Knowledge, attitudes and practices regarding evidence-based medicine and outcome assessment: a survey of British Columbia cataract surgeons

Background: While the advantages of practising evidence-based medicine are well-documented, It is frequently suggested that doctors' attitudes are a m ajor roadblock to its implementation. We carried out a survey to determine the knowledge, attitudes and practices of British Columbia cataract surgeon s regarding evidence-based medicine and outcome assessment. Methods: The survey was conducted in the spring of 1999. The study populati on was drawn from the directory of the British Columbia College of Physicia ns and Surgeons. A 16-item questionnaire designed to elicit the knowledge o f, attitudes toward and use of evidence-based medicine and outcome assessme nt was sent to all surgeons performing cataract surgery in British Columbia . Results: Of the 103 eligible participants, 70 (68%) returned completed ques tionnaires. Surgeons affiliated with the University of British Columbia wer e more likely to respond than those not affiliated with the university (81% vs. 58%) (p < 0.05). Most surgeons (89%) viewed the responsibility of moni toring quality of care as primarily their own. Although 79% of the responde nts felt that outcome assessment is an effective method for determining qua lity of care, less than half (49%) reported that they routinely include som e form of outcome assessment in their clinical practice. There was wide var iation in the respondents' understanding of the nature of outcome assessmen t and evidence-based medicine. Respondents professed little inclination or motivation to committing time or resources to an outcome program. They also expressed concerns over the use of outcome data for external management ac tivities. Interpretation: Cataract surgeons in British Columbia clearly appreciate th e advantages of outcome assessment, but translation of this understanding i nto practice is limited. There appears to be a need for further education o n outcome assessment and evidence-based medicine through academic bodies an d professional societies.