![[Return to article]](../../images/backbutton.gif){kind=small}
Evidence Based Medicine 1997
| 1.AUTHOR | Lomas-J, Haynes-R-B. |
|---|---|
| TITLE | A taxonomy and critical review of tested strategies for the application of clinical practice recommendations: from "official" to "individual clinical policy". |
| SOURCE | In: Battista-R-N, Lawrence-R-S, ed. Implementing preventive services; New York: American College of Preventive Medicine, 1988:77-93. |
| 2.AUTHOR | Sackett-D-L, Rosenberg-W-M-C, Gray-J-A-M, Haynes-R-B, Richardson-W-S. |
|---|---|
| TITLE | Evidence-based medicine: what it is and what it isn't. |
| SOURCE | Based on an editorial BMJ 1996; 312: 71-2. |
| 3.AUTHOR | Liggins GC, Howie RN. |
|---|---|
| TITLE | A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants. |
| SOURCE | Pediatrics. 1972;50:515-25. |
| 4.AUTHOR | Osiris Collaborative Group. |
|---|---|
| TITLE | Early versus delayed neonatal administration of a synthetic surfactant. |
| SOURCE | Lancet. 1992;340: 1363-9. |
| 5.AUTHOR | McAlister-F-A, Koon-K-T, Lewandzuk-R-Z, Wells-G, Montague-T-J. |
|---|---|
| TITLE | Contemporary practice patterns in the management of newly diagnosed hypertension. |
| SOURCE | Can Med Assoc J 1997;157(1):23-30. |
| 6.AUTHOR | Kenny-N-P. |
|---|---|
| TITLE | Does good science make good medicine? |
| SOURCE | Can Med Assoc J 1997;157(1):33-36. |
| 7.AUTHOR | Balas-E-A, Boren-S-A, Brown-G-D, Ewigman-B-G, Mitchell-J-A, Perkoff-G-T. |
|---|---|
| INSTITUTION | Program in Health Services Management, University of Missouri, Columbia 65211, USA. |
| TITLE | Effect of physician profiling on utilization. Meta-analysis of randomized clinical trials (see comments). |
| SOURCE | J-Gen-Intern-Med 1996 Oct, VOL: 11 (10), P: 584-90, ISSN: 0884-8734. |
| CM | Comment in: ACP-J-Club 1997 May-Jun; 126(3):81. |
| Abstract | OBJECTIVES:
An American Medical Association survey reported that more than half of physicians are subjects of either clinical or economic profiling. This multilevel meta-analysis was designed to assess the clinical effect of peer-comparison feedback intervention (profiles) in changing practice patterns. METHODS: Systematic computerized and manual searches were combined to retrieve articles on randomized controlled clinical trials testing profiling reports. Eligible studies were randomized, controlled clinical trials that tested peer-comparison feedback intervention and measured utilization of clinical procedures. To use all available information, data were abstracted and analyzed on three levels: (1) direction of effects, (2) p value fro the statistical comparison, and (3) odds ratio (OR). MAIN RESULTS: In the 12 eligible trials, 553 physicians were profiled. The test result was p < .05 for the vote-counting sign test of 12 studies (level 1) and p < .05 for the z-transformation test of 8 studies (level 2). There were 5 trials included in the OR analysis (level 3). The primary effect variable in two of the 5 trials had a nonsignificant OR. However, the overall OR calculated by the Mantel-Haenszel method was significant (1.091, confidence interval: 1.045 to 1.136). CONCLUSIONS: Profiling has a statistically significant, but minimal effect on the utilization of clinical procedures. The results of this study indicate a need for controlled clinical evaluations before subjecting large numbers of physicians to utilization management interventions. Author. |
Copyright © 2008 Electronic Handbook of Legal Medicine