A group of researchers from New South Wales in Australia, undertook a study to evaluate the immediate impact of national evidence-based guidelines about colorectal cancer on Australian surgeons' self-reported practice and their deficits in awareness of scientific evidence underpinning clinical management practices.
The investigators studied preguidelines surveys (November 1998) and postguidelines surveys (February 2001).
In total, the investigators received 114 Australian surgeons postguidelines surveys, of whom 103 (90%) agreed to matching of their pre- and postguidelines responses.
National distribution of the CRC guidelines occurred in November 1999.
Over the ensuing year, dissemination strategies included seminars, presentations at conferences and journal articles.
The researchers were interested in looking at changes in awareness of evidence for each of 23 clinical recommendations, changes in overall awareness score and changes in subscore for 9 items for which evidence was compelling and predictors of change in order to gauge a study outcome.
|95% of the surgeons were aware of the guidelines|
95% of the surgeons that the researchers followed-up were aware of the guidelines and 32% had read them in detail. Only 47% recalled the consumer version.
The investigators found that the three most highly rated topics in the guidelines were: high-risk familial syndromes (45%); screening based on family history of colorectal cancer (40%) and population screening for colorectal cancer (25%).
Compared with baseline, the research group found that there was a modest improvement in the mean overall awareness score.
Paired analyses of awareness of the evidence for each of 23 individual topics revealed significant improvement only in 5. For 2, awareness significantly decreased.
Professor Ward commented, "Our pre/post findings are not inconsistent with the expectation that dissemination of the CRC guidelines has had some short-term impact."
"However, definitive evidence acquired through more rigorously designed controlled trials will be needed to determine first, whether surgical practice has changed and, second, whether implementation of the CRC guidelines or some other secular event caused such change."