Do consensus conferences influence their participants?

Objective: To determine whether participation in a consensus conference on the assessment of dementia would influence conference participants with respect to their recommendations to primary care physicians for the assessment of dementia. Design: Questionnaire before and after the conference. Setting: Canadian Consensus Conference on the Assessment of Dementia, held in Montreal, Oct. 5 and 6, 1989. Participants: All 38 experts representing relevant health disciplines who participated in the consensus conference; 36 completed both questionnaires. Outcome measures: Participants' opinion before and after the conference as to how frequently each of 28 manoeuvres (12 blood tests, 4 neurologic imaging procedures, 4 types of consultation and 8 'other' tests) should be ordered by primary care physicians as part of an assessment of a patient with dementia suspected on clinical grounds. Results: For 18 (64%) of the 28 manoeuvres (10 of the 12 blood tests, 3 of the 4 neurologic imaging procedures and 5 of the 8 'other' tests), there was a shift in opinion after the conference toward recommending that primary care physicians order them less often; for 10 of these 18 (5 blood tests and 5 'other' tests) the shift was statistically significant. For the remaining 10 manoeuvres (36%) the shift in opinion was toward a recommendation that primary care physicians order them more often; the shift was not statistically significant for any of these 10 manoeuvres. Conclusion: Expert members of a consensus conference are influenced by the process of having participated in such a conference and are capable and willing to change their initial recommendations when confronted with relevant data.