Knowledge, attitudes and practices regarding evidence-based medicine and outcome assessment: a survey of British Columbia cataract surgeons.
BACKGROUND
While the advantages of practising evidence-based medicine are well-documented, it is frequently suggested that doctors' attitudes are a major roadblock to its implementation. We carried out a survey to determine the knowledge, attitudes and practices of British Columbia cataract surgeons regarding evidence-based medicine and outcome assessment.


METHODS
The survey was conducted in the spring of 1999. The study population was drawn from the directory of the British Columbia College of Physicians and Surgeons. A 16-item questionnaire designed to elicit the knowledge of, attitudes toward and use of evidence-based medicine and outcome assessment was sent to all surgeons performing cataract surgery in British Columbia.


RESULTS
Of the 103 eligible participants, 70 (68%) returned completed questionnaires. Surgeons affiliated with the University of British Columbia were more likely to respond than those not affiliated with the university (81% vs. 58%) (p < 0.05). Most surgeons (89%) viewed the responsibility of monitoring quality of care as primarily their own. Although 79% of the respondents felt that outcome assessment is an effective method for determining quality of care, less than half (49%) reported that they routinely include some form of outcome assessment in their clinical practice. There was wide variation in the respondents' understanding of the nature of outcome assessment and evidence-based medicine. Respondents professed little inclination or motivation to committing time or resources to an outcome program. They also expressed concerns over the use of outcome data for external management activities.


CONCLUSIONS
Cataract surgeons in British Columbia clearly appreciate the advantages of outcome assessment, but translation of this understanding into practice is limited. There appears to be a need for further education on outcome assessment and evidence-based medicine through academic bodies and professional societies.
Mildon
D
D
BC Centre for Epidemiologic and International Ophthalmology University of British Columbia, Vancouver.
Courtright
P
P
Rollins
D
D
Blicker
J
J
Law
F
F
D001955:British Columbia / Q000453:epidemiology; D002387:Cataract Extraction / Q000706:statistics & numerical data*; D019317:Evidence-Based Medicine / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009885:Ophthalmology / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D012424:Rural Population; D011795:Surveys and Questionnaires; D014505:Urban Population