Supporting Statement B

Physicians’ Experience of Ethical Dilemmas and Resource Allocation

Supporting Statement B

Project officer:

Marion Danis, M.D.

Department of Clinical Bioethics

National Institutes of Health

Building 10, Room 1C118

Bethesda, MD 20892-1156

Telephone: (301)435-8727

Facsimile: (301)496-0760

Email: mdanis@cc.nih.gov

2. Collections of Information Employing Statistical Methods

B1. Respondent Universe and Sampling Methods

For the purposes of this survey, a random sample would be requested from the American Medical Association Master List of Physicians and Medical Students for Mailing Purposes. We are expecting a response rate of 70%, for this survey, because the issues it addresses are important to internists’ everyday functioning, and because the time commitment will be approximately 20 minutes.

B2.Procedures for the Collection of Information

The survey (attached as Appendix 1) will take approximately 20 minutes to complete. An initial mailing will contain a letter of invitation to participate in the survey including an explanation of the aims of the study (Appendix 2). Physicians will subsequently called to complete a telephone interview. With the collaboration of a survey firm (Medtap International, London, UK), responses will be double entered into a computerised database, checked and cleaned before analysis.

B3. Methods to Maximize Response Rates and Deal with Nonresponse

The response rate will be calculated by dividing the number of respondents to our survey by the number of internists sampled. We have taken several measures to make sure that non-response is minimized. First, we are keeping the survey short. Second, we are focusing on an area that is of direct interest to our target population. Third, we will protect the confidentiality of the respondents by destroying all identifiers as soon as data collection is finished.

B4. Test of Procedures or Methods to be Undertaken

A formalized survey instrument has been developed for the European survey. Pre-testing involved three phases: 1. The survey instrument was extensively administered to individuals at the Department of Clinical Bioethics, for comments on the clarity and appropriateness of the questions 2. The survey instrument was given out for comments to two expert reviewers familiar with the area of resource allocation, and their opinion was that the questions addressed the target domains in an appropriate manner. 3. As part of our pilot, we surveyed 9 physicians in the US and the dynamics of the questions were assessed based on their responses. They were also asked for comments on any parts of the survey that seemed difficult to understand or burdensome and the survey instrument was revised based on these comments.

B5.Individuals Consulted on Statistical Aspects and Individuals Collecting and/or Analyzing Data

We will utilize the services of a research assistant in the Department of Clinical Bioethics at the National Institutes of Health to administer the questionnaire. We will use the services of (Medtap International) to manage the data. We are consulting with Joanne Garrett (University of North Carolina at Chapel Hill ) on statistical analysis in this study.