Document Detail


How doctors practice evidence-based medicine.
MedLine Citation:
PMID:  21883721     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Rationale and aims  Evidence-based medicine (EBM) has gained worldwide attention. Many studies have used questionnaires to discuss factors obstructing the practice of EBM. However, no large-scale data analysis has focused on who has practised EBM and when they practised it. This retrospective study aims to fill the research gap by applying nationally representative data to analyse EBM practice after the provision of new evidence regarding the prescription of rosiglitazone which has been shown to increase the risk of myocardial infarction. Methods  We used the National Health Insurance Database in Taiwan to analyse the variations in rosiglitazone prescription among physicians. The study period was from the second quarter of 2007 to the fourth quarter of 2008. A total of 2536 physicians who prescribed rosiglitazone at least once were included in this study. We applied multivariate logistic analyses to predict the probability of physicians ceasing to prescribe rosiglitazone. Results  We observed a significant improvement in EBM practice among specialists and experienced physicians. Endocrinologists were four times more likely to change rosiglitazone prescription habits than other specialists (odds ratio 4.129, 95% confidence interval 2.484-6.863). Doctors with more than 10 years of specialist experience performed better in EBM practice. Moreover, a prominent time lag with more than 6 months between EBM emergence and EBM practice was noticed. Conclusions  Our study suggested that EBM was still not well practised, using rosiglitazone prescription as a study case. Further education and encouragement to strengthen physicians' EBM practice remain urgently needed within the medical community.
Authors:
Yun-Chieh Lu; Ying-Chun Li
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-24
Journal Detail:
Title:  Journal of evaluation in clinical practice     Volume:  -     ISSN:  1365-2753     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-9-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9609066     Medline TA:  J Eval Clin Pract     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Blackwell Publishing Ltd.
Affiliation:
Pulmonarist, Director of Chaozhou An-Tai Hospital, Pingtung, Taiwan Associate Professor, Graduate Program of Health Care Management, National Sun Yat-Sen University, Kaohsiung, Taiwan.
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