医生如何应对新的医学研究?

IF 2 3区 医学 Q2 ECONOMICS
Health economics Pub Date : 2024-07-05 DOI:10.1002/hec.4879
Philip DeCicca, Maripier Isabelle, Natalie Malak
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引用次数: 0

摘要

当一项著名医学研究的结果被推翻时会发生什么?我们利用臀位分娩的医学试验,估算了推翻此类医学研究对医生选择和婴儿健康结果的影响。利用 1995 年至 2010 年的美国出生证明记录,我们对剖腹产、低 Apgar 值和低出生体重进行了差异估计。我们发现,在剖腹产率总体呈上升趋势的情况下,一项针对足月臀位新生儿适当分娩的多地点、高知名度随机对照试验--足月臀位试验--的逆转导致此类新生儿的剖腹产率下降了 15%-23%。我们发现,在传统弱势群体(即非白人和受教育程度最低的群体)中,估计效果最大。然而,我们并没有发现这种做法的改变对婴儿健康有重大影响。与之前的研究相反,我们发现医生们很快就更新了他们的观念,并且确实在强制性政策或专业指南出台之前根据新的医学研究进行了调整,尤其是年轻医生。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
How do physicians respond to new medical research?

What happens when the findings of a prominent medical study are overturned? Using a medical trial on breech births, we estimate the effect of the reversal of such a medical study on physician choices and infant health outcomes. Using the United States Birth Certificate Records from 1995 to 2010, we employ a difference-in-differences estimator for C-sections, low Apgar, and low birth weight measures. We find that the reversal of a multi-site, high profile, randomized control trial on the appropriate delivery of term breech births, the Term Breech Trial, led to a 15%–23% decline in C-sections for such births at a time when the overall trend in C-sections was rising. We find our largest estimated effects amongst traditionally disadvantaged groups (i.e., non-white, and minimal education). However, we do not find that such a change in practice had significant impacts on infant health. Contrary to prior studies, we find that physicians updated their beliefs quickly, and do indeed adjust to new medical research, particularly young physicians, prior to mandatory policy or professional guidelines.

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来源期刊
Health economics
Health economics 医学-卫生保健
CiteScore
3.60
自引率
4.80%
发文量
177
审稿时长
4-8 weeks
期刊介绍: This Journal publishes articles on all aspects of health economics: theoretical contributions, empirical studies and analyses of health policy from the economic perspective. Its scope includes the determinants of health and its definition and valuation, as well as the demand for and supply of health care; planning and market mechanisms; micro-economic evaluation of individual procedures and treatments; and evaluation of the performance of health care systems. Contributions should typically be original and innovative. As a rule, the Journal does not include routine applications of cost-effectiveness analysis, discrete choice experiments and costing analyses. Editorials are regular features, these should be concise and topical. Occasionally commissioned reviews are published and special issues bring together contributions on a single topic. Health Economics Letters facilitate rapid exchange of views on topical issues. Contributions related to problems in both developed and developing countries are welcome.
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