title: Can surveying practitioners about their practices help identify priority clinical practice guideline topics?
abstract: BACKGROUND
  Clinical practice guidelines are systematically developed statements designed to assist in patient and physician clinical decision making for specific clinical circumstances. In order to establish which guideline topics are priorities, practitioners were surveyed regarding their current practice.
  
  
  METHODS
  One hundred ninety-seven practitioners in Ontario, Canada were mailed a survey exploring their current practice or opinion regarding the prophylactic use of anticonvulsant drugs in patients with malignant glioma who had never had a seizure. The survey consisted of seven questions regarding the relevance of a guideline on the subject to the practitioner's practice, the proportion of clinical cases involving anticonvulsant use, knowledge of existing guidelines on this topic, interest in reviewing a completed practice guideline and three clinical scenarios.
  
  
  RESULTS
  There were 122 respondents who returned the survey (62% rate of return). Eighty percent of the practitioners who responded indicated that less than 25% of their clinical cases involved the use of anticonvulsants; however, only 16% of respondents indicated that a practice guideline would be irrelevant to their practice. Eighty percent of respondents volunteered to review a draft version of a practice guideline on the use of anticonvulsants. The survey presented the practitioners with three scenarios where anticonvulsants in patients with brain tumours may be appropriate: peri-operatively in patients without seizures, postoperatively in patients currently using anticonvulsants, and thirdly in patients not currently using anticonvulsants or undergoing surgery. In contrast to the third situation, the first two situations yielded considerable variation in practitioner response.
  
  
  CONCLUSIONS
  The survey established that there is some variation present in the current practice of anticonvulsant use in the patients with brain tumours. Whether there is an optimal treatment practice has yet to be determined. Practitioners do seem to feel that a guideline on anticonvulsant use in warranted, and most practitioners would be interested in being part of the guideline development process.
authors.affiliation: Program in Evidence-based Care, Cancer Care Ontario, Hamilton, Ontario, Canada. mbrouwer@mcmaster.ca
authors.forename: Melissa C
authors.initials: MC
authors.lastname: Brouwers
authors.forename: Alexandra
authors.initials: A
authors.lastname: Chambers
authors.forename: James
authors.initials: J
authors.lastname: Perry
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D001932:Brain Neoplasms / Q000150:complications* / Q000188:drug therapy; D002173:Cancer Care Facilities; D018890:Chemoprevention; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005910:Glioma / Q000150:complications* / Q000188:drug therapy; D019538:Health Care Surveys; D006764:Hospitals, Community; D006801:Humans; D008511:Medicine / Q000592:standards; D009864:Ontario; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011331:Private Practice; D012640:Seizures / Q000150:complications / Q000517:prevention & control*; D013038:Specialization
chemical_list: D000927:Anticonvulsants