title: Barriers to Australian physicians' and paediatricians' involvement in randomised controlled trials.
abstract: OBJECTIVE
  To compare attitudes of Australian physicians and paediatricians about treatment and randomised controlled trial (RCT) participation.
  
  
  METHODS
  A cross-sectional survey using the validated "Physician Orientation Profile" (POP), with 250 physicians and 250 paediatricians surveyed.
  
  
  METHODS
  Five indices - primary allegiance, decision making under uncertainty, professional activities, perceived rewards, and peer-group influence - with scores for each participant ranging along a continuum from clinician-oriented to research-oriented and expressed as a number between 0 and 1.
  
  
  RESULTS
  Overall response rate was 60%, with 135 physicians (54%) and 165 paediatricians (66%) responding. Paediatricians and physicians were similar in their attitudes to RCT participation, being generally clinician-oriented rather than research-oriented and less inclined to participate in RCTs when there is uncertainty about the best treatment. Most assign limited time to research, with 26.9% not currently involved in research and 31.5% having no experience of RCT participation. Doctors perceive few rewards and little peer-group influence regarding trial participation. Independent predictors of favourable attitudes to trial participation (based on POP scores) were the presence of allocated research time (0.37 for no allocated research time v 0.61 for > 70% research time; P < 0.0001), previous experience enrolling a patient in an RCT (0.40 for no experience v 0.46 for experience; P < 0.0001), and articles published in the past 12 months (0.40 for no publications v 0.55 for > 3 publications; P < 0.0001).
  
  
  CONCLUSIONS
  This study highlights the minor importance of research for most Australian physicians. Research plays only a small role in their professional activities, and the importance of research participation is not recognised. They are clinician-oriented in their attitudes to RCT participation. To encourage greater involvement in trials among physicians in Australia, clinical research needs to be restructured in a primarily clinically oriented setting with dedicated research time.
authors.affiliation: Centre for Kidney Research, NHMRC Centre for Clinical Research Excellence in Renal Medicine, The Children's Hospital at Westmead, Locked bag 4001, Westmead, NSW 2145, Australia. Patrinac@chw.edu.au
authors.forename: Patrina H Y
authors.initials: PH
authors.lastname: Caldwell
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Craig
authors.forename: Phyllis N
authors.initials: PN
authors.lastname: Butow
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D001315:Australia; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010372:Pediatrics; D010820:Physicians; D010818:Practice Patterns, Physicians'; D016032:Randomized Controlled Trials as Topic