Practice patterns versus practice guidelines in pediatric otitis media

OBJECTIVE: To study the practice patterns of physicians and their adherence to an evidence-based practice guideline (PG) on pediatric otitis media wit h effusion. We hypothesized that overall knowledge of the recommendations f rom the guidelines would be less than 75%, and that specialist physicians w ould have better knowledge of the recommendations than generalist physician s, METHODS: We performed a survey study of 1167 otolaryngologists, pediatricia ns, and pediatric otolaryngologists. Each physician was sent a 6-item surve y asking about their practice patterns and treatment preferences for young children with otitis media with effusion. We compared responses between dif ferent specialties, RESULTS: The overall response rate was 48%. Only 8 (1.4%) of the 558 respon ding physicians answered all 6 items congruent with the PG. Overall, pediat ricians, otolaryngologists, and pediatric otolaryngologists had similar tot al scores, but different scores on Individual items. CONCLUSIONS: These results indicate that the practice patterns of pediatric ians, otolaryngologists, and pediatric otolaryngologists differ from the re commendations of an evidence-based PG, In particular, 2 items covering key treatment recommendations were answered in agreement with the PG by fewer t han half of the physicians, It is not clear from this study whether these d iscrepancies were due to poor dissemination or knowledge concerning the PG, or disagreement with its recommendations.