Leiðir mikilvægrar nýrrar þekkingar til lækna : dæmið um Helicobacter pylori og sár í maga og skeifugörn
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Authors
Auðbergur JónssonMartin, Peter
Rautanen, Kirsti
Thomsen, Arne Scheel
Hjalt, Carl-Åke
Löfroth, Göran
Issue Date
2001-09-01
Metadata
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The channels for important new knowledge to medical doctors. The case of Helicobacter pylori and stomach and duodenal ulcersCitation
Læknablaðið 2001, 87(9):707-12Abstract
A retrospective survey of the flow of information to medical doctors as regards the relationship between Helicobacter pylori and stomach and duodenal ulcer and other gastrointestinal diseases. This is the Icelandic part of a joint study in five Nordic countries. Objective: The objective of the research was to assess the effectiveness of different sources of information, to measure the length of time it takes for the information to spread and influence medical practice. Material and methods: The information was collected with the help of questionnaires that were sent to 159 general practitioners (GP) and 110 physicians in three medical specialities. Among the questions asked were when and how the information had reached the respondents and when and how it had influenced their medical practices. Results: The knowledge about Helicobacter pylori had generally reached medical doctors six to eight years after it first appeared in the medical journals and had three years later led to changes in the routine examinations and treatment. The specialists got the news one to three years earlier than the GPs and also started to prescribe antibiotics one to three years earlier. The most frequently cited source of information was international medical journals, then scientific conferences, colleagues and The Icelandic Medical Journal. The most important source was considered to be international medical journals, then scientific conferences and colleagues. A certain difference was found between GPs and the specialist doctors. More GPs said they had got information from the pharmaceutical industry or through The Icelandic Medical Journal and relied on clinical diagnosis. More specialist doctors considered the most important source of new knowledge to be the colleagues, they also said they used endoscopy and took tissue samples more often and more often considered it correct to do so. Conclusions: Only a decade after the first reports on Helicobacter pylori appeared in medical journals most Icelandic doctors had got the knowledge and were prescribing appropriate treatment, the specialist doctors in the lead. International medical journals spread the news most effectively but The Icelandic Medical Journal played only a minor role. The question is if the process could have been accelerated any further by some more hitting Icelandic news and by more definite initiative in framing guidelines.Lýst er afturskyggnri rannsókn á upplýsingaflæði til lækna af tengslum Helicobacter pylori við sár í maga og skeifugörn og fleiri meltingarfærasjúkdóma. Þetta er íslenski hlutinn af sameiginlegri rannsókn í fimm Norðurlöndum. Tilgangur: Tilgangur rannsóknarinnar var að fá fram mynd af virkni dreifingarleiða faglegrar þekkingar og sjá hve lengi merk tíðindi eru að berast og valda breytingum á hefbundnum vinnubrögðum. Efniviður og aðferðir: Sendir voru spurningalistar til 159 íslenskra heimilislækna og 110 lækna í þremur sérgreinum. Meðal annars var spurt hvenær og hvaðan umrædd frétt barst, hvenær og hvernig hún breytti vinnubrögðum við greiningu og meðferð. Niðurstöður: Tíðindin um H. pylori höfðu almennt borist læknum sex til átta árum eftir fyrstu skrif um þau í fagritum og þremur árum síðar höfðu þau leitt til viðeigandi breytinga á rannsóknum og meðferð. Sérgreinalæknarnir fengu fréttirnar einu til þremur árum á undan heimilislæknunum og fóru einnig einu til þremur árum á undan þeim að nota sýklalyf í meðferð sýrusára. Fróðleiksuppspretturnar, sem flestir nefndu, voru erlend fagrit, þá vísindaráðstefnur, starfssystkini og íslenskt fagrit. Mikilvægustu heimild töldu flestir erlend fagrit, þá vísindaráðstefnur og starfssystkini. Viss munur kom fram á heimilislæknahópnum og sérgreinalæknahópnum. Fleiri heimilislæknar sögðust fá fréttir frá lyfjaiðnaðinum, fleiri lesa þær í Læknablaðinu og treysta fleiri á klíníska sjúkdómsgreiningu. Sérgreinalæknarnir töldu fleiri mikilvægustu heimildina vera starfssystkini, einnig sögðust þeir fleiri nota og telja rétt að nota speglanir og vefjasýnatökur en heimilislæknarnir. Ályktanir: Aðeins áratugi eftir birtingu fyrstu greina í fagritum um Helicobacter pylori höfðu íslenskir læknar aflað sér þekkingar og tekið upp viðeigandi meðferð, og fóru sérgreinalæknar þar eðlilega fyrir. Fréttin barst flestum með erlendu fagriti, en hlutverk innlends fagrits var lítið. Spurning er hvort hægt hefði verið að hraða þessu ferli enn frekar með markvissari innlendri fréttamiðlun og frumkvæði að gerð vinnureglna.
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