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Clinicians' assessments of practice guidelines in oncology: The CAPGO survey

Published online by Cambridge University Press:  01 November 2004

Melissa C. Brouwers ,
Ian D. Graham ,
Steven E. Hanna ,
David A. Cameron  and
George P. Browman
Melissa C. Brouwers
Affiliation:
Cancer Care Ontario McMaster University
Ian D. Graham
Affiliation:
University of Ottawa
Steven E. Hanna
Affiliation:
McMaster University
David A. Cameron
Affiliation:
McMaster University
George P. Browman
Affiliation:
Cancer Care Ontario McMaster University Hamilton Regional Cancer Centre
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Abstract

Objectives: Promoting the adoption of clinical practice guidelines is a challenging task. Research shows that adopters' beliefs about guidelines and the process of their development are important predictors of guideline use. Our objective is to report on the development and refinement of an instrument designed to measure oncologists' assessments of guidelines in oncology.

Method: A theoretically derived instrument was drafted. Oncologists were asked to complete a questionnaire for each draft guideline they were asked to review. Factor analyses and multilevel modeling techniques were undertaken to explore the properties of the instrument and refine it.

Results: A total of 488 Ontario clinicians were sent 1,494 new questionnaires regarding 34 clinical practice guidelines produced between 1999 and 2002. A refined eighteen-item questionnaire with four stable factors that predicted 60 percent of the variance emerged. The factors are interpreted as guideline quality, applicability, acceptability, and comparative value. The four factors predicted oncologists' endorsements of draft guidelines and, with the exception of quality, predicted their intentions to use the guidelines. As expected, variation in the factor scores could be attributed more to the differences among the oncologist who completed the survey than to the differences among the guidelines themselves.

Conclusions:An instrument composed of four stable and theoretically relevant factors emerged. The findings support the hypothesis that beliefs about guideline attributes and development attributes relate to oncologists' endorsement of and intentions to use guidelines. Our next step is to link the responses of the survey with actual clinical behavior.

Keywords

Clinical practice guidelines
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 20 , Issue 4 , November 2004 , pp. 421 - 426
Copyright
© 2004 Cambridge University Press

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