The European Journal of Public Health Advance Access published online on January 7, 2009
The European Journal of Public Health, doi:10.1093/eurpub/ckn134
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Physicians’ knowledge, attitudes and professional use of RCTs and meta-analyses: A cross-sectional survey
Corrado De Vito1, Carmelo G. Nobile2, Giacomo Furnari1, Maria Pavia2, Maria De Giusti1, Italo F. Angelillo3 and Paolo Villari1
1 Department of Experimental Medicine, ‘Sapienza’ University of Rome, Italy
2 Chair of Hygiene, Medical School, University of Catanzaro ‘Magna Graecia’, Catanzaro, Italy
3 Department of Public, Clinical and Preventive Medicine, Second University of Naples, Naples, Italy
Correspondence: Paolo Villari, Department of Experimental Medicine, ‘Sapienza’ University of Rome, Viale Regina Elena 324, 00161 Rome, Italy. tel: + 39 06 49970251, fax: +39 06 49972473, e-mail: paolo.villari{at}uniroma1.it
Received August 7, 2008 , accepted December 8, 2008
Background: Familiarity with Randomized Control Trials (RCTs) and meta-analyses is essential to practice Evidence Based Medicine (EBM). The aims of this study were to describe knowledge, attitudes and professional behavior of physicians towards methods to evaluate the efficacy of health interventions, particularly meta-analysis and to find out their possible associated factors. Methods: A cross-sectional survey was carried out on a random sample of Italian physicians through a self-administered questionnaire. Results: A response rate of 70.1% was achieved (654 questionnaires). Despite satisfactory knowledge and substantial positive attitudes, Italian physicians have not integrated the use of RCTs and meta-analyses into their practice to a large extent, because they infrequently read and use RCTs and meta-analyses to make decisions in clinical practice. There is a high correlation between knowledge, attitudes and professional use of RCTs and meta-analyses. Moreover, the results of our multivariate analysis show that the probability of an appropriate professional use, that is higher for doctors who know the English language, have internet access and dedicate a proper amount of time to continuing medical education, increases significantly with a previous exposure to meta-analysis during graduate/post-graduate training (OR 2.25, 95% CI 1.44–3.52), and with the attendance of post-graduate courses about EBM (OR 1.75, 95% CI 1.09–2.82). Finally, Italian physicians demonstrate a high level of interest in further training. Conclusions: The association between the EBM educational background of doctors and the appropriate professional use of RCTs and meta-analyses suggest that EBM training may promote a more evidence-based practice among physicians.
Keywords: attitudes, knowledge, meta-analysis, physicians, professional use, RCT