title: Professional networks and EBM use: a study of inter-physician interaction across levels of care.
abstract: Physicians around the globe are increasingly encouraged to adopt guidelines, protocols and other scientific material when making clinical decisions. Extant research suggests that the clinicians' propensity to use evidence-based medicine (EBM) is strongly associated with the professional collaborative networks they establish and maintain with peers. In this paper we explore whether and how the connectedness of primary care physicians with colleagues working in hospital settings is related to their frequency of EBM use in clinical practice. We used survey data from 104 pediatricians working in five local health authorities in the Italian NHS. Social network and attributional data concerning single physicians, as well as their self-reported frequency of EBM use, were collected for three major pathologies in pediatric care: asthmatic, gastro-enteric and urinary pathologies. Ordered regression analysis was employed. Our findings documented a positive association between the number of physicians' relationships with hospital colleagues and the frequency of use EBM. Results also indicated that physicians' organizational affiliations influence the frequency of EBM use. Finally, contrary to our expectations, it was found that clinicians' affiliation to formal collaborative arrangements is at odds with the likelihood of reporting higher frequency of EBM use.
authors.affiliation: Catholic University of the Sacred Heart, Department of Public Health, Largo F. Vito 1, 00168 Rome, Italy. Electronic address: dmascia@rm.unicatt.it.
authors.forename: Daniele
authors.initials: D
authors.lastname: Mascia
authors.affiliation: LUISS Guido Carli University, Department of Business and Management, Viale Pola 12, 00198 Rome, Italy. Electronic address: rdandi@luiss.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: Dandi
authors.affiliation: G. d'Annunzio University, Department of Economic Studies, Viale Pindaro 42, 65100 Pescara, Italy. Electronic address: f.divincenzo@unich.it.
authors.forename: Fausto
authors.initials: F
authors.lastname: Di Vincenzo
mesh_terms: D019317:Evidence-Based Medicine / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D007558:Italy; D008297:Male; D009313:National Health Programs; D010372:Pediatrics; D010820:Physicians / Q000523:psychology* / Q000706:statistics & numerical data; D012944:Social Support
keywords: Evidence-based medicine; Influence; Italy; Organizational theory; Social contagion; Social network analysis