Canadian oncologists and clinical practice guidelines: A national survey of attitudes and reported use

Purpose: To determine (1) Canadian oncologists' attitudes toward practice g uidelines, (2) oncologists' self-reported use of practice guidelines and, ( 3) physicians' characteristics and attitudes associated with self-reported use of practice guidelines, Participants and Methods: A cross-sectional, se lf-administered postal survey was administered to Canadian oncologists. Mai n outcome measures were level of agreement with 8 descriptive statements ab out guidelines, score on the attitudinal scale of the guideline of Tunis et al., and physicians' stated use of guideline. chi (2) and logistic regress ion procedures were used to explore the relationship between physician char acteristics and use of guidelines. Results: Over 80% of respondents agreed that they were Flood educational tools, convenient sources of advice, inten ded to improve quality of care; over 40% agreed that they were unbiased syn theses of expert opinion. Conversely, 42, 26, 20 and 16% felt they were int ended to cut costs, were oversimplified cookbook medicine, were too rigid t o apply to individual patients, and a challenge to physicians' authority, r espectively. Forty-one percent reported using practice guidelines routinely or most of the time. Use was associated with positive attitudes about guid elines, receiving medical school training abroad and being a radiation onco logist. Conclusion: Canadian oncologists were quite positive about practice guidelines and reported using them frequently. Our results suggest that us e of guidelines by oncologists may be related to attitudes about guidelines in general, specialty within oncology and country of medical school traini ng. Copyright (C) 2000 S, Karger AG. Basel.