How much influence do medical publications have on your doctor? A great deal, says new SLU research

ST. LOUIS New research by Saint Louis University in today's Journal of the American Medical Association asks two intriguing questions: How much impact do articles in prominent medical journals really have on how doctors treat patients, and how fast does that impact affect clinical practice?

The answers? Quite a bit, and very quickly if the news is negative.

Researchers from the Saint Louis University Center for Outcomes Research studied nearly 400,000 hospital admissions of heart failure patients before and after two articles appeared in Circulation and JAMA in early 2005 suggesting nesiritide, a popular medication for acute decompensated heart failure, had an increased risk of kidney failure and death.

After the articles were published, nesiritide use in heart failure patients fell from a peak of 16.6 percent in March 2005 to only 5.6 percent in December 2005. The decreases were greatest in the elderly, reflecting heightened concerns about risks in this population.

"The results were notable and to a large extent unexpected," says Paul J. Hauptman, M.D., cardiologist at Saint Louis University School of Medicine and lead author. "Not only did doctors appear to change practice when confronted with a potential safety problem, but they also did so far more rapidly than we expected."

Hauptman says this is remarkable, considering that earlier studies have shown that the opposite is true.

"When medications are shown to improve survival, it takes doctors longer to adopt them into practice," he says.

Likening it to the effect articles in Vogue have on the fashion industry, co-author Mark Schnitzler, Ph.D., associate professor of medicine at Saint Louis University, says articles in major medical journals have tremendous influence over physicians.

"Most doctors, academic or not, read JAMA and the New England Journal of Medicine," Schnitzler says. "Most are probably just scanning the articles or mon

Contact: Rachel Otto
Saint Louis University

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