CAMPISANO, PETER; PHD

                         BOSTON UNIVERSITY, 1984

                         SOCIOLOGY, GENERAL (0626)

                         The goals of this study were: to enlarge our understanding of medical technological diffusion; analyze
                         the influence of medical literature on the diffusion process; test McKinlay's (1981) paradigm of the career
                         of an innovation as an analytical model; identify intervention points for aiding the development of public
                         policy relating to diffusion and proposing standards for monitoring the adoption of clinical technology.
                         The clinical innovation of coronary artery bypass graft surgery (CABGS) was chosen as a case study to
                         test these propositions. Variables were selected from theoretical work in the sociology of science, health
                         services research, and medical sociology, representing issues thought to be important in the diffusion
                         process. These variables, seen as essential measures documenting the reporting of overall conclusions,
                         were correlated with one of McKinlay's phases, other data such as type of journal, center in which
                         treatments were performed and citation information. Results showed that low levels of
                         comprehensiveness in reporting were related to positive attitudes toward the innovation and conversely,
                         the more comprehensive the discussion, the more negative the overall attitude. Overall attitude toward
                         the innovation was examined as a function of time. In the early phases, positive attitudes predominated.
                         In the middle and late phases, attitudes ranged from negative to neutral to mixed. Comparing these data
                         with the growth in the number of procedures performed during each phase suggests that the extreme
                         optimism expressed in early reports, supporting rapid adoption, is not influenced by later less optimistic
                         data. This suggests a need for early critical examination of the documentary evidence supporting the
                         recommendation for the use of new technology. Findings demonstrate that McKinlay's paradigm is a
                         useful analytical aid for empirical inquiry into the diffusion process. This research adds details to the
                         articulation of this model as well as offering a modification of the characteristics of one major element.
                         Refinement of the data from this research will be helpful to those monitoring the medical communication
                         system and the formulation of public policy dealing with technological diffusion.


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