title: "Us and them": a social network analysis of physicians' professional networks and their attitudes towards EBM.
abstract: BACKGROUND
  Extant research suggests that there is a strong social component to Evidence-Based Medicine (EBM) adoption since professional networks amongst physicians are strongly associated with their attitudes towards EBM. Despite this evidence, it is still unknown whether individual attitudes to use scientific evidence in clinical decision-making influence the position that physicians hold in their professional network. This paper explores how physicians' attitudes towards EBM is related to the network position they occupy within healthcare organizations.
  
  
  METHODS
  Data pertain to a sample of Italian physicians, whose professional network relationships, demographics and work-profile characteristics were collected. A social network analysis was performed to capture the structural importance of physicians in the collaboration network by the means of a core-periphery analysis and the computation of network centrality indicators. Then, regression analysis was used to test the association between the network position of individual clinicians and their attitudes towards EBM.
  
  
  RESULTS
  Findings documented that the overall network structure is made up of a dense cohesive core of physicians and of less connected clinicians who occupy the periphery. A negative association between the physicians' attitudes towards EBM and the coreness they exhibited in the professional network was also found. Network centrality indicators confirmed these results documenting a negative association between physicians' propensity to use EBM and their structural importance in the professional network.
  
  
  CONCLUSIONS
  Attitudes that physicians show towards EBM are related to the part (core or periphery) of the professional networks to which they belong as well as to their structural importance. By identifying virtuous attitudes and behaviors of professionals within their organizations, policymakers and executives may avoid marginalization and stimulate integration and continuity of care, both within and across the boundaries of healthcare providers.
authors.affiliation: Catholic University of the Sacred Heart, Department of Public Health, Largo Francesco Vito 1, Rome 00168, Italy. dmascia@rm.unicatt.it.
authors.forename: Daniele
authors.initials: D
authors.lastname: Mascia
authors.forename: Americo
authors.initials: A
authors.lastname: Cicchetti
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Damiani
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003625:Data Collection; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000458:organization & administration / Q000523:psychology*; D012944:Social Support; D011795:Surveys and Questionnaires