Norwegian Physicians' Knowledge of and Opinions about Evidence-Based Medicine: Cross-Sectional Study

Objective: To answer five research questions: Do Norwegian physicians know about the three important aspects of EBM? Do they use EBM methods in their clinical practice? What are their attitudes towards EBM? Has EBM in their opinion changed medical practice during the last 10 years? Do they use EBM based information sources? Design: Cross sectional survey in 2006. Setting: Norway. Participants: 966 doctors who responded to a questionnaire (70% response rate). Results: In total 87% of the physicians mentioned the use of randomised clinical trials as a key aspect of EBM, while 53% of them mentioned use of clinical expertise and only 19% patients' values. 40% of the respondents reported that their practice had always been evidence-based. Many respondents experienced difficulties in using EBM principles in their clinical practice because of lack of time and difficulties in searching EBM based literature. 80% agreed that EBM helps physicians towards better practice and 52% that it improves patients' health. As reasons for changes in medical practice 86% of respondents mentioned medical progress, but only 39% EBM. Conclusions: The results of the study indicate that Norwegian physicians have a limited knowledge of the key aspects of EBM but a positive attitude towards the concept. They had limited experience in the practice of EBM and were rather indifferent to the impact of EBM on medical practice. For solving a patient problem, physicians would rather consult a colleague than searching evidence based resources such as the Cochrane Library

Group differences in the three identified principal components of attitudes towards EBM.

<p>Means with 95% confidence intervals. Circle – Indifferent. Square – Positive. Triangle – Negative.</p

Three principal components of attitudes towards EBM.

<p>Varimax rotated. Only loadings over 0.4 are shown.</p

Violin plots (box plots) of responses to the use of some of the information sources in medical practice by job category.

<p>The red dots represent medians, the thick blue vertical lines the interquartile range and the yellow areas the general distribution of responses. The question was: “If you need information for the treatment of a patient, which source would you use?” Likert scale from 1 (never) to 5 (often). A - Junior hospital doctors. B - Senior hospital doctors. C - General practitioners. D - Private practice specialists. E - Other doctors.</p

Frequency distributions on ten statements about EBM.

<p>Likert scale from 1 (strongly disagree) to 5 (strongly agree). Percent.</p