Improving Consensus Development for Health Technology Assessment An International Perspective (1990) / Chapter Skim
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Dissemination and Impact of Consensus Development Statements
Dissemination and Impact of Consensus Development Statements
Pages 69-86
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From page 69... ...
in 1977 as a method for developing a statement of accepted standards for clinical practice either with regard to the use of a particular technology or the treatment of a particular disease or syndrome. Other countries have organized conferences, although their formats and purposes have changed over time and between countries.
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From page 70... ...
Thus, the selection of topics for consensus and the range of criteria upon which judgments are made are extremely important in the design of a dissemination strategy. A review of consensus development conferences indicates that they take a fairly inclusive view of the types of technology subject to the consensus development process.
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From page 71... ...
. Consensus statements ;narac~er~zea as a~aacuc otter cacaos practical and detailed guidance, while scholarly statements offer up-to-date descriptions of the scientific evidence bearing on a topic and devote more attention to detail than most statements.
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Three countries report evaluation efforts to link conference recommendations with actual clinical practice patterns. Of these three studies' only the Norwegian results suggest that the
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From page 74... ...
Results showed that the conferences largely failed to stimulate change in physicians' practices, despite moderate success in reaching appropriate target audiences. While this analysis involved physicians and hospitals in only one geographic region of the United States, and thus is subject to severe limits of generalization, the data did reveal that physicians' preferred practice patterns bear a strong relationship to what they actually do.
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From page 75... ...
For example, the aggressive marketing strategies of pAvate corporations that produce medical technologies and the clinical policies of hospitals and clinics that provide care influence physician behavior. The extent to which environmental constraints and incentives affect dissemination or are considered in formulating a dissemination plan varies according to the structure and function of the program.
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From page 76... ...
. Consensus development conferences have used a variety of channels, giving primary importance to professional journals, both general and specialty, and direct mailings of consensus statements.
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~ - w v' To to .
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From page 78... ...
enhancing the effectiveness of consensus development conferences vis-a-vis their stated goals and objectives and (2) providing a data base from which to evaluate the consensus conference approach to dissemination compared with other methodologies and programmatic initiafives that can influence physician practice patterns (e.g., standards and protocol participation)
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From page 79... ...
Obviously, this requires replication in other settings along with the opportunity to evaluate other dissemination strategies such as the use of"clinical alerts" by relevant governmental agencies, computerized physician query systems, and the use of follow-up meetings for selected clinicians that are related to a particular consensus statement. · Role of organizational intermediaries.
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From page 80... ...
· Dissemination and changes in actual clinical practice. While evaluations of dissemination strategies have focused primarily on awareness of Me consensus development program and/or specific program recommendations, the real issue is whether dissemination and the resulting awareness actually change physician practice patterns.
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Consumer involvement and influence in changing physician practice patterns is not well understood and is worthy of investigation and evaluation. SUMMARY The consensus development programs and the resulting consensus statements represent one approach to influencing clinical practice.
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From page 82... ...
1986. Direct mailing as a means of disseminating NIH consensus statements.
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1989. The role of consensus statements in changing physician's awareness and attitudes, knowledge and behavior.
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From page 85... ...
Program Profiles
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Key Terms
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