Patient-Care Questions that Physicians Are Unable to Answer

Ely, John; Osheroff, Jerome A.; Maviglia, Saverio M.; Rosenbaum, Marcy

doi:10.1197/jamia.m2398

Cited by 54 publications

(46 citation statements)

References 40 publications

(31 reference statements)

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“…Only 10% of questions were answered during the patient visit. As does previous similar research in the United States, [18][19][20][21][22] this work shows the need for effi cient and effective ways of answering clinical questions in real time. 23 A Canadian study is relevant for initiatives to reform primary health care.…”

Section: Health Care Services Deliverymentioning

confidence: 65%

In This Issue: Clinical Diagnosis and Management

Stange¹

2007

The Annals of Family Medicine

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Section: Health Care Services Deliverymentioning

confidence: 65%

In This Issue: Clinical Diagnosis and Management

Stange¹

2007

The Annals of Family Medicine

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“…The remaining 39% (6,482) were not mapped at all. For GoldMiner, these numbers are, respectively, 18.2% (36,372), 38.4% (76,928), 5.7% (11,419) and 37.8% (75,642).…”

Section: What Do Users Search For?mentioning

confidence: 93%

“…Often, they only have five minutes to look for the answer to a question [5]. In a study conducted by Ely et al [6], physicians were unable to find an answer to over 40% of a set of clinical questions. As part of their conclusions, the authors suggest physicians should change their search strategies.…”

Section: Introductionmentioning

confidence: 97%

Comparing image search behaviour in the ARRS GoldMiner search engine and a clinical PACS/RIS

De‐Arteaga

Eggel

et al. 2015

Journal of Biomedical Informatics

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Information search has changed the way we manage knowledge and the ubiquity of information access has made search a frequent activity, whether via Internet search engines or increasingly via mobile devices. Medical information search is in this respect no different and much research has been devoted to analyzing the way in which physicians aim to access information. Medical image search is a much smaller domain but has gained much attention as it has different characteristics than search for text documents. While web search log files have been analysed many times to better understand user behaviour, the log files of hospital internal systems for search in a PACS/RIS (Picture Archival and Communication System, Radiology Information System) have rarely been analysed. Such a comparison between a hospital PACS/RIS search and a web system for searching images of the biomedical literature is the goal of this paper. Objectives are to identify similarities and differences in search behaviour of the two systems, which could then be used to optimize existing systems and build new search engines. Log files of the ARRS GoldMiner medical image search engine (freely accessible on the Internet) containing 222,005 queries, and log files of Stanford's internal PACS/RIS search called radTF containing 18,068 queries were analysed. Each query was preprocessed and all query terms were mapped to the RadLex (Radiology Lexicon) terminology, a comprehensive lexicon of radiology terms created and maintained by the Radiological Society of North America, so the semantic content in the queries and the links between terms could be analysed, and synonyms for the same concept could be detected. RadLex was mainly created for the use in radiology reports, to aid structured reporting and the preparation of educational material (Lanlotz, 2006) [1]. In standard medical vocabularies such as MeSH (Medical Subject Headings) and UMLS (Unified Medical Language System) specific terms of radiology are often underrepresented, therefore RadLex was considered to be the best option for this task. The results show a surprising similarity between the usage behaviour in the two systems, but several subtle differences can also be noted. The average number of terms per query is 2.21 for GoldMiner and 2.07 for radTF, the used axes of RadLex (anatomy, pathology, findings, …) have almost the same distribution with clinical findings being the most frequent and the anatomical entity the second; also, combinations of RadLex axes are extremely similar between the two systems. Differences include a longer length of the sessions in radTF than in GoldMiner (3.4 and 1.9 queries per session on average). Several frequent search terms overlap but some strong differences exist in the details. In radTF the term "normal" is frequent, whereas in GoldMiner it is not. This makes intuitive sense, as in the literature normal cases are rarely described whereas in clinical work the comparison with normal cases is often a first step. The general similarity in many points is likely due to t...

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“…She found that, even then, traditional faceto-face communication and use of print sources was still prevalent among qualified medical staff in the clinical setting. Again in 2007, Ely described the kinds of patient care questions physicians can't answer [8]. Also in 2007, Gonzalez reviewed 3500 patient consults in Spain to identify the most frequent questions asked by physicians there [9].…”

Section: Literature Reviewmentioning

confidence: 99%

The Information Needs of Clinicians: a Study of the Doctors Nova Scotia Clinical Library

Lee¹

2013

J Can Health Libr Assoc

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Background: The Clinical Library (CL) is a virtual library of books, journals, drug information, and patient information. It has no hard copy books or journals to lend. Objectives: On the 10-year anniversary of the CL, feedback from information skills training indicated a need for a user assessment survey to ensure that the CL continues to meet the medical information needs of the modern clinician. The study was conducted to assess the level of electronic information use, the geographical distribution of users, and the frequency of use by various clinical practitioners. The study also contained a survey of health librarians in the United Kingdom to assess whether our information strategies are in line with international practices and needs. Methods: External consultants were hired to conduct interviews and a survey among the membership and to perform an environmental scan of Canadian and U.S. services. A series of interviews was conducted by the health librarian at health libraries in the U.K. Results: Sixty-two percent of survey respondents said they access information to help inform patient diagnosis or treatment at least every 2Á3 days, 40% of respondents regularly use web-based medical information services, and 46% of respondents used the CL as part or all of their electronic search strategy. The use of the CL varied widely depending on the location of respondents and their access to a health library. Respondents in rural areas and those unaffiliated with hospital libraries were more likely to use the virtual CL. Family practitioners showed the most familiarity with the CL offerings and reported the highest use of the CL (66.7% of respondents). A significant minority of respondents found the CL difficult to navigate. The U.K. arm of the study showed that services offered there were similar to those offered by the CL. Conclusions: Based on the findings, the CL remains a vital service for members. The CL should maintain its services for members and make the user interface easier to use. A majority of clinicians are seeking evidence to support decisions about patient care. The use of web-based resources, including journals and textbooks, is growing. The CL is meeting the needs of a significant portion of respondents, mainly family physicians. The U.K. study found that librarians there offer similar services to those offered by the CL and that, based on their use, U.K. librarians expect to be offering these services for some time to come. The CL must look for synergies and duplication with affiliated libraries and find ways to collaborate and promote services.

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Patient-Care Questions that Physicians Are Unable to Answer

Cited by 54 publications

References 40 publications

In This Issue: Clinical Diagnosis and Management

In This Issue: Clinical Diagnosis and Management

Comparing image search behaviour in the ARRS GoldMiner search engine and a clinical PACS/RIS

The Information Needs of Clinicians: a Study of the Doctors Nova Scotia Clinical Library

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