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Factors that influence practitioners' interpretations of evidence from alternative medicine trials: a factorial vignette experiment embedded in a national survey.

Publication ,  Journal Article
Tilburt, JC; Miller, FG; Jenkins, S; Kaptchuk, TJ; Clarridge, B; Bolcic-Jankovic, D; Emanuel, EJ; Curlin, FA
Published in: Med Care
April 2010

BACKGROUND: Clinical trial evidence in controversial areas such as complementary and alternative medicine (CAM) must be approached with an open mind. OBJECTIVE: To determine what factors may influence practitioners' interpretation of evidence from CAM trials. RESEARCH DESIGN: In a mailed survey of 2400 US CAM and conventional medicine practitioners we included 2 hypothetical factorial vignettes of positive and negative research results for CAM clinical trials. Vignettes contained randomly varied journal (Annals of Internal Medicine vs. Journal of Complementary and Alternative Medicine) and CAM treatment type (acupuncture, massage, glucosamine, meditation, and reiki). Response items also included randomly varied patient circumstances-chronic refractory symptoms and the patient requesting CAM. MEASURES: All practitioners rated the effectiveness and their willingness to recommend the therapy for a described patient. We used logistic regression to determine the independent influence of the 4 factors on respondents' effectiveness and legitimacy judgments. RESULTS: A total of 1561 practitioners responded (65%). Relative to Reiki, conventional medicine practitioners were most willing to recommend glucosamine (OR = 3.0; 95% CI [1.6-5.4]), than massage (1.9 [1.1-3.3]), acupuncture (1.3 [0.8-2.2]), and meditation (1.2 [0.7-2.0]). CAM practitioners rated acupuncture as effective more than other CAM therapies (OR = 5.8 [2.6-12.8] compared with Reiki), and were more willing to recommend acupuncture (OR = 12.3 [4.8-31.8]). When presented evidence of inefficacy, CAM practitioners were most willing to recommend acupuncture relative to other CAM therapies (OR = 15.5 [9.0-26.9]). CONCLUSIONS: Practitioners' judgments about CAM trial evidence depend on the type of treatments reported. Confirmation bias may play a role in the clinical translation of new evidence from clinical trials.

Duke Scholars

Published In

Med Care

DOI

EISSN

1537-1948

Publication Date

April 2010

Volume

48

Issue

4

Start / End Page

341 / 348

Location

United States

Related Subject Headings

  • Surveys and Questionnaires
  • Physicians
  • Patient Preference
  • Middle Aged
  • Male
  • Judgment
  • Humans
  • Health Policy & Services
  • Female
  • Evidence-Based Medicine
 

Citation

APA
Chicago
ICMJE
MLA
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Tilburt, J. C., Miller, F. G., Jenkins, S., Kaptchuk, T. J., Clarridge, B., Bolcic-Jankovic, D., … Curlin, F. A. (2010). Factors that influence practitioners' interpretations of evidence from alternative medicine trials: a factorial vignette experiment embedded in a national survey. Med Care, 48(4), 341–348. https://doi.org/10.1097/mlr.0b013e3181ca3ee2
Tilburt, Jon C., Franklin G. Miller, Sarah Jenkins, Ted J. Kaptchuk, Brian Clarridge, Dragana Bolcic-Jankovic, Ezekiel J. Emanuel, and Farr A. Curlin. “Factors that influence practitioners' interpretations of evidence from alternative medicine trials: a factorial vignette experiment embedded in a national survey.Med Care 48, no. 4 (April 2010): 341–48. https://doi.org/10.1097/mlr.0b013e3181ca3ee2.
Tilburt JC, Miller FG, Jenkins S, Kaptchuk TJ, Clarridge B, Bolcic-Jankovic D, et al. Factors that influence practitioners' interpretations of evidence from alternative medicine trials: a factorial vignette experiment embedded in a national survey. Med Care. 2010 Apr;48(4):341–8.
Tilburt, Jon C., et al. “Factors that influence practitioners' interpretations of evidence from alternative medicine trials: a factorial vignette experiment embedded in a national survey.Med Care, vol. 48, no. 4, Apr. 2010, pp. 341–48. Pubmed, doi:10.1097/mlr.0b013e3181ca3ee2.
Tilburt JC, Miller FG, Jenkins S, Kaptchuk TJ, Clarridge B, Bolcic-Jankovic D, Emanuel EJ, Curlin FA. Factors that influence practitioners' interpretations of evidence from alternative medicine trials: a factorial vignette experiment embedded in a national survey. Med Care. 2010 Apr;48(4):341–348.

Published In

Med Care

DOI

EISSN

1537-1948

Publication Date

April 2010

Volume

48

Issue

4

Start / End Page

341 / 348

Location

United States

Related Subject Headings

  • Surveys and Questionnaires
  • Physicians
  • Patient Preference
  • Middle Aged
  • Male
  • Judgment
  • Humans
  • Health Policy & Services
  • Female
  • Evidence-Based Medicine