Form #1 Form #1 Clinician Questionnaire

OMB Control No.: 0935-XXXX

Expiration Date: xx-xx-xxxx

Survey of Clinician Use of Information Resources for Making Patient Treatment Decisions

Battelle Memorial Institute (Battelle) is conducting this survey on behalf of the Agency for Healthcare Research and Quality (AHRQ). AHRQ is a Federal agency under the US Department of Health and Human Services charged with improving the quality, safety, efficiency, and effectiveness of health care for all Americans.

The purpose of the survey is to learn how clinicians use health care information resources to make treatment decisions for their patients. The results of the survey will be used to inform AHRQ’s efforts to develop and disseminate unbiased, evidence-based information to patients, doctors, and others involved in health care decision-making.

Based on a proprietary list of all U.S. physicians compiled by the American Medical Association, we randomly selected approximately 2500 physicians to participate in this survey. You are being asked to participate in this survey because you were among the physicians selected.

Your participation in the survey is entirely voluntary. You can discontinue participation at any time. You can decline to answer any of the questions on the survey.

Completing the survey will take approximately 20 minutes. If you choose to participate, please fill out the questionnaire as completely and accurately as possible and return to Battelle in the postage-paid envelope provided in the survey packet. You will receive $50 in appreciation for your time and effort for this survey.

This survey is designed to benefit society by gaining new knowledge that will assist AHRQ’s efforts to develop and disseminate information for health care decision-making. You may not benefit personally from being in this research study.

Battelle will take several steps to maintain the confidentiality of survey participants. First, each survey participant will be assigned a unique identification number and names or any other personally identifying information will not be linked to survey responses. Second, we will not report the names and responses of individual participants to AHRQ or in any report or publication. Additionally, data provided to AHRQ at the completion of the study will not contain the names or any other personally identifying information.

If you have any questions about this study, please contact Dr. Judith Berkowitz (Battelle) at 1-404-460-1449. If you have any questions about your rights as a study participant, please call Dr. Margaret Pennybacker, chair of Battelle’s Institutional Review Board, toll free at 1-877-810-9530, ext. 500.

By completing and returning the survey questionnaire, you are providing your consent to participate in this study.

Public reporting burden for this collection of information is estimated to average 20 minutes per response, the estimated time required to complete the survey. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: AHRQ Reports Clearance Officer Attention: PRA, Paperwork Reduction Project (0935-XXXX) AHRQ, 540 Gaither Road, Room # 5036, Rockville, MD 20850.

This part of the survey asks questions that will let us describe the survey participants. Please write in or check () the best answer.

1. What is your age?

_______ years

2. What is your sex?

• Male

• Female

3. Are you Hispanic or Latino/Latina? __ No __ Yes

4. What is your race? (Please check  all that apply.)

• American Indian or Alaska Native

• Asian

• Black or African American

• Native Hawaiian or other Pacific Islander

• White

5. State of residence: (Please check  only one.)

AL AK AZ AR CA CO CT DE DC FL GA HI ID

IL IN IA KS KY LA ME MD MA MI MN MS MO

MT NE NV NH NJ NM NY NC ND OH OK OR PA

RI SC SD TN TX UT VT VA WA WV WI WY

6. Are you a: (Please check  only one.)

• Physician

• Physician Assistant

• Nurse Practitioner

• Nurse

• Pharmacist

• Other (specify)______________________

7. Since completing your medical training for the role you indicated in Question 6 (including residency and fellowship), how long have you been practicing medicine?

_______ years

8.      If you are a physician, what is your primary clinical specialty? (Please check  only one.)

• Family Medicine

• General Internal Medicine

• Obstetrics/Gynecology

• Other – Please specify: ________________________________________________

• Not Applicable ( “I am not a physician”)

9. If you are a physician, what is your clinical sub-specialty, if any?

______________________________________________________________________

• No clinical sub-specialty

10. Is your primary practice site located in one of the following? (Please check  only one.)

• Private practice office

• Ambulatory care clinic of hospital/medical center

• Urgent care clinic

• Community health center

• Public health clinic

• Hospital emergency department

• Institutional setting/clinic (e.g., correctional, nursing home)

• Clinic that is part of a Health Maintenance Organization (HMO)

• Academic or teaching hospital

• Other type of clinic (Specify): ___________________________________________

11. Please provide your best estimate for the total number of clinical staff in your department or unit at your primary practice site who provide direct care to patients. Include physicians, nurses, physician assistants, full-time and part-time, etc.

Number of clinical staff providing direct care: ___ ___ ___ ___ (Record number 0001-9999)

• Don’t know/not sure

12. On average, how many hours per week do you spend on direct patient care?

_____________ HRS / WK

If you spend less than 8 hours per week on direct patient care, please STOP and return the survey in the postage-paid envelope.

13. In general, with how many patients, if any, do you share educational materials to help them make informed decisions about their treatment options? (Please check  only one.)

• I share materials with every patient

• I share materials with most patients

• I share materials with some patients

• I rarely share materials with patients

• I have never shared any fact sheets, guides, or materials with my patients

• Does not apply, I do not help patients make treatment decisions Go to Question #16

14. When I do not discuss treatment options with my patients it is because… (Please check  all that apply.)

• I don’t have enough time

• I don’t want to confuse my patients

• My organization or practice doesn’t encourage my talking to patients about treatment options

• My patients don’t seem interested in hearing about treatment options

• My patients look uncomfortable when I discuss treatment options with them

• My patients have difficulty understanding their treatment options

• My patients are quickly overwhelmed by the amount of information

• My patients are already aware of their treatment options

• My patients expect me to know what is best for them

• When there are not treatment options to discuss

• Not applicable, I discuss options with every patient

• None of the above

15. When I do discuss treatment options with my patients… (Please check  all that apply.)

• It is because my patients ask me for options

• It is because my patients ask me about specific options

• I tell them about the relative effectiveness of each option

• I describe the potential cost of each option with them

• I describe the risks and benefits of each option with them

• I tell them about my experience with each option

• None of the above

Please Continue to Next Page

16. For many medical conditions, there are a variety of treatment options. Different treatments often have different levels of benefit and different levels of risk for side effects. Treatments can also differ on cost.

Have you ever heard about types of research that are designed to help you make treatment decisions with your patients by comparing the benefits and harms of different treatment options?

• Yes  Go to Question #16a

• No

• Don’t know/not sure

16a. If you answered “Yes”, what is this type of research called?

Please answer the relevant questions on this page before proceeding to the next page.

17. How familiar are you with the following types of research that help you make treatment decisions based on comparisons of benefits and harms of different options?

	Not at all familiar / never heard of it	Have heard the name but not familiar	Somewhat familiar	Mostly/Very familiar
Comparative effectiveness research (CER)	 1	 2	 3	 4
Evidence-based medicine (EBM)	 1	 2	 3	 4
Comparative treatments analysis (CTA)	 1	 2	 3	 4
Health technology assessment (HTA)	 1	 2	 3	 4
Patient-centered outcomes research (PCOR)	 1	 2	 3	 4
Risks-benefits research (RBR)	 1	 2	 3	 4

Please answer the questions on this page before proceeding to the next page.

The next questions are about your awareness and understanding of patient-centered outcomes research (PCOR).

18. Patient-centered outcomes research compares different health care interventions for common conditions by rigorously evaluating existing scientific literature and generates new findings through scientific studies of different treatment and diagnostic interventions.

Where, if ever, have you read or heard about Patient Centered Outcomes Research? (Please check  all that apply.)

• Nowhere – never heard of Patient Centered Outcomes Research  Go to Question #22

• Article in a medical/science journal

• Advertisement in journal or trade magazines

• Web site

• Conference or professional meeting

• Colleagues

• Employer

• Advertisement on TV, radio, or in a store

• Educational visit at your place of practice by a trained professional

• Article in a newspaper or magazine or story on TV news

• Through a continuing education course

• Other (specify): ___________________________________________________

• I’ve heard of it before, but don’t know where

19. In the table below, indicate whether or not each of the following statements reflects the principles and methods of patient-centered outcomes research.

	Yes	No	Not Sure
Compares effectiveness and risks of established and emerging treatments	 1	 2	 3
Addresses treatments for common chronic medical conditions	 1	 2	 3
Includes reviews of existing scientific literature	 1	 2	 3
Includes new studies based on analyses of health care databases	 1	 2	 3
Includes new scientific studies testing the efficacy of specific new medical treatments or technologies	 1	 2	 3
Is conducted by pharmaceutical companies and medical device manufacturers	 1	 2	 3
Intended to support informed decision-making	 1	 2	 3
Addresses treatments for acute medical conditions	 1	 2	 3
Identifies areas of clinical uncertainty and gaps in the scientific literature	 1	 2	 3
Intended to assist in shared decision-making between clinicians and individual patients	 1	 2	 3
Provides specific clinical practice recommendations for medical conditions	 1	 2	 3

20. In the table below, please indicate the extent to which you agree or disagree with the following statements about patient-centered outcomes research in clinical decision-making.

Patient-centered outcomes research….	Strongly Disagree	Disagree	Neither agree nor disagree	Agree	Strongly agree
Is neutral and unbiased	 1	 2	 3	 4	 5
Is scientifically rigorous	 1	 2	 3	 4	 5
Provides findings that are descriptive, not prescriptive	 1	 2	 3	 4	 5
Provides objective information about drugs, medical equipment, and treatments	 1	 2	 3	 4	 5
Provides findings that support informed decision-making	 1	 2	 3	 4	 5
Highlights current evidence about effectiveness, risks, and side effects	 1	 2	 3	 4	 5
Identifies areas of clinical uncertainty and gaps in the scientific literature	 1	 2	 3	 4	 5
Includes confidence ratings on evidence in its reports, products, and materials	 1	 2	 3	 4	 5
Helps me deliver better health care to my patients	 1	 2	 3	 4	 5
In general, medical decisions based on patient-centered outcomes research lead to better patient outcomes	 1	 2	 3	 4	 5
Medical decisions based on patient-centered outcomes research are more cost effective in the long run	 1	 2	 3	 4	 5
Leads to shared decision-making between clinicians and individual patients	 1	 2	 3	 4	 5

21. Below, we present a pair of adjectives that could be used to describe opinions about patient-centered outcomes research. For each pair of words, please check  the box along the scale for each word pairing that describes your opinion of patient-centered outcomes research. Selecting a box closer to the word on the left means that your opinion is closer to the word on the left. Selecting a box closer to the right means your opinion is closer to the word on the right.

For clinical decision-making, patient-centered outcomes research is:

Beneficial						Not beneficial
Unhelpful						Helpful
Easy to understand						Hard to understand
Objective						Biased
Not credible						Credible
Trustworthy						Untrustworthy
Not valuable						Extremely valuable

22. How interested are you in learning more about patient-centered outcomes research? (Please check  only one.)

• Not at all interested

• Not very interested

• Somewhat interested

• Interested

• Very interested

The next questions are about the U.S. Agency for Healthcare Research and Quality and its Effective Health Care Program.

23. The U.S. Agency for Healthcare Research and Quality (AHRQ) is a Federal government agency charged with improving the quality, safety, efficiency, and effectiveness of health care for all Americans. AHRQ is part of the U.S. Department of Health and Human Services and supports health services research that will improve the quality of health care and promote evidence-based decision-making.

How familiar are you with the U.S. Agency for Healthcare Research and Quality (AHRQ)? (Please check  only one.)

• Not at all familiar/never heard of it

• Have heard the name but not familiar

• Somewhat familiar

• Mostly/very familiar

24. The Effective Health Care Program funds individual researchers, research centers, and academic organizations to work together with the Agency for Healthcare Research and Quality (AHRQ) to produce effectiveness and patient-centered outcomes research for clinicians, consumers, and policymakers.

How familiar are you with AHRQ’s Effective Health Care Program? (Please check  only one.)

• Not at all familiar/never heard of it  Go to Question #32

• Have heard the name but not familiar Go to Question #32

• Somewhat familiar

• Mostly/Very familiar

25. Where have you heard about the Effective Health Care Program? (Please check  all that apply.)

• Article in a medical/science journal

• Advertisement in journal or trade magazines

• Web site

• Conference or professional meeting

• Colleagues

• Advertisement on TV, radio, or in a store

• Educational visit at your place of practice by a trained professional

• Article in a newspaper or magazine or story on TV News

• Through a continuing education course

• From a professional organization I belong to via email, newsletter, or professional organization’s Web site

• Other – Please specify: _________________________________

• I’ve heard of it, but I don’t know where

26. In the table below, indicate whether or not each of the following statements describes the Effective Health Care Program?

	Yes	No	Not Sure
Is co-sponsored by private health care and medical technology firms	 1	 2	 3
Funds and conducts patient-centered outcomes research in the U.S.	 1	 2	 3
Funds the development of new treatments	 1	 2	 3
Screens all sponsored researchers for conflicts of interest	 1	 2	 3
All reports are posted for public comment	 1	 2	 3
All reports are peer reviewed	 1	 2	 3
Is sponsored by the Agency for Healthcare Research and Quality (AHRQ)	 1	 2	 3
Open for public participation	 1	 2	 3
Uses transparent and clearly documented processes	 1	 2	 3
Includes clinicians as a target audience for research results	 1	 2	 3
Includes consumers/patients as a target audience for research results	 1	 2	 3
Includes policymakers as a target audience for research results	 1	 2	 3

For Questions 27, 28 and 29, please mark your responses in the appropriate column in the following table.

27. Which of the following materials and products produced by the Effective Health Care Program have you ever heard of?

28. Which of the following materials and products produced by the Effective Health Care Program have you ever read or used?

29. Which of the following materials and products produced by the Effective Health Care Program have you ever shared with a colleague or other health care professional?

Effective Health Care Program Materials and Products	Q27. Check the box if you have heard of it	Q28. Check the box if you have read/used it	Q29. Check the box if you shared it
Research reviews – comprehensive comparative reports based on completed scientific studies			
Original research reports – based on clinical research and studies that use health-care databases and other scientific resources and approaches.			
Summary guides – Short, plain-language guides summarizing findings of research reviews			
Consumer/patient guides			
Clinician guides			
Policymaker summaries			
Continuing Medical Education/Continuing Education activities			
Webcast conferences			
Slide library for presentations and presentation materials			
Educational videos on research topics			
If you have heard of NONE of the materials or products in Question 27, please check  this box  and then go to Question # 30.

30. When was the last time you used any of the Effective Health Care Program’s clinician products (e.g., treatment guides, research reviews) to help you become better informed about treatment options for your patients? (Please check  only one.)

• I have never used the products  Go to Question #30a

• In the last 3 months

• In the last 6 months

• 6 months to a year ago

• More than a year ago

• Don’t know/not sure

30a. What are the reasons that you are not using Effective Health Care Program’s clinician products? (Please check  all that apply.)

• I’ve never heard of them

• The data are inconclusive or insufficient to guide me in patient-centered treatment and management decisions

• The information is not relevant to my current area of practice

• I do not have time to access/refer to the information

• I do not remember to access/refer to the information

• Other – Please specify: ___________________________________

• Don’t know/Not sure

31. When was the last time that you shared any of the Effective Health Care Program’s consumer guides with your patients to help them make better informed decisions about their treatment options? (Please check  only one.)

• I have never shared any of those products with my patients

• In the last 3 months

• In the last 6 months

• 6 months to a year ago

• More than a year ago

• Don’t know/not sure

The next questions are about your experience with the Effective Health Care Program’s Web site – www.effectivehealthcare.ahrq.gov.

32. Where have you ever heard about the Effective Health Care Program Web site?
(Please check  all that apply.)

• I’ve never heard of the Web site  Skip to Question #36

• Article in a medical/science journal

• Advertisement in journal or trade magazines

• From another Web site

• Conference or professional meeting

• Colleagues

• Advertisement on TV, radio, or in a store

• Educational visit at your place of practice by a trained professional

• Article in a newspaper or magazine or story on TV news

• Through a continuing education course

• From a professional organization I belong to via email, newsletter, or professional organization’s Web site

• Other – Please specify: _____________________________________

• I haven’t seen any advertising or mention of the Web site

• Don’t know/not sure

33. Have you ever visited the Effective Health Care Program’s Web site – www.effectivehealthcare.ahrq.gov?

• Yes

• No  Skip to Question #36

34. What, if anything, have you done while visiting the Effective Health Care Program’s Web site? (Please check  all that apply.)

• Read/downloaded a clinician guide

• Read/downloaded a consumer guide

• Suggested a topic

• Made comments on a review

• Taken a continuing education course

• Requested additional information

• Find information about a particular health condition or treatment topic

• Learned more about the Effective Health Care Program

• Learned more about patient-centered outcomes research

• Just looked around on the site

• Other – Please specify: _____________________________________

• Don’t know/not sure

35. When was the last time you visited the Effective Health Care Program’s Web site? (Please check  only one.)

• In the last 3 months

• In the last 6 months

• 6 months to a year ago

• More than a year ago

• Don’t know/not sure

The next questions are about your interests and future intentions regarding the Effective Health Care Program.

36. How interested are you in learning more about the Effective Health Care Program? (Please check  only one.)

• Not at all interested

• Not very interested

• Somewhat interested

• Interested

• Very interested

37. Within the next year, how likely are you to use any of the Effective Health Care Program’s clinician products to help you become better informed about treatment options for your patients? (Please check  only one.)

• Definitely will not

• Probably will not

• Might or might not

• Probably will

• Definitely will

38. Within the next year, how likely are you to use any of the Effective Health Care Program’s guides for patients to help your patients make better-informed decisions about their treatment options? (Please check  only one.)

• Definitely will not

• Probably will not

• Might or might not

• Probably will

• Definitely will

The next questions are about your experience with various ongoing efforts to share information about patient-centered outcomes research and the Effective Health Care Program.

39. In the last 12 months, have you taken any on-line Continuing Medical Education / Continuing Education course that presented the findings from a systematic evidence review that used patient-centered outcomes research methods to compare two or more treatment options or practices?

• Yes

• No

• Don’t know/not sure

40. In the last 12 months, have you been visited by a patient centered outcomes consultant who talked to you (or others in your practice) about patient-centered outcomes research findings and the Effective Health Care Program?

• Yes  Go to Question #40a

• No

• Don’t know/not sure

40a. What were the topics addressed by the patient centered outcomes consultant? (Please check  all that apply.)

• Premixed Insulin Analogs

• [INSERT OTHER TOPICS AS THEY ARE RELEASED]

• Other condition or treatment: Please specify: _________________________________

• Don’t know/not sure

41. In the last 12 months, have any of the professional organizations of which you are a member sent you any information about patient-centered outcomes research or the Effective Health Care Program?

• Yes

• No

• Don’t know/not sure

42. To which of the following professional organizations do you belong? (Please check  all that apply.)

[List up to 10 partner organizations from Regional Office contractor that have the greatest reach or most “creative/multiple” activities]

• Other – Please specify: _____________________________________________

43. In the last 12 months, have you seen, read, or heard anything with the tagline “[INSERT TAGLINE]”?

• Yes  Go to Question #43a.

• No

• Don’t know/not sure

43a. When was the last time you saw this information? (Please check  only one.)

• In the last week

• In the last month

• About 2-3 months ago

• About 4-6 months ago

• More than 6 months ago

44. How familiar are you with the John M. Eisenberg Center for Clinical Decisions and Communications Science? (Please check  only one.)

• Not at all familiar/never heard of it

• Have heard the name but not familiar

• Somewhat familiar

• Mostly/very familiar

Thank you for your time and effort in participating in this survey. Please mail the completed survey in the postage paid envelope to:

Attn:  _______________________

1100 Dexter Avenue North, Suite 400

Seattle, WA 98109-3598

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