A comparison of the accuracy of clinical decisions based on full-text articles and on journal abstracts alone: a study among residents in a tertiary care hospital

Abstract

BackgroundMany clinicians depend solely on journal abstracts to guide clinical decisions.ObjectivesThis study aims to determine if there are differences in the accuracy of responses to simulated cases between resident physicians provided with an abstract only and those with full-text articles. It also attempts to describe their information-seeking behaviour.MethodsSeventy-seven resident physicians from four specialty departments of a tertiary care hospital completed a paper-based questionnaire with clinical simulation cases, then randomly assigned to two intervention groups—access to abstracts-only and access to both abstracts and full-text. While having access to medical literature, they completed an online version of the same questionnaire.FindingsThe average improvement across departments was not significantly different between the abstracts-only group and the full-text group (p=0.44), but when accounting for an interaction between intervention and department, the effect was significant (p=0.049) with improvement greater with full-text in the surgery department. Overall, the accuracy of responses was greater after the provision of either abstracts-only or full-text (p<0.0001). Although some residents indicated that ‘accumulated knowledge’ was sufficient to respond to the patient management questions, in most instances (83% of cases) they still sought medical literature.ConclusionsOur findings support studies that doctors will use evidence when convenient and current evidence improved clinical decisions. The accuracy of decisions improved after the provision of evidence. Clinical decisions guided by full-text articles were more accurate than those guided by abstracts alone, but the results seem to be driven by a significant difference in one department.

Comparing data accuracy between structured abstracts and full-text journal articles: implications in their use for informing clinical decisions

“…To be most useful, current clinical evidence needs to be conveniently accessible 45. When provided access to either abstracts or full-text articles, improvements in clinical decisions have been observed 3. With a high percentage of clinicians (69%) using abstracts only in seeking answers to clinical questions,3 it is crucial that a high standard of quality for published abstracts is present.…”

“…When provided access to either abstracts or full-text articles, improvements in clinical decisions have been observed 3. With a high percentage of clinicians (69%) using abstracts only in seeking answers to clinical questions,3 it is crucial that a high standard of quality for published abstracts is present. A 10-year follow-up study found that using structured abstracts, regardless of precise formats, has helped maintain a high quality of available abstracts 38…”

“…Through PubMed/MEDLINE, abstracts can now be conveniently accessed at the point of care 1 2. The universal accessibility of abstracts as a knowledge resource in many parts of the world with mobile Internet access has sparked interest in using journal abstracts as evidence-based sources when full-text articles are unavailable to clinicians especially in geographic areas with limited resources 1 3. Hence, it was recently proposed that a clinician-oriented web application formatted for mobile devices such as ‘Consensus Abstracts’ could be used to search and review multiple concurring abstracts in MEDLINE/PubMed to inform clinical decisions 1…”

Consolidated Standards of Reporting Trials (CONSORT): Considerations for Neuropsychological Research

“…It is further critical to write an abstract that contains a concise summary of the study design. The importance of an abstract that conforms to CONSORT cannot be overestimated, as the abstract of a paper is the most publicly accessible component of the manuscript after the title; may be all that is read after the title (Barry, Ebell, Shaughnessy, Slawson, & Nietzke, 2001;Fontelo, 2011;Haynes et al, 1990;Marcelo et al, 2013;Saint et al, 2000); and major search engines including PubMed and Google Scholar both focus on title and abstract rather than full text. An official CONSORT extension specific to reporting of both article and conference abstracts has been published (Hopewell et al, 2008).…”

Assessing the impact of bibliographical support on the quality of medical care in patients admitted to an internal medicine service: a prospective clinical, open, randomised two-arm parallel study

“…These aspects are to be taken into account when practising evidence-based medicine for the best approach to medical decision-making. The concept of EBM , as described above, is to translate the need of physicians for information into answerable questions to track down the best information used to answer those questions 13 14…”