Evidence map›Paper›PMID 28532470›Full record

ArticleBMC medical informatics and decision making2017

Health care professionals' attitudes towards evidence-based medicine in the workers' compensation setting: a cohort study.

Nieke A Elbers, Robin Chase, Ashley Craig, Lyn Guy, Ian A Harris, James W Middleton, Michael K Nicholas, Trudy Rebbeck, John Walsh, Simon Willcock and 2 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC medical informatics and decision making, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.0field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 9 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 2 countries.

Nieke A ElbersSydney Medical School Northern, University of Sydney; Northern Sydney Local Health District, St Leonards, Australia. nieke.elbers@sydney.edu.au.ORCID 0000-0001-7438-2273
Robin ChaseTyrrell Consulting, Adelaide, South Australia, Australia.
Ashley CraigSydney Medical School Northern, University of Sydney; Northern Sydney Local Health District, St Leonards, Australia.
Lyn GuySchool of Health Sciences, University of Newcastle, Newcastle, Australia.
Ian A HarrisIngham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW, Sydney, Australia.
James W MiddletonSydney Medical School Northern, University of Sydney; Northern Sydney Local Health District, St Leonards, Australia.
Michael K NicholasSydney Medical School Northern, University of Sydney; Northern Sydney Local Health District, St Leonards, Australia.
Trudy RebbeckSydney Medical School Northern, University of Sydney; Northern Sydney Local Health District, St Leonards, Australia.
John WalshSydney Medical School Northern, University of Sydney; Northern Sydney Local Health District, St Leonards, Australia.
Simon WillcockMacquarie University Hospital and Health Sciences Centre, Sydney, Australia.
Keri LockwoodSydney Medical School Northern, University of Sydney; Northern Sydney Local Health District, St Leonards, Australia.
Ian D CameronSydney Medical School Northern, University of Sydney; Northern Sydney Local Health District, St Leonards, Australia.
The University of Sydney · AUMacquarie University · AUUniversity of Newcastle Australia · AUUNSW Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundProblems may arise during the approval process of treatment after a compensable work injury, which include excess paperwork, delays in approving services, disputes, and allegations of over-servicing. This is perceived as undesirable for injured people, health care professionals and claims managers, and costly to the health care system, compensation system, workplaces and society. Introducing an Evidence Based Medicine (EBM) decision tool in the workers' compensation system could provide a partial solution, by reducing uncertainty about effective treatment. The aim of this study was to investigate attitudes of health care professionals (HCP) to the potential implementation of an EBM tool in the workers' compensation setting.

methodsThe study has a mixed methods design. The quantitative study consisted of an online questionnaire asking about self-reported knowledge, attitudes and behaviour to EBM in general. The qualitative study consisted of interviews about an EBM tool being applied in the workers' compensation process. Participants were health care practitioners from different clinical specialties. They were recruited through the investigators' clinical networks and the workers' compensation government regulator's website.

resultsParticipants completing the questionnaire (n = 231) indicated they were knowledgeable about the evidence-base in their field, but perceived some difficulties when applying EBM. General practitioners reported having the greatest obstacles to applying EBM. Participants who were interviewed (n = 15) perceived that an EBM tool in the workers' compensation setting could potentially have some advantages, such as reducing inappropriate treatment, or over-servicing, and providing guidance for clinicians. However, participants expressed substantial concerns that the EBM tool would not adequately reflect the impact of psychosocial factors on recovery. They also highlighted a lack of timeliness in decision making and proper assessment, particularly in pain management.

conclusionsOverall, HCP are supportive of EBM, but have strong concerns about implementation of EBM based decision making in the workers' compensation setting. The participants felt that an EBM tool should not be applied rigidly and should take into account clinical judgement and patient variability and preferences. In general, the treatment approval process in the workers' compensation insurance system is a sensitive area, in which the interaction between HCP and claims managers can be improved.

Indexed as

Attitude of Health PersonnelEvidence-Based MedicineWorkers' CompensationAdolescentAdultAgedCohort StudiesCross-Sectional StudiesHumansInterviews as TopicMaleMiddle AgedQualitative ResearchSurveys and QuestionnairesYoung AdultEvidence-based medicineGuidelinesHealth care practitionersWorkers’ compensation process

Identifiers

PMID28532470
PMCPMC5440905
OpenAlexW2619953089

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.