Guidelines on difficult intubation in anesthesia: assessment of two diffusion methods

Background: In 1996 experts from the Societe' Francaise d'Anesthesie et de Reanimation published guidelines about difficult intubation. We aimed to as sess the effectiveness of two diffusion methods of these guidelines, media versus direct mailing plus media diffusion, and the relation between readin g of the guidelines and practice behavior and training willingness. Methods: Data were collected in two different samples of 300 anesthetists f rom three regions for pre and post-intervention surveys (E1 and E2 samples) . Half of the anesthetists from E2, randomly chosen, received a direct mail ing of the guidelines (E2a sample), The remaining constituted the nb sample , Three assessment criteria were used, two concerning practice behavior and one training willingness. Relationship between these criteria and diffusio n methods and reading was tested using logistic regression. Results: The response rates were respectively 91%, 80% and 78% in the E1, E 2a and E2b samples. The socio-professional features were not statistically different between the three samples. There was no relationship between the criteria and the diffusion methods. The direct mailing did not increase the reading rate (81% and 82% respectively in the E2a and E2b samples). The ra te of anesthetists who routinely screened for predictive signs of difficult intubation (one of the practice criteria) was higher ill E2a than in E2b ( 28% and 12% respectively). In the multivariate analysis, the difference onl y appeared among the sub-group of anesthetists who did not receive the dire ct mailing. The private practice was associated with a lower rate of routin e screening. Conclusion: No impact of the diffusion methods on practice behavior and tra ining willingness was Sound. Reading was inconstantly associated with pract ice behavior.