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| |  Surgeons Are Slow to Adopt Evidence-Based Guidelines: Presented at ACS By Jill Stein CHICAGO -- October 13, 2009 -- Investigators are reporting that the dissemination and implementation of evidence-based guidelines for surgical clinical practice remains slow and inconsistent. The results were released here October 12th at the American College of Surgeons (ACS) 95th Annual Clinical Congress. Marcovalerio Melis, MD, New York University School of Medicine, New York, New York, and colleagues analysed responses to a questionnaire that aimed to measure the level of implementation of available evidence in clinical practice among US surgeons. “In theory, randomised trials, meta-analyses, and guidelines form the basis of clinical decision-making and routine surgical practices,” said Dr. Melis. “However, little is known about the impact of such data on surgical practices.” The questionnaire included 13 questions for which correct answers were supported by level 1 evidence based on meta-analyses or prospective randomised trials. Overall, 110 faculty and trainee surgeons from 3 academic medical centres completed the questionnaire. Results showed that only 60% of the answers were concordant with existing evidence. The percentages of correct answers did not differ significantly according to the institution or the level of experience of the participants. Dr. Melis cautioned that the results may be limited by intrinsic flaws in the questionnaire since few questions involved topics that have controversial or equivocal answers. He also noted that results of this survey are similar to those observed in a French study 5 years ago. However, he was quick to add that the 2 studies queried different populations in a different country at a different time period. Overall, the study shows that despite significant efforts by the medical community to synthesise evidence into systematic reviews, develop computerised, clinical evidence- based decision algorithms, and improve electronic access to this information, guidelines are only slowly moving into clinical practice, Dr. Melis concluded. [Presentation Title: Evidenced-Based Surgical Practice in Academic Medical Centers: Consistently Anecdotal. Abstract Number SE162-M]
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