V Taliercio, J Logan, J Kalpathy-Cramer, P Otero

1. Developing a Survey to Assess Factors that Contribute to Physician Involvement in Clinical Research V Taliercio, J Logan, J Kalpathy-Cramer, P Otero Presented by: Judith R. Logan, MD MedInfo, August 22, 2013

2. Clinical research productivity How can we promote clinical research in Latin America?

3. Latin America lags behind other areas of the world in research productivity • Clinical research can lead to benefits in the current and future health of a population (and has economic impact) • There is limited investment in research in Latin America, relatively low numbers of research projects and publications

4. Investment in research Adapted from: Thorn K. Science, Technology and innovation in Argentina [Internet]. WB Working Paper; 2005. Available from: http://siteresources.worldbank.org/INTARGENTINA/Resources/ScienceTechnologyandInnovationinArgentina.pdf Karlberg J. Biomedical Publication Trends by Geographic Area. Clinical Trial Magnifier. 2010

5. Clinical research productivity Can we create a survey to determine those factors? What are the factors that affect research productivity? How can we promote clinical research in Latin America?

6. The problem is complex and multidimensional • Knowledge and skills • Desire to perform research • Belief that research is useful in daily management of patients • Belief that evidence-based medicine improves care of the patient • Supportive community • Social and political norms

7. Kagan and associates: • 2009 study on an evaluation system for an HIV/AIDS clinical trials program • Case-study approach to construct a conceptual framework • Used framework to suggest a method to evaluate the network Kagan JM, Kane M, Quinlan KM, Rosas S, Trochim WMK. Developing a conceptual framework for an evaluation system for the NIAID HIV/AIDS clinical trials networks. Health Res Policy Syst. 2009;7:12.

8. Sarre and Cooke: • Indicators to measure research capacity in primary care organizations • Nominal group technique • 26 indicators • Example: Evidence of accessible guidance to help researchers through the research process including governance and ethics Sarre G, Cooke J. Developing indicators for measuring Research Capacity Development in primary care organizations: a consensus approach using a nominal group technique. Health Soc Care Community. 2009 May;17(3):244-253.

9. Cork, Detmer and Friedman: • Computers in Medical Care • Four scales: • attributes of computer use • self-reported computer knowledge • computer feature demand • computer optimism of academic physicians Cork RD, Detmer WM, Friedman CP. Development and initial validation of an instrument to measure physicians’ use of, knowledge about, and attitudes toward computers. J Am Med Inform Assoc. 1998 Apr;5(2):164–76.

10. The initial survey • Initial survey 74 questions, 5 themes • research experience (measuring the current research productivity of the respondent) • education in research • environmental factors • computer experience • collaborative technologies

11. Validation • Tested with users for • meaning • ambiguity • comprehensibility • language options / synonyms • restricted response range • average time for completion

12. Pilot study, 30 physicians • Feasibility analysis • questions not answered • incomplete surveys • Test-test reliability • intra-class coefficients • Ceiling effect • frequency of responsefor each option

13. Pilot study, 30 physicians • Feasibility analysis • 80% returned • 95% complete • Test-test reliability • 14 intra-class coefficients <0.65 • Ceiling effect • highest frequency of response 60%

26. Survey results

27. Results: Cluster analysis • 3 clusters characterized the physician's involvement in research

28. Results: Principal component analysis • Environmental support • Use of communication tools • Computer use for academic activities • Computer knowledge • Knowledge in statistical analysis • Independent variable: Number of information resources

29. Radar chart: Median of each component by cluster

30. Thank you!