DO CONTINUING MEDICAL EDUCATION CME ARTICLES FOSTER SHARED DECISIONMAKING

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DO CONTINUING MEDICAL EDUCATION (CME) ARTICLES
FOSTER SHARED DECISION-MAKING?

• Michel Labrecque
• Valérie Lafortune
• Judith Lajeunesse
• Anne-Marie Lambert-Perrault
• Hermes Manrique
• Johanne Blais
• France Légaré

Canada Research Chair in Implementation of
Shared Decision Making in Primary Care
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RELEVANCE

• Providing the best available evidence on benefits
  and harms of all available options is an
  essential step to Evidence-Based Practice (EBP)
  and Shared Decision-Making (SDM).
• Physicians must have a clear understanding of
  this information to translate it to the patients.
• CME articles reviews on clinical topics in
  medical journals - constitute one of physicians
  main sources of clinical information.
• CME articles should provide this knowledge to
  physicians.

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OBJECTIVE

• To assess whether CME articles on therapeutic or
  preventive interventions provide the
  evidence-based information on benefits and harms
  of available options.

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METHODOLOGY CME Articles
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METHODOLOGY CME Articles
6 most recent CME articles on therapeutic or
preventive interventions in each journal Total
30
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METHODOLOGY Evaluation Tool

• A 10-item checklist based on the first two
  sections of the quality framework criteria of
• Providing information about options in sufficient
  detail for decision making
• Presenting probabilities of outcomes in an
  unbiased and understandable way.

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METHODOLOGY Evaluation Tool
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METHODOLOGY Evaluation Process

• Independent evaluation
• Each article randomly assigned to 2 residents in
  Family Medicine
• Independent evaluation using the 10-item
  checklist
• Consensus meeting
• For each article
• Comparison of score attributed to each of the 10
  items
• Discrepancies discussed referring to the article
  as necessary
• Consensus on each item (present 1 absent0)
• Total score on 10

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Mean and Median Score (on 10) of the 30 CME
Articles According to Journal
3.6
3.5
3.3
2.4
1.3
Kruskal-Wallis test, p 0.05
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Mean and Median Scores of Each Item (n30)
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BOTTOM LINE
Do CME articles foster evidence-based patient
choice and shared decision-making?
NO
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BOTTOM LINE
Medical journals should require authors of CME
articles to describe information deemed essential
for evidence-based patient choice and SDM to
occur.
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Thank you!
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Statistiques descriptives du score consensuel
(sur 10) des articles de FMC selon le journal
Test de Kruskal-Wallis, p 0,05
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Scores moyen (sur 10) des 10 présentations de FMC
présentées du 13-09-2007 au 20-11-2007 selon le
type