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Healthy Skepticism Library item: 19674

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.


Publication type: Journal Article

Doumit G, Wright FC, Graham ID, Smith A, Grimshaw J
Opinion leaders and changes over time: a survey
Implementation Science 2011 Oct 11; 6:(1):117


Opinion leaders represent one way to disseminate new knowledge and influence the practice behaviours of physicians. This study explored: the stability of opinion leaders over time; whether opinion leaders were polymorphic (influencing multiple practice areas) or monomorphic (influencing one practice area); and reach of opinion leaders in their local network.

We surveyed surgeons and pathologists in Ontario to identify opinion leaders for colorectal cancer in 2003 and 2005 and to identify opinion leaders for breast cancer in 2005. We explored whether opinion leaders for colorectal cancer identified in 2003 were re-identified in 2005. We examined if opinion leaders were considered polymorphic (nominated in 2005 as opinion leaders for both colorectal and breast cancer) or monomorphic (nominated in 2005 for only one condition). Social network mapping was used to identify the number of local colleagues identifying opinion leaders.

Response rates for surgeons were: 41% (2003) and 40% (2005); response rates for pathologists were: 42% (2003) and 37% (2005). Four (25%) of the surgical opinion leaders identified in 2003 for colorectal cancer were re-identified in 2005. No pathology opinion leaders for colorectal cancer were identified in both 2003 and 2005. Only 29% of surgical opinion leaders and 17% of pathology opinion leaders identified in the 2005 survey were considered influential for both colorectal cancer and breast cancer. Social network mapping revealed only a limited number of general surgeons (12%) or pathologists (7%) were connected to the social networks of identified opinion leaders.

Opinion leaders identified in this study were not stable over a two-year time period and generally appear to be monomorphic with clearly demarcated areas of expertise and limited spheres of influence. These findings may limit the practicability of routinely using opinion leaders to influence practice.


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As an advertising man, I can assure you that advertising which does not work does not continue to run. If experience did not show beyond doubt that the great majority of doctors are splendidly responsive to current [prescription drug] advertising, new techniques would be devised in short order. And if, indeed, candor, accuracy, scientific completeness, and a permanent ban on cartoons came to be essential for the successful promotion of [prescription] drugs, advertising would have no choice but to comply.
- Pierre R. Garai (advertising executive) 1963