Sources of information influencing decision-making in orthopaedic surgery - an international online survey of 1147 orthopaedic surgeons

Abstract

BackgroundManufacturers of implants and materials in the field of orthopaedics use significant amounts of funding to produce informational material to influence the decision-making process of orthopaedic surgeons with regards to choice between novel implants and techniques. It remains unclear how far orthopaedic surgeons are really influenced by the materials supplied by companies or whether other, evidence-based publications have a higher impact on their decision-making. The objective was to evaluate the subjective usefulness and usage of different sources of information upon which orthopaedic surgeons base their decisions when acquiring new implants or techniques.MethodsWe undertook an online survey of 1174 orthopaedic surgeons worldwide (of whom n = 305 were head of their department). The questionnaire included 34 items. Sequences were randomized to reduce possible bias. Questions were closed or semi-open with single or multiple answers. The usage and relevance of different sources of information when learning about and selecting orthopaedic treatments were evaluated. Orthopaedic surgeons and trainees were targeted, and were only allowed to respond once over a period of two weeks. Baseline information included country of workplace, level of experience and orthopaedic subspecialisation. The results were statistically evaluated.ResultsIndependent scientific proof had the highest influence on decisions for treatment while OEM (Original Equipment Manufacturer) driven activities like newsletters, white papers or workshops had the least impact. Comparison of answers from the three best-represented countries in this study (Germany, UK and USA) showed some significant differences: Scientific literature and congresses are significantly more important in the US than in the UK or Germany, although they are very important in all countries.ConclusionsIndependent and peer-reviewed sources of information are preferred by surgeons when choosing between methods and implants. Manufacturers of medical devices in orthopaedics employ a considerable workforce to inform or influence hospital managers and leading doctors with marketing activities. Our results indicate that it might be far more effective to channel at least some of these funds into peer-reviewed research projects, thereby assuring significantly higher acceptance of the related products.

What Sources Are Natural Resource Managers Using to Make Decisions?

“…Managers who had been out of school for longer periods of time appeared to be more skeptical about the value of the peer‐reviewed literature as it pertained to management recommendations, which is counter to results from the medical field (Schulz et al 2013). Skeptical respondents to our survey may believe that years of experience in the field offer better insights into the management options than more recently published research on the topic.…”

Redesigning an International Orthopaedic CME Course: The Effects on Participant Engagement over 5 Years

“…Most physicians would agree that commitment to continuing learning is the best way to provide evidence-based care, and CME is important in surgical education to remain abreast of new technology, techniques and practice patterns. In orthopaedic surgery, the preferred way to receive education in most countries is by nonindustry-based courses [6,26]. Successful CME programmes require participation and satisfaction to enable learning, but there has been limited literature on how to increase participation and satisfaction within CME courses [5].…”

Will an App Fill the Gap? Innovative Technology to Provide Point-of-Care Information

“…Most of the apps are available on the smartphones, but tablet computer is also being increasingly used for “surgical consultations, operating theaters, post-operative care, and surgical education … mainly in thoracic, orthopedic, and ophthalmic surgery where it was shown to improve surgical performance and safety” ( 3 ). While Franko claims that medical apps for textbook/reference and techniques/guides are highly requested by orthopedic surgeons ( 14 , 15 ), rigorously peer-reviewed scientific literature is still found to be most influential for their decision-making process ( 16 ).…”