Recognised barriers to the optimal use of EBM in a variety of specialties include competing priorities and lack of time, inability to cope with ‘information explosion’,3 misconceptions about what constitutes quality evidence,4 lack of awareness of EBM resources,3 threat following website to professional autonomy,5 6 concerns about the trustworthiness of the data,5 fear of conflict with colleagues,7 and institutional dynamics and culture.8–10

However, there is little information on how EBM is regarded and practised by radiologists and whether barriers to optimal use may differ. For example, technological innovation in imaging and interventional technologies has intensified the demand on radiologists to assimilate the proliferation of new information

to deliver safe and cost-effective care,11 12 and the promotion of new tests may occur prior to published evidence supporting widespread use. EBM use within radiology has not been examined, but a survey of radiation oncologists found widespread support for EBM, although most had not undertaken formal EBM training and were unaware of integral resources such as the Cochrane Library.3 We aimed to describe radiologist’s attitudes and perspectives on learning and applying EBM in practice, and in doing so, inform strategies for improving EBM training, and assist development of resources to facilitate greater use of EBM. This may help to foster appropriate decisions regarding imaging and interventional procedures for improved patient outcomes. Methods Participant selection and practice setting Radiologists in Australia and New Zealand were purposively selected to capture a range of age, gender, years of clinical experience, radiology subspecialties, EBM training, and practice locations. Invitations were emailed to radiologists enrolled in the critical skills appraisal programme at The University of Sydney (July 2013) or were attending an Annual Scientific Meeting (October 2013).

Radiologists known to the investigators were also invited and participants could nominate other radiologists who could offer a different perspective about EBM. Interviews were conducted in meeting rooms, clinic offices and conference venue. All participants provided informed consent. Data collection The interview guide was based Drug_discovery on a review of the literature3–8 13 14 and discussion among the research team (box 1). AT conducted a face-to-face semistructured interview with each participant from July to November 2013. Participant recruitment ceased when theoretical saturation was reached that is, when little or no new concepts were being raised in subsequent interviews. All interviews were audio-recorded and transcribed. Box 1 Interview guide 1. Role as a radiologist/radiology trainee A.