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Persuasive Communication and Medical Technology Assessment

Persuasive Communication and Medical Technology Assessment Abstract • Assessments of medical technologies with respect to their efficacy, safety, and cost-effectiveness are expected to influence clinical practice, but they are often lost in an avalanche of medical information. We developed a conceptual model that may aid understanding of the potential impact on clinical practice of new medical information in general and assessment information in particular. The model identifies aspects of medical communication that may influence an assessment's subsequent impact, including sources, messages, channels, audiences, and settings. We reviewed the literature on how medical information diffuses to physicians and highlighted those factors likely to heighten physicians' awareness and decisions to incorporate recommended medical advances. We outlined implications for educational interventions and promising research directions. (Arch Intern Med 1985;145:314-317) References 1. Fineberg HV, Hiatt HH: Evaluation of medical practices: The case for technology assessment. N Engl J Med 1979;301:1086-1091.Crossref 2. Development of Medical Technology: Opportunities for Assessment , publication OTA-H-34. Office of Technology Assessment, 1976. 3. Stross JK, Harlan WR: The dissemination of new medical information. JAMA 1979;241:2622-2624.Crossref 4. Thomson GE, Alderman MH, Wassertheil-Smoller S, et al: High blood pressure diagnosis and treatment: Consensus recommendations vs. actual practice. Am J Public Health 1981;71:413-416.Crossref 5. Frazier HS, Hiatt HH: Evaluation of medical practices. Science 1978;200:875-878.Crossref 6. Altman SH, Blendon R (eds): Medical Technology: The Culprit Behind Health Care Costs? Proceedings of the 1977 Sun Valley Forum on National Health, DHEW publication (PHS) 79-3216. Dept of Health, Education, and Welfare, 1979. 7. Kessner DM: Diffusion of new medical information. Am J Public Health 1981;71:367-368.Crossref 8. Rogers EM, Shoemaker FF: Communication of Innovations: A Cross-Cultural Approach , ed 2. New York, Free Press, 1971. 9. McGuire WJ: The nature of attitudes and attitude change , in Lindzey G, Aronson E (eds): Handbook of Social Psychology. Reading, Mass, Addison-Wesley Publishing Co Inc, 1969, vol 3, pp 136-314. 10. McLaughlin CP, Penchansky R: Diffusion of innovation in medicine: A problem of continuing medical education. J Med Educ 1965;40:437-447. 11. Stinson ER, Mueller DA: Survey of health professionals' information habits and needs. JAMA 1980;243:140-143.Crossref 12. Miller RR: Prescribing habits of physicians: A review of studies on prescribing of drugs. Drug Intell Clin Pharm 1974;8:81-91. 13. Coleman JS, Katz E, Menzel H: Medical Innovation: A Diffusion Study. Indianapolis, Bobbs-Merill, 1966. 14. Christensen DB, Wertheimer AI: Sources of information and influence on new drug prescribing physicians in an HMO. Soc Sci Med 1979;13A:313-322. 15. Manning PR, Denson TA: How cardiologists learn about echocardiography: A reminder for medical educators and legislators. Ann Intern Med 1979;91:469-471.Crossref 16. Fineberg HV, Gabel RA, Sosman MB: Acquisition and application of new medical knowledge by anesthesiologists: Three recent examples. Anesthesiology 1978;48:430-436.Crossref 17. Christensen DB, Bush PJ: Drug prescribing: Patterns, problems, and proposals. Soc Sci Med 1981;15A:343-355. 18. Weinberg AD, Ullian L, Richards WD, et al: Informal advice- and information-seeking between physicians. J Med Educ 1981;56:174-180. 19. Young DA: Communications linking clinical research and clinical practice , in Roberts EB, Levy RI, Finkelstein SN, et al (eds): Biomedical Innovation. Cambridge, Mass, MIT Press, 1981, pp 177-199. 20. Warner KE: A 'desperation-reaction' model of medical diffusion. Health Serv Res 1975;10:369-383. 21. Mapes REA: Physicians' drug innovation and relinquishment. Soc Sci Med 1977;11:619-624.Crossref 22. Chalmers TC: The impact of controlled trials on the practice of medicine. Mt Sinai J Med 1974;41:753-759. 23. Becker M: Sociometric location and innovativeness: Reformulation and extension of the diffusion model. Am Sociol Rev 1970;35:267-282.Crossref 24. Bauer RA, Wortzel LH: Doctor's choice: The physician and his sources of information about drugs. J Marketing Res 1966;3:40-47.Crossref 25. Stross JK, Hiss RG, Watts CM, et al: Continuing education in pulmonary disease for primary-care physicians. Am Rev Respir Dis 1983;127:739-746. 26. Jordan HS, Burke JF, Fineberg H, et al: Diffusion of innovations in burn care: Selected findings. Burns 1983;9:271-279.Crossref 27. Williamson PM: The adoption of new drugs by doctors practicing in group and solo practice. Soc Sci Med 1975;9:233-236.Crossref 28. Russell LB: Technology in Hospitals: Medical Advances and Their Diffusion. Washington, DC, Brookings Institution, 1979. 29. Kalzuny AD: Innovation in health services: Theoretical framework and review of research. Health Serv Res 1974;9:101-120. 30. Greer AL: Advances in the study of diffusion of innovation in health care organizations. Milbank Mem Fund Q 1977;55:505-532.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Persuasive Communication and Medical Technology Assessment

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Publisher
American Medical Association
Copyright
Copyright © 1985 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1985.00360020156024
Publisher site
See Article on Publisher Site

Abstract

Abstract • Assessments of medical technologies with respect to their efficacy, safety, and cost-effectiveness are expected to influence clinical practice, but they are often lost in an avalanche of medical information. We developed a conceptual model that may aid understanding of the potential impact on clinical practice of new medical information in general and assessment information in particular. The model identifies aspects of medical communication that may influence an assessment's subsequent impact, including sources, messages, channels, audiences, and settings. We reviewed the literature on how medical information diffuses to physicians and highlighted those factors likely to heighten physicians' awareness and decisions to incorporate recommended medical advances. We outlined implications for educational interventions and promising research directions. (Arch Intern Med 1985;145:314-317) References 1. Fineberg HV, Hiatt HH: Evaluation of medical practices: The case for technology assessment. N Engl J Med 1979;301:1086-1091.Crossref 2. Development of Medical Technology: Opportunities for Assessment , publication OTA-H-34. Office of Technology Assessment, 1976. 3. Stross JK, Harlan WR: The dissemination of new medical information. JAMA 1979;241:2622-2624.Crossref 4. Thomson GE, Alderman MH, Wassertheil-Smoller S, et al: High blood pressure diagnosis and treatment: Consensus recommendations vs. actual practice. Am J Public Health 1981;71:413-416.Crossref 5. Frazier HS, Hiatt HH: Evaluation of medical practices. Science 1978;200:875-878.Crossref 6. Altman SH, Blendon R (eds): Medical Technology: The Culprit Behind Health Care Costs? Proceedings of the 1977 Sun Valley Forum on National Health, DHEW publication (PHS) 79-3216. Dept of Health, Education, and Welfare, 1979. 7. Kessner DM: Diffusion of new medical information. Am J Public Health 1981;71:367-368.Crossref 8. Rogers EM, Shoemaker FF: Communication of Innovations: A Cross-Cultural Approach , ed 2. New York, Free Press, 1971. 9. McGuire WJ: The nature of attitudes and attitude change , in Lindzey G, Aronson E (eds): Handbook of Social Psychology. Reading, Mass, Addison-Wesley Publishing Co Inc, 1969, vol 3, pp 136-314. 10. McLaughlin CP, Penchansky R: Diffusion of innovation in medicine: A problem of continuing medical education. J Med Educ 1965;40:437-447. 11. Stinson ER, Mueller DA: Survey of health professionals' information habits and needs. JAMA 1980;243:140-143.Crossref 12. Miller RR: Prescribing habits of physicians: A review of studies on prescribing of drugs. Drug Intell Clin Pharm 1974;8:81-91. 13. Coleman JS, Katz E, Menzel H: Medical Innovation: A Diffusion Study. Indianapolis, Bobbs-Merill, 1966. 14. Christensen DB, Wertheimer AI: Sources of information and influence on new drug prescribing physicians in an HMO. Soc Sci Med 1979;13A:313-322. 15. Manning PR, Denson TA: How cardiologists learn about echocardiography: A reminder for medical educators and legislators. Ann Intern Med 1979;91:469-471.Crossref 16. Fineberg HV, Gabel RA, Sosman MB: Acquisition and application of new medical knowledge by anesthesiologists: Three recent examples. Anesthesiology 1978;48:430-436.Crossref 17. Christensen DB, Bush PJ: Drug prescribing: Patterns, problems, and proposals. Soc Sci Med 1981;15A:343-355. 18. Weinberg AD, Ullian L, Richards WD, et al: Informal advice- and information-seeking between physicians. J Med Educ 1981;56:174-180. 19. Young DA: Communications linking clinical research and clinical practice , in Roberts EB, Levy RI, Finkelstein SN, et al (eds): Biomedical Innovation. Cambridge, Mass, MIT Press, 1981, pp 177-199. 20. Warner KE: A 'desperation-reaction' model of medical diffusion. Health Serv Res 1975;10:369-383. 21. Mapes REA: Physicians' drug innovation and relinquishment. Soc Sci Med 1977;11:619-624.Crossref 22. Chalmers TC: The impact of controlled trials on the practice of medicine. Mt Sinai J Med 1974;41:753-759. 23. Becker M: Sociometric location and innovativeness: Reformulation and extension of the diffusion model. Am Sociol Rev 1970;35:267-282.Crossref 24. Bauer RA, Wortzel LH: Doctor's choice: The physician and his sources of information about drugs. J Marketing Res 1966;3:40-47.Crossref 25. Stross JK, Hiss RG, Watts CM, et al: Continuing education in pulmonary disease for primary-care physicians. Am Rev Respir Dis 1983;127:739-746. 26. Jordan HS, Burke JF, Fineberg H, et al: Diffusion of innovations in burn care: Selected findings. Burns 1983;9:271-279.Crossref 27. Williamson PM: The adoption of new drugs by doctors practicing in group and solo practice. Soc Sci Med 1975;9:233-236.Crossref 28. Russell LB: Technology in Hospitals: Medical Advances and Their Diffusion. Washington, DC, Brookings Institution, 1979. 29. Kalzuny AD: Innovation in health services: Theoretical framework and review of research. Health Serv Res 1974;9:101-120. 30. Greer AL: Advances in the study of diffusion of innovation in health care organizations. Milbank Mem Fund Q 1977;55:505-532.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Feb 1, 1985

References