U.S. surgeons don't always follow guidelines

By Jill Stein

CHICAGO (Reuters Health) - U.S. surgeons do a mediocre job of incorporating "evidence-based" guidelines into their practice, according to research reported here at the American College of Surgeons (ACS) 95th Annual Clinical Congress.

Dr. Marcovalerio Melis, with New York University School of Medicine in New York City, and colleagues at other centers analyzed questionnaire responses from 110 faculty and trainee surgeons at three U.S. academic medical centers.

The survey was designed to determine whether key elements of surgical practice were concordant with available evidence.

Overall, only 60 percent of the answers were concordant with existing evidence, Melis and colleagues found.

The percentages of correct answers did not differ significantly according to the institution or participants' level of experience.

The researchers emphasize that their results may be limited by flaws in the questionnaire, because a few questions involved topics with controversial or equivocal answers.

However, they also note that even if these types of questions were eliminated, the percentage of responses in agreement with available evidence would still only be 69 percent.

"The medical community has been placing a high value on synthesizing evidence into systematic reviews, developing computerized clinical evidence-based decision algorithms, and improving electronic access to this information," the investigators noted.