Opinion leaders and changes over time: a survey

Area of Science:

• Medical Practice
• Health Services Research
• Social Network Analysis

Background:

• Physician opinion leaders are crucial for disseminating new knowledge and influencing medical practice.
• Understanding the stability, scope, and reach of these opinion leaders is essential for effective knowledge translation.

Purpose of the Study:

• To assess the temporal stability of opinion leaders in colorectal cancer care.
• To determine if opinion leaders are polymorphic (influential across multiple practice areas) or monomorphic (influential in a single area).
• To evaluate the reach of opinion leaders within their local professional networks.

Main Methods:

• Surveys of surgeons and pathologists in Ontario were conducted in 2003 and 2005.
• Opinion leaders for colorectal cancer were identified in 2003 and re-evaluated in 2005.
• Polymorphism/monomorphism was assessed by their nomination for colorectal and breast cancer leadership in 2005.
• Social network mapping quantified the number of local colleagues connected to identified opinion leaders.

Main Results:

• Only 25% of surgical opinion leaders for colorectal cancer identified in 2003 were re-identified in 2005; no pathology opinion leaders were stable.
• A majority of identified opinion leaders were monomorphic, with only 29% of surgical and 17% of pathology leaders influential in both colorectal and breast cancer.
• Social network analysis indicated limited reach, with few surgeons (12%) or pathologists (7%) connected to these opinion leaders' networks.

Conclusions:

• Opinion leaders in surgical and pathology fields demonstrated limited stability over a two-year period.
• These leaders generally exhibited monomorphic influence, specializing in distinct practice areas.
• The findings suggest that the practical utility of opinion leaders for widespread practice change may be constrained by their limited stability, specialization, and network reach.