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IF32HL078167-01/HL/NHLBI NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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