How does evidence affect clinical decision-making?

Fontelo, Paul; Liu, Fang; Uy, Raymonde Charles Y.

doi:10.1136/ebmed-2015-110250

Cited by 9 publications

(22 citation statements)

References 16 publications

(19 reference statements)

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“…The ability to use information-seeking behavior with specific clinical questions, methods, and reliable websites are important to clinicians [ 1 , 2 ]. A survey of clinicians by White et al [ 3 ] found that only 65% used PubMed often.…”

Section: Introductionmentioning

confidence: 99%

“…Wireless mobile devices can alleviate barriers to access and improve delivery of reliable clinical information to support clinical decision making at the point of care. Fontelo and colleagues [ 1 ] noted that clinicians using a Web version of PubMed4Hh [PubMed for Handhelds] preferred “bottom-line summaries” more than abstracts. The PubMed4Hh mobile application can be useful for providing clinicians with a quick way to access online biomedical literature in support of evidence-based medicine at the point of care if it is integrated into clinical workflow.…”

Section: Introductionmentioning

confidence: 99%

“…The ‘Evidence Cart’, which physicians carried during their clinical rounds, contained multiple sources of printed materials, such as evidence from Cochrane Library, MEDLINE, a physician examination textbook, a radiology anatomy textbook, and a Simulscope. Nowadays, the bulky ‘Evidence Cart’ has been replaced by the “virtual evidence cart” through wireless mobile devices, online resources and the Internet access [ 1 , 9 ]. Many clinicians other than physicians also recognize the importance of scientific evidence in clinical decision making, and evidence-based practice (EBP) is widespread across healthcare disciplines [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Reliable evidence summaries and validated and expert synthesized resources on smartphone and tablet applications (e.g., UpToDate, DynaMed, or PubMed for Handhelds) can help clinicians’ search for evidence to support the practice of EBM [ 20 ]. Point of care decision support tools provide clinicians with useful information in a timely manner for informing patient care [ 1 ] and improving patient-clinician communication [ 21 – 23 ]. However, research evidence is lacking on the effectiveness of clinical decision support for clinicians other than physicians.…”

Section: Introductionmentioning

confidence: 99%

“…Currently, only two studies [ 1 , 15 ] tested the usefulness of the Web version of PubMed4Hh among clinicians or nurse practitioner students. Considering the lack of evidence with regard to retrieval of health information that supports clinical decision making among clinicians, our study expands previous research by Fontelo et al [ 1 ] on the usefulness of the PubMed4Hh in clinical practice at the point of care, and make this evidence available to clinicians where it’s needed most. The aim of this study was to demonstrate how evidence provided as abstracts and the bottom-line (TBL) summaries, accessed with mobile devices on a wireless network [PubMed4Hh], were useful for clinicians’ decision-making at the point of care.…”

Section: Introductionmentioning

confidence: 99%

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Clinicians’ perceptions of usefulness of the PubMed4Hh mobile device application for clinical decision making at the point of care: a pilot study

Gartrell

Brennan

Wallen

et al. 2018

BMC Med Inform Decis Mak

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BackgroundAlthough evidence-based practice in healthcare has been facilitated by Internet access through wireless mobile devices, research on the effectiveness of clinical decision support for clinicians at the point of care is lacking. This study examined how evidence as abstracts and the bottom-line summaries, accessed with PubMed4Hh mobile devices, affected clinicians’ decision making at the point of care.MethodsThree iterative steps were taken to evaluate the usefulness of PubMed4Hh tools at the NIH Clinical Center. First, feasibility testing was conducted using data collected from a librarian. Next, usability testing was carried out by a postdoctoral research fellow shadowing clinicians during rounds for one month in the inpatient setting. Then, a pilot study was conducted from February, 2016 to January, 2017, with clinicians using a mobile version of PubMed4Hh. Invitations were sent via e-mail lists to clinicians (physicians, physician assistants and nurse practitioners) along with periodic reminders. Participants rated the usefulness of retrieved bottom-line summaries and abstracts and indicated their usefulness on a 7-point Likert scale. They also indicated location of use (office, rounds, etc.).ResultsOf the 166 responses collected in the feasibility phase, more than half of questions (57%, n = 94) were answerable by both the librarian using various resources and by the postdoctoral research fellow using PubMed4Hh. Sixty-six questions were collected during usability testing. More than half of questions (60.6%) were related to information about medication or treatment, while 21% were questions regarding diagnosis, and 12% were specific to disease entities. During the pilot study, participants reviewed 34 abstracts and 40 bottom-line summaries. The abstracts’ usefulness mean scores were higher (95% CI [6.12, 6.64) than the scores of the bottom-line summaries (95% CI [5.25, 6.10]). The most frequent reason given was that it confirmed current or tentative diagnostic or treatment plan. The bottom-line summaries were used more in the office (79.3%), and abstracts were used more at point of care (51.9%).ConclusionsClinicians reported that retrieving relevant health information from biomedical literature using the PubMed4Hh was useful at the point of care and in the office.Electronic supplementary materialThe online version of this article (10.1186/s12911-018-0607-9) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%