title: Role for opinion leaders in promoting evidence-based surgery.
abstract: OBJECTIVE
  "Opinion leaders" can be identified by surgeons from among their peers, and opinion leaders have a role in promoting best surgical practice.
  
  
  METHODS
  Postal survey.
  
  
  METHODS
  Four hundred eighteen (77% response fraction) randomly selected fellows of the Royal Australasian College of Surgeons.
  
  
  METHODS
  Number of opinion leaders identified locally, statewide, and nationally; ratings of 22 possible attributes in conferring status as an opinion leader; and views about and ratings of the role of opinion leaders.
  
  
  RESULTS
  Most respondents were unable to identify a local colleague whom they considered to be an opinion leader in their own specialty (mode, 0; and median, 1) or in surgery in general (mode, 0; and median, 0). Estimated numbers of opinion leaders were significantly higher at the state and national levels for the respondents' own specialty and for surgery in general (P<.001 for all). Surgical expertise and teaching skills were rated most highly as conferring status as an opinion leader. Academic and professional contributions received the lowest ratings. Most surgeons (88%; 95% confidence interval, 84%-91%) agreed that opinion leaders could influence them to change their practice. Opinion leaders were rated as "very influential" by significantly more surgeons than clinical audit (38% vs 27%, chi21 = 13.6, P<.001) and clinical practice guidelines (38% vs 24%, chi21 = 21.4, P<.001) (McNemar test for both).
  
  
  CONCLUSIONS
  Australian surgeons support the concept of opinion leaders. Although few local colleagues whom they consider as fulfilling such a role can be identified, opinion leaders are evident at a national level. Once opinion leaders are identified using attributes ranked in our survey, interventional studies will further delineate their influence in improving evidence-based surgical practice.
authors.affiliation: Surgical Outcomes Research Centre, Central Sydney Area Health Service, and School of Public Health, University of Sydney, New South Wales, Australia. jyoung@email.cs.nsw.gov.au
authors.forename: Jane M
authors.initials: JM
authors.lastname: Young
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Hollands
authors.forename: Jeanette
authors.initials: J
authors.lastname: Ward
authors.forename: C D'Arcy J
authors.initials: CD
authors.lastname: Holman
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D016009:Chi-Square Distribution; D003657:Decision Making; D019317:Evidence-Based Medicine; D005260:Female; D013502:General Surgery; D006302:Health Services Research; D006801:Humans; D007857:Leadership; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires