title: Agreement between reported use of interventions for liver diseases and research evidence in Cochrane systematic reviews.
abstract: OBJECTIVE
  This study evaluates the agreement between reported use of interventions for patients with liver diseases and research evidence in Cochrane systematic reviews.
  
  
  METHODS
  In July 2002, the Cochrane Hepato-Biliary Group had completed 28 systematic reviews on 36 interventions that were available in Denmark. Based on the reviews, three interventions (n-acetylcysteine for paracetamol overdose, terlipressin for bleeding oesophageal varices, and antibiotics for patients with cirrhosis and gastrointestinal bleeding) with significant beneficial effects on clinical outcomes were classified as 'evidence-based', whereas 19 were classified as 'possibly evidence-based', and 14 as 'not evidence-based'. Questionnaires on reported use and perceived intervention effects were mailed to 108 physicians practising in Danish hospitals. Sixty-six returned their questionnaire.
  
  
  RESULTS
  The proportion of physicians who reported that they never used the three evidence-based interventions varied considerably (2, 62, and 57%, respectively). The perceived intervention effect, duration of clinical experience, employment as head of department, and university hospital employment were significant predictors of more frequent use of evidence-based interventions. Physicians also reported that they used the interventions that were not evidence-based more often if they were employed at a university hospital.
  
  
  CONCLUSIONS
  Considerable disagreements between reported use and research evidence were identified. Additional research on methods to introduce evidence-based medicine in practice seems warranted.
authors.affiliation: DSI Danish Institute for Health Services Research, Copenhagen, Denmark.
authors.forename: Pia
authors.initials: P
authors.lastname: Kürstein
authors.forename: Lise L
authors.initials: LL
authors.lastname: Gluud
authors.forename: Marlene
authors.initials: M
authors.lastname: Willemann
authors.forename: Kim R
authors.initials: KR
authors.lastname: Olsen
authors.forename: Jakob
authors.initials: J
authors.lastname: Kjellberg
authors.forename: Jes
authors.initials: J
authors.lastname: Sogaard
authors.forename: Christian
authors.initials: C
authors.lastname: Gluud
mesh_terms: D019317:Evidence-Based Medicine; D006801:Humans; D008107:Liver Diseases / Q000150:complications / Q000209:etiology / Q000628:therapy*; D011364:Professional Practice; D012196:Review Literature as Topic