Role for opinion leaders in promoting evidence-based surgery.

Full Abstract

HYPOTHESIS:
"Opinion leaders" can be identified by surgeons from among their peers, and opinion leaders have a role in promoting best surgical practice.

DESIGN:
Postal survey.

SETTING AND PARTICIPANTS:
Four hundred eighteen (77% response fraction) randomly selected fellows of the Royal Australasian College of Surgeons.

MAIN OUTCOME MEASURES:
Number of opinion leaders identified locally, statewide, and nationally; ratings of 22 possible attributes in conferring status as an opinion leader; and views about and ratings of the role of opinion leaders.

RESULTS:
Most respondents were unable to identify a local colleague whom they considered to be an opinion leader in their own specialty (mode, 0; and median, 1) or in surgery in general (mode, 0; and median, 0). Estimated numbers of opinion leaders were significantly higher at the state and national levels for the respondents' own specialty and for surgery in general (P<.001 for all). Surgical expertise and teaching skills were rated most highly as conferring status as an opinion leader. Academic and professional contributions received the lowest ratings. Most surgeons (88%; 95% confidence interval, 84%-91%) agreed that opinion leaders could influence them to change their practice. Opinion leaders were rated as "very influential" by significantly more surgeons than clinical audit (38% vs 27%, chi21 = 13.6, P<.001) and clinical practice guidelines (38% vs 24%, chi21 = 21.4, P<.001) (McNemar test for both).

CONCLUSIONS:
Australian surgeons support the concept of opinion leaders. Although few local colleagues whom they consider as fulfilling such a role can be identified, opinion leaders are evident at a national level. Once opinion leaders are identified using attributes ranked in our survey, interventional studies will further delineate their influence in improving evidence-based surgical practice.

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Author information

Author/s: Young, Jane M (JM); Hollands, Michael J (MJ); Ward, Jeanette (J); Holman, C D'Arcy J (CD);

Affiliation: Surgical Outcomes Research Centre, Central Sydney Area Health Service, and School of Public Health, University of Sydney, New South Wales, Australia. jyoung(-atsign-)email.cs.nsw.gov.au

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: Archives of surgery (Chicago, Ill. : 1960) (Arch Surg), published in United States. (Language: eng)

Reference: 2003-Jul; vol 138 (issue 7) : pp 785-91

Dates: Created 2003/07/15; Completed 2003/08/06; Revised 2006/11/15;

PMID: 12860762, status: MEDLINE (last retrieval date: 11/6/2008)

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