Perceptions and Competence in Evidence-Based Medicine: A Survey of the American Urological Association Membership

PURPOSE: We investigated the attitudes and opinions of urologists toward evidence-based medicine to help guide future efforts of the American Urological Association and other organizations vested in the education and training of urologists. MATERIALS AND METHODS: From August to November 2006 we performed a mail survey of a random sample of 2,000 members of the American Urological Association. Questions in the survey addressed the role of evidence-based medicine in urology, participants' self-assessed understanding of evidence-based medicine related terminology, their familiarity with and use of web based evidence-based medicine resources, as well as their evidence-based medicine competence based on their understanding of core concepts such as randomization and blinding. RESULTS: A total of 889 respondents completed the survey resulting in a response rate of 45%. There was widespread agreement that practicing evidence-based medicine improves patient care (median score 8; IQR 7, 10) and that every urologist should be familiar with critical appraisal techniques (median score 9; IQR 8, 10). The percentage of respondents who indicated that they "understand and could explain to others" the terms number needed to treat, power and level of evidence was 42%, 29% and 18%, respectively. The American Urological Association Guidelines were used regularly by 35% and on occasion by 51% of respondents. Of the participants 44% were unaware of the PubMed(R) search engine and only 14% used it regularly, while 76% were unaware of the Cochrane Database of Systematic Reviews and only 8% had ever used it. The mean evidence-based medicine competence score for all respondents was 67.2% +/- 17.0%. CONCLUSIONS: The findings of this survey confirm that urologists have a favorable attitude toward evidence-based medicine. However, understanding of evidence-based medicine terminology, concepts and use of related resources among American Urological Association members leaves room for improvement. Increased efforts to promote an understanding of evidence-based medicine through workshops, publications and web based resources specifically for a urological audience appear indicated.