Clinical Practice Guidelines as a Medical Profession Government Technology in Medellín, Colombia
Abstract
1. Introduction
2. Materials and Methods
Type of Study: Cross-Sectional
3. Results
4. Discussion
4.1. General Perception of CPGs
4.2. CPGs Facilitators and Barriers
4.3. Clinical Practice Guidelines and Professional Autonomy
4.4. Effects of CPGs on the Patient–Physician Relationship
4.5. Limitations and Strengths of the Study
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Lambda | Item–Other Domain Correlation | |||||||
General Perception of CPGs | Item–Domain Correlation | Facilitators and Barriers | Professional Autonomy | Patient–Physician Relationship | ||||
Based on the best available evidence | 0.657 | 0.523 ** | 0.325 ** | 0.175 ** | 0.220 ** | |||
Based on experts’ opinion | 0.433 | 0.165 ** | −0.010 | −0.236 ** | −0.113 * | |||
Reduce medical error | 0.432 | 0.630 ** | 0.238 ** | −0.041 | 0.278 ** | |||
Useful for clinical work and improve treatment quality | 0.866 | 0.726 ** | 0.323 ** | 0.227 ** | 0.353 ** | |||
Useful to confirm diagnoses, initiate treatments and manage complications | 0.799 | 0.581 ** | 0.140 * | 0.122 * | 0.219 ** | |||
% variance | 43.8% | |||||||
% success of content validity | 100% (5/5) | |||||||
% success of internal consistency | 80% (4/5) | |||||||
% success of discriminating power | 100% (15/15) | |||||||
Cronbach’s α | 0.676 | |||||||
Facilitators and Barriers | Lambda | Item–Domain Correlation | General Perception | Professional Autonomy | Patient–Physician Relationship | |||
Their interpretation is difficult | 0.525 | 0.739 ** | 0.244 ** | 0.330 ** | 0.268 ** | |||
Their interpretation is difficult because treatments are expensive | 0.561 | 0.696 ** | 0.079 | 0.503 ** | 0.363 ** | |||
There is no time to read CPGs during medical consultations | 0.203 | 0.563 ** | 0.304 ** | 0.104 | 0.373 ** | |||
Finding information in CPGs is difficult | 0.569 | 0.738 ** | 0.207 ** | 0.329 ** | 0.316 ** | |||
They are not easily understood | 0.777 | 0.784 ** | 0.223 ** | 0.408 ** | 0.478 ** | |||
% variance | 52.7% | |||||||
% success of content validity | 80% (4/5) | |||||||
% success of internal consistency | 100% (5/5) | |||||||
% success of discriminating power | 100% (15/15) | |||||||
Cronbach’s α | 0.780 | |||||||
Professional Autonomy | Lambda | Item–Domain Correlation | General Perception | Facilitators and Barriers | Patient–Physician Relationship | |||
CPGs reduce physicians’ autonomy (they are like cook recipes) | 0.803 | 0.623 ** | 0.233 ** | 0.486 ** | 0.517 ** | |||
CPGs limit treatment options | 0.814 | 0.636 ** | 0.154 ** | 0.382 ** | 0.563 ** | |||
CPGs are a way of ensuring clinical control by insurance companies and the government | 0.769 | 0.675 ** | 0.192 ** | 0.394 ** | 0.373 ** | |||
Non-adherence to CPGs may cause labor conflicts | 0.566 | 0.668 ** | −0.142 * | 0.133 * | 0.019 | |||
Non-adherence to CPGs may cause legal conflicts | 0.545 | 0.615 ** | −0.202 ** | 0.151 ** | 0.067 | |||
% variance | 50.3% | |||||||
% success of content validity | 100% (5/5) | |||||||
% success of internal consistency | 100% (5/5) | |||||||
% success of discriminating power | 100% (15/15) | |||||||
Cronbach’s α | 0.778 | |||||||
Patient–Physician Relationship | Lambda | Item–Domain Correlation | General Perception | Facilitators and Barriers | Autonomy | |||
Patients do not like it when physicians follow CPGs | 0.734 | 0.688 ** | 0.265 ** | 0.233 ** | 0.283 ** | |||
CPGs hinder individual patient approach | 0.689 | 0.645 ** | 0.213 ** | 0.500 ** | 0.502 ** | |||
CPGs address standard patients and do not reflect reality | 0.754 | 0.662 ** | 0.294 ** | 0.483 ** | 0.408 ** | |||
CPGs are an obstacle against feeling empathy towards patients | 0.695 | 0.736 ** | 0.238 ** | 0.323 ** | 0.191 ** | |||
Sometimes, it is difficult to align CPGs with patients’ preferences | 0.779 | 0.764 ** | 0.124 * | 0.294 ** | 0.236 ** | |||
% variance | 53.4% | |||||||
% success of content validity | 100% (5/5) | |||||||
% success of internal consistency | 100% (5/5) | |||||||
% success of discriminating power | 100% (15/15) | |||||||
Cronbach’s α | 0.786 | |||||||
Rho Correlation Coefficients Between Constructs | General Perception | Facilitators and Barriers | Professional Autonomy | Patient–Physician Relationship | ||||
General perception | 1 | 0.347 ** | 0.074 | 0.330 ** | ||||
Facilitators and barriers | 0.347 ** | 1 | 0.436 ** | 0.477 ** | ||||
Professional autonomy | 0.074 | 0.436 ** | 1 | 0.416 ** | ||||
Patient–physician relationship | 0.330 ** | 0.477 ** | 0.416 ** | 1 |
n | 95% CI | |
---|---|---|
Sex | ||
Women | 136 | 43.7 (38.3–49.3) |
Men | 175 | 56.3 (50.7–61.7) |
Age group | ||
20 to 40 years | 195 | 62.7 (57.2–67.9) |
>40 years | 116 | 37.3 (32.1–42.8) |
General or specialized physician | ||
General physician | 235 | 75.6 (70.6–80.1) |
Specialized physician | 76 | 24.4 (19.9–29.4) |
Work experience (years) | ||
One year | 51 | 16.4 (12.6–20.8) |
Two to ten years | 105 | 33.8 (28.7–39.1) |
More than ten years | 155 | 49.8 (44.3–55.4) |
CPGs use | ||
Never or seldom | 47 | 15.1 (11.5–19.4) |
Always or almost always | 264 | 84.9 (80.6–88.5) |
Number of CPGs known | ||
One to two | 21 | 6.8 (4.4–9.9) |
Three to four | 58 | 18.6 (14.6–23.3) |
More than four | 229 | 73.6 (68.5–78.3) |
None | 3 | 1.0 (0.3–2.6) |
General Perception | Facilitators and Barriers | Professional Autonomy | Patient–Physician Relationship | |
---|---|---|---|---|
Median (IQR) | Median (IQR) | Median (IQR) | Median (IQR) | |
Sex | ||||
Women | 70.0 (60.0–75.0) | 65.0 (50.0–80.0) | 60.0 (50.0–75.0) | 65,0 (50,0–80,0) |
Men | 75.0 (65.0–80.0) | 72.5 (55.0–85.0) | 60.0 (50.0–70.0) | 65.0 (60.0–80.0) |
p-value | <0.001 ** | 0.035 ** | 0.875 | 0.338 |
Age group | ||||
20–40 years | 70.0 (60.0–80.0) | 65.0 (50.0–80.0) | 60.0 (50.0–75.0) | 65.0 (55.0–75.0) |
>40 years | 75 (65.0–80.0) | 70.0 (60.0–82.5) | 60.0 (50.0–75.0) | 70.0 (55.0–85.0) |
p-value | 0.105 | 0.032 ** | 0.728 | 0.017 ** |
General or specialized physician | ||||
General physician | 70.0 (60.0–80.0) | 70.0 (55.0–80.0) | 60.0 (50.0–75.0) | 65.0 (55.0–80.0) |
Specialized physician | 75.0 (65.0–80.0) | 70.0 (60.0–85.0) | 60.0 (50.0–75.0) | 67.5 (57.5–90.0) |
p-value | 0.071 | 0.092 | 0.575 | 0.297 |
Work experience (years) | ||||
One year | 70.0 (60.0–80.0) | 62.5 (45.0–75.0) | 60.0 (52.5–77.5) | 65.0 (50.0–75.0) |
Two to ten years | 70.0 (65.0–75.0) | 70.0 (55.0–85.0) | 60.0 (50.0–75.0) | 65.0 (55.0–75.0) |
More than ten years | 75.0 (65.0–80.0) | 70.0 (60.0–80.0) | 60.0 (50.0–75.0) | 70.0 (55.0–80.0) |
p-value | 0.145 | 0.035 ** | 0.737 | 0.420 |
Frequency of CPGs use in medical practice | ||||
Always or almost always | 65.0 (60.0–75.0) | 60.0 (45.0–70.0) | 55.0 (50.0–70.0) | 60.0 (45.0–75.0) |
Seldom or never | 70.0 (65.0–80.0) | 70.0 (55.0–85.0) | 60.0 (50.0–75.0) | 70.0 (55.0–80.0) |
p-value | 0.008 ** | 0.003 ** | 0.135 | 0.002 ** |
Number of CPGs known | ||||
None | 60.0 (60.0–65.0) | 80.0 (75.0–80.0) | 100.0 (90.0–100.0) | 100.0 (65.0–100) |
One to two | 65.0 (55.0–70.0) | 60.0 (30.0–65.0) | 55.0 (42.5–70.0) | 55.0 (40.0–65.0) |
Three to four | 65.0 (60.0–80.0) | 60.0 (50.0–72.5) | 65.0 (50.0–75.0) | 55.0 (45.0–75.0) |
More than four | 75.0 (65.0–80.0) | 70.0 (55.0–85.0) | 60.0 (50.0–75.0) | 70.0 (60.0–85.0) |
p-value | <0.001 ** | <0.001 ** | 0.026 ** | <0.001 ** |
Regression Model | Regression Coefficient |
---|---|
Perception of CPGs construct | |
Sex | 0.140 ** |
Number of CPGs known | 0.105 ** |
Facilitators and barriers score | 0.241 ** |
Autonomy score | −0.161 ** |
Patient–physician relationship score | 0.242 ** |
Facilitators and barriers score | |
Years of experience | 0.098 ** |
CPGs use | 0.081 ** |
Perception of CPGs score | 0.191 ** |
Patient–physician relationship score | 0.306 ** |
Autonomy score | 0.292 ** |
Professional autonomy construct | |
Perception of CPGs score | −0.155 ** |
Facilitators and barriers score | 0.342 ** |
Patient–physician relationship score | 0.292 ** |
Patient–physician relationship construct | |
Number of CPGs known | 0.191 ** |
Perception of CPGs score | 0.186 ** |
Facilitators and barriers score | 0.284 ** |
Autonomy score | 0.255 ** |
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Estrada-Mesa, D.A.; Higuita-Gutiérrez, L.F.; Cardona-Arias, J.A. Clinical Practice Guidelines as a Medical Profession Government Technology in Medellín, Colombia. Societies 2025, 15, 147. https://doi.org/10.3390/soc15060147
Estrada-Mesa DA, Higuita-Gutiérrez LF, Cardona-Arias JA. Clinical Practice Guidelines as a Medical Profession Government Technology in Medellín, Colombia. Societies. 2025; 15(6):147. https://doi.org/10.3390/soc15060147
Chicago/Turabian StyleEstrada-Mesa, Diego Alejandro, Luis Felipe Higuita-Gutiérrez, and Jaiberth Antonio Cardona-Arias. 2025. "Clinical Practice Guidelines as a Medical Profession Government Technology in Medellín, Colombia" Societies 15, no. 6: 147. https://doi.org/10.3390/soc15060147
APA StyleEstrada-Mesa, D. A., Higuita-Gutiérrez, L. F., & Cardona-Arias, J. A. (2025). Clinical Practice Guidelines as a Medical Profession Government Technology in Medellín, Colombia. Societies, 15(6), 147. https://doi.org/10.3390/soc15060147