Sources of evidence in HIV/AIDS care: pilot study comparing family physicians and AIDS service organization staff

Surveys were distributed to staff at two local AIDS service organizations and to family physicians at three community health centres treating people living with HIV/AIDS. Participants were asked to rate the importance of 10 different sources of evidence for HIV/AIDS treatment information on a 5-point Likert-type scale. Mean rating scores and relative rankings were compared.Findings suggest that a discordance exists between the two health information provider groups in terms of their perceptions of the various sources of evidence. Furthermore, AIDS service organization staff ranked health care professionals as the most important source of information whereas physicians deemed AIDS service organizations to be relatively unimportant. The two groups appear to share a common mistrust for information from pharmaceutical industries.Discordance exists between medical "experts" from different backgrounds relating to their perceptions of evidence. Further investigation is warranted in order to reveal any effects on the quality of treatment information and implications in the decision-making process. Possible effects on collaboration and working relationships also warrant further exploration.Evidence-based approaches to medical decision-making are assuming increased significance in health care. To be sure, there is greater focus on the incorporation of evidence derived from clinical research into clinical practice. Randomized control trials are considered the gold standard of evidence and there is a tendency to give other forms of evidence – clinical expertise, intuition, qualitative data – a relatively lower profile [1]. Given the distinct nature of every patient/provider encounter, the unique context of individual patients, the distinguishing values and experiences of different physicians, and the breathtaking heterogeneity of modern health care, the assumption that it is possible to attain, or maintain, a "univocal notion of evidence" may be doubtful [2].The definition of e