Do consensus conferences influence
their participants?
A. Mark Clarfield, MD, CCFP, FRCPC; Sandra Kogan, BSc; Howard Bergman, MD, CCFP, CSPQ;
David E. Shapiro, PhD; Marie P. Beaudet, PhD
Canadian Medical Association Journal 1996; 154: 331-336
Dr. Clarfield is director of academic affairs, Herzog Memorial Hospital, Jerusalem, Israel, director of geriatrics, Ministry of Health, Jerusalem, and professor and geriatrician, Sir Mortimer B. Davis-Jewish General Hospital and McGill University, Montreal, Que. Ms. Kogan is research coordinator in the Division of Geriatric Medicine, Sir Mortimer B. Davis-Jewish General Hospital, Montreal. Dr. Bergman is director of the Division of Geriatric Medicine and Aging and associate professor of medicine and family medicine, McGill University, and director of the Division of Geriatric Medicine, Sir Mortimer B. Davis-Jewish General Hospital, Montreal. Dr. Shapiro is research associate in the Department of Biostatistics, Harvard School of Public Health, Boston, Mass. Dr. Beaudet is with Statistics Canada, Ottawa, Ont.; at the time of the study she was in the Division of Geriatric Medicine, Sir Mortimer B. Davis-Jewish General Hospital, Montreal.
Paper reprints of the full text may be obtained from: Dr. A. Mark Clarfield, Herzog Memorial Hospital, PO Box 35300, Jerusalem 91351, Israel; fax 011-972-2-6536075
Abstract
Objective: To determine whether participation in a consensus conference on the assessment of dementia would influence conference participants with respect to their recommendations to primary care physicians for the assessment of dementia.
Design: Questionnaire before and after the conference.
Setting: Canadian Consensus Conference on the Assessment of Dementia, held in Montreal, Oct. 5 and 6, 1989.
Participants: All 38 experts representing relevant health disciplines who participated in the consensus conference; 36 completed both questionnaires.
Outcome measures: Participants' opinion before and after the conference as to how frequently each of 28 manoeuvres (12 blood tests, 4 neurologic imaging procedures, 4 types of consultation and 8 "other" tests) should be ordered by primary care physicians as part of an assessment of a patient with dementia suspected on clinical grounds.
Results: For 18 (64%) of the 28 manoeuvres (10 of the 12 blood tests, 3 of the 4 neurologic imaging procedures and 5 of the 8 "other" tests), there was a shift in opinion after the conference toward recommending that primary care physicians order them less often; for 10 of these 18 (5 blood tests and 5 "other" tests) the shift was statistically significant. For the remaining 10 manoeuvres (36%) the shift in opinion was toward a recommendation that primary care physicians order them more often; the shift was not statistically significant for any of these 10 manoeuvres.
Conclusion: Expert members of a consensus conference are influenced by the process of having participated in such a conference and are capable and willing to change their initial recommendations when confronted with relevant data.
| CMAJ February 1, 1996 (vol 154, no 3) |