Article type
Year
Abstract
Introduction:
Objectives: To assess preferences for a Cochrane review (CR) vs a traditional review (TR) as a guide for therapy of Crohn's disease (CD).
Methods: Gastroenterologists were randomized to receive either the CR of azathioprine (Aza) tor induction ot remission of CD, a relevant TR, or the TR with concealment ot author and journal (TRc). We selected a TR by an acknowledged expert, published in the N Eng J Med as likely to be considered authoritative. Outcome measure: perception of usefulness tor recommending appropriate treatment tor chronically active CD. Evaluation tool: 100 mm visual analogue scale (0 = useless and 100 = extremely useful). -Participants were also asked whether Aza was indicated for a patient (case scenario). Response rate: 264/423 (62.4%).
Results: Mean (+/- SEM) preference scores were: CR 71.55( +/- 2.21), TR 54.99 (+/- 2.42), TRc 50.29( +/- 2.59), E.<001). Multivariate analysis showed no relationsllip of response to practice site (university vs community), year of graduation, or formal training in critical appraisal.
Discussion: The study shows a strong preference for the Cochrane review over the traditional review as a guide to recommending azathioprine therapy for induction of remission of Crohn's disease. The response to the case scenario suggests that the type of review may influence the decision to prescribe azathiopnne tor patients with chronically active, steroid-dependem Crohn's disease. There are previous data showing that this spxitic intervention is prescribed less frequently by gastroenterologists in Canada than in the UK. A greater patential may exist for influencing prescribing practice by active dissemination of the appropriate Cochrane review as opposed to a traditional review. Supported by the Crohn's and Colitis Foundation of Canada and LHSC
Objectives: To assess preferences for a Cochrane review (CR) vs a traditional review (TR) as a guide for therapy of Crohn's disease (CD).
Methods: Gastroenterologists were randomized to receive either the CR of azathioprine (Aza) tor induction ot remission of CD, a relevant TR, or the TR with concealment ot author and journal (TRc). We selected a TR by an acknowledged expert, published in the N Eng J Med as likely to be considered authoritative. Outcome measure: perception of usefulness tor recommending appropriate treatment tor chronically active CD. Evaluation tool: 100 mm visual analogue scale (0 = useless and 100 = extremely useful). -Participants were also asked whether Aza was indicated for a patient (case scenario). Response rate: 264/423 (62.4%).
Results: Mean (+/- SEM) preference scores were: CR 71.55( +/- 2.21), TR 54.99 (+/- 2.42), TRc 50.29( +/- 2.59), E.<001). Multivariate analysis showed no relationsllip of response to practice site (university vs community), year of graduation, or formal training in critical appraisal.
Discussion: The study shows a strong preference for the Cochrane review over the traditional review as a guide to recommending azathioprine therapy for induction of remission of Crohn's disease. The response to the case scenario suggests that the type of review may influence the decision to prescribe azathiopnne tor patients with chronically active, steroid-dependem Crohn's disease. There are previous data showing that this spxitic intervention is prescribed less frequently by gastroenterologists in Canada than in the UK. A greater patential may exist for influencing prescribing practice by active dissemination of the appropriate Cochrane review as opposed to a traditional review. Supported by the Crohn's and Colitis Foundation of Canada and LHSC