scholarly journals Translating Clinical Questions by Physicians Into Searchable Queries: Analytical Survey Study

10.2196/16777 ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. e16777
Author(s):  
Aurélie Seguin ◽  
Robert Brian Haynes ◽  
Sebastian Carballo ◽  
Alfonso Iorio ◽  
Arnaud Perrier ◽  
...  
Keyword(s):  
Search Engine ◽  
Controlled Trial ◽  
Real Life ◽  
Educational Interventions ◽  
Primary Objective ◽  
Survey Study ◽  
Evidence Based ◽  
Search Term ◽  
Federated Search ◽  
Clinical Questions

Background Staying up to date and answering clinical questions with current best evidence from health research is challenging. Evidence-based clinical texts, databases, and tools can help, but clinicians first need to translate their clinical questions into searchable queries. MacPLUS FS (McMaster Premium LiteratUre Service Federated Search) is an online search engine that allows clinicians to explore multiple resources simultaneously and retrieves one single output that includes the following: (1) evidence from summaries (eg, UpToDate and DynaMed), (2) preappraised research (eg, EvidenceAlerts), and (3) non-preappraised research (eg, PubMed), with and without validated bibliographic search filters. MacPLUS FS can also be used as a laboratory to explore clinical questions and evidence retrieval. Objective Our primary objective was to examine how clinicians formulate their queries on a federated search engine, according to the population, intervention, comparison, and outcome (PICO) framework. Our secondary objective was to assess which resources were accessed by clinicians to answer their questions. Methods We performed an analytical survey among 908 clinicians who used MacPLUS FS in the context of a randomized controlled trial on search retrieval. Recording account log-ins and usage, we extracted all 1085 queries performed during a 6-month period and classified each search term according to the PICO framework. We further categorized queries into background (eg, “What is porphyria?”) and foreground questions (eg, “Does treatment A work better than B?”). We then analyzed the type of resources that clinicians accessed. Results There were 695 structured queries, after exclusion of meaningless queries and iterations of similar searches. We classified 56.5% (393/695) of these queries as background questions and 43.5% (302/695) as foreground questions, the majority of which were related to questions about therapy (213/695, 30.6%), followed by diagnosis (48/695, 6.9%), etiology (24/695, 3.5%), and prognosis (17/695, 2.5%). This distribution did not significantly differ between postgraduate residents and medical faculty physicians (P=.51). Queries included a median of 3 search terms (IQR 2-4), most often related to the population and intervention or test, rarely related to the outcome, and never related to the comparator. About half of the resources accessed (314/610, 51.5%) were summaries, 24.4% (149/610) were preappraised research, and 24.1% were (147/610) non-preappraised research. Conclusions Our results, from a large sample of real-life queries, could guide the development of educational interventions to improve clinicians’ retrieval skills, as well as inform the design of more useful evidence-based resources for clinical practice. Trial Registration ClinicalTrials.gov NCT02038439; https://www.clinicaltrials.gov/ct2/show/NCT02038439

scholarly journals Translating Clinical Questions by Physicians Into Searchable Queries: Analytical Survey Study (Preprint)

2019 ◽  
Author(s):  
Aurélie Seguin ◽  
Robert Brian Haynes ◽  
Sebastian Carballo ◽  
Alfonso Iorio ◽  
Arnaud Perrier ◽  
...  
Keyword(s):  
Search Engine ◽  
Controlled Trial ◽  
Real Life ◽  
Educational Interventions ◽  
Primary Objective ◽  
Survey Study ◽  
Evidence Based ◽  
Search Term ◽  
Federated Search ◽  
Clinical Questions

BACKGROUND Staying up to date and answering clinical questions with current best evidence from health research is challenging. Evidence-based clinical texts, databases, and tools can help, but clinicians first need to translate their clinical questions into searchable queries. MacPLUS FS (McMaster Premium LiteratUre Service Federated Search) is an online search engine that allows clinicians to explore multiple resources simultaneously and retrieves one single output that includes the following: (1) evidence from summaries (eg, UpToDate and DynaMed), (2) preappraised research (eg, EvidenceAlerts), and (3) non-preappraised research (eg, PubMed), with and without validated bibliographic search filters. MacPLUS FS can also be used as a laboratory to explore clinical questions and evidence retrieval. OBJECTIVE Our primary objective was to examine how clinicians formulate their queries on a federated search engine, according to the population, intervention, comparison, and outcome (PICO) framework. Our secondary objective was to assess which resources were accessed by clinicians to answer their questions. METHODS We performed an analytical survey among 908 clinicians who used MacPLUS FS in the context of a randomized controlled trial on search retrieval. Recording account log-ins and usage, we extracted all 1085 queries performed during a 6-month period and classified each search term according to the PICO framework. We further categorized queries into background (eg, “What is porphyria?”) and foreground questions (eg, “Does treatment A work better than B?”). We then analyzed the type of resources that clinicians accessed. RESULTS There were 695 structured queries, after exclusion of meaningless queries and iterations of similar searches. We classified 56.5% (393/695) of these queries as background questions and 43.5% (302/695) as foreground questions, the majority of which were related to questions about therapy (213/695, 30.6%), followed by diagnosis (48/695, 6.9%), etiology (24/695, 3.5%), and prognosis (17/695, 2.5%). This distribution did not significantly differ between postgraduate residents and medical faculty physicians (<i>P</i>=.51). Queries included a median of 3 search terms (IQR 2-4), most often related to the population and intervention or test, rarely related to the outcome, and never related to the comparator. About half of the resources accessed (314/610, 51.5%) were summaries, 24.4% (149/610) were preappraised research, and 24.1% were (147/610) non-preappraised research. CONCLUSIONS Our results, from a large sample of real-life queries, could guide the development of educational interventions to improve clinicians’ retrieval skills, as well as inform the design of more useful evidence-based resources for clinical practice. CLINICALTRIAL ClinicalTrials.gov NCT02038439; https://www.clinicaltrials.gov/ct2/show/NCT02038439

Knowledge and satisfaction of pharmacists attending an educational workshop on evidence-based management of low back pain

2015 ◽  
Vol 21 (2) ◽  
pp. 126 ◽  
Author(s):  
Christina Abdel Shaheed ◽  
Christopher G. Maher ◽  
Wendy Mak ◽  
Kylie A. Williams ◽  
Andrew J. McLachlan
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Teaching Method ◽  
Real Life ◽  
Educational Interventions ◽  
Evidence Based ◽  
Low Back ◽  
Case Scenario ◽  
Pharmacological Management ◽  
Educational Workshop

Pharmacists are well positioned to provide quality care to people with low back pain (LBP). Education and training can equip pharmacists with the knowledge to optimally manage LBP in primary care. The aim of this study was to investigate the knowledge and satisfaction of pharmacists who attended a 2-h educational workshop on the evidence-based management of LBP. Case-based learning, underpinned by key adult learning principles, was one teaching method used to deliver important educational messages. Knowledge was assessed using a questionnaire consisting of multiple-choice, true/false questions and a written vignette based on a real-life clinical case scenario. Written feedback from pharmacists was used to gauge the success and limitations of the intervention. One hundred and ninety-three pharmacists completed the in-house assessment. Pharmacists demonstrated an accurate understanding of evidence-based pharmacological management of LBP, with all identifying paracetamol as the first-line drug choice for non-specific LBP. Ninety-nine per cent of pharmacists identified the symptoms presented in the vignette as a syndrome representing a significant clinical red flag requiring urgent referral. This educational intervention has delivered key messages on LBP management to pharmacists. There is a continued need for educational interventions addressing common conditions.

From science to practice

2012 ◽  
pp. 122-130
Author(s):  
John R. Geddes
Keyword(s):  
Evidence Based Medicine ◽  
Real Life ◽  
Clinical Problem ◽  
Research Articles ◽  
Evidence Based ◽  
Clinical Tool ◽  
Biomedical Journals ◽  
Assessment And Treatment ◽  
Clinical Questions ◽  
Based Medicine

Clinicians need accurate and up-to-date information about emerging knowledge on assessment and treatment as well as other developments in practice. The presentation of this knowledge needs to be timely, accurate, and unbiased. In an ideal world, every psychiatrist would have instantaneous access to the original scientific articles. As this is not feasible because clinicians are busy and the skills needed for an adequate systematic search, critical appraisal, and interpretation of research articles are not routinely available. Further, the volume of research articles is staggering: about 2 million papers are published in 20 000 biomedical journals every year, and even if a psychiatrist restricted her reading to those clinical psychiatry journals it would be necessary to read about 5500 papers each year—equivalent to 15 papers every day. Clearly, a strategy is required for efficient and timely identification of research that is both methodologically sound and clinically relevant. A coherent set of strategies designed as a clinical tool to link the best available evidence directly to the care of individual patients was first formulated at McMaster University in Canada—an approach called evidence-based medicine. Evidence-based medicine is problem-based and splits the process of linking research to practice into five stages (formulating a structured clinical question, finding evidence and advances in the organization of clinical knowledge, using a systematic approach to searching for the best available evidence, applying the evidence to the clinical problem, and assessing and improving the process) plus the identification of clinical questions in need of more research. To make evidence-based practice feasible in real-life clinical practice, a number of problems need to be solved at each stage of the process.

Patients’ Perceptions and Attitudes Regarding the Pre-Anesthesia Clinic (PAC) at the National Guard Hospital in Riyadh, Saudi Arabia: An Exploratory Study (Preprint)

2020 ◽  
Author(s):  
Ghdeer Tashkandi ◽  
Samina Abidi
Keyword(s):  
Saudi Arabia ◽  
Exploratory Study ◽  
National Guard ◽  
Active Role ◽  
Relevant Information ◽  
Educational Interventions ◽  
Evidence Based ◽  
Quantitative Research Methods ◽  
Perceptions And Attitudes ◽  
Educational Information

BACKGROUND Preoperative services and education allow patients to take an active role in their recovery and reduce the risk of post-operative complications. Exploring patients’ perceptions and attitudes regarding pre-anesthesia services and education helps reveal gaps in patients’ uptake of them so that targeted educational interventions can be designed and implemented. OBJECTIVE This is an exploratory study aimed at increasing the understanding of patients’ perceptions and concerns about and the adequacy of the pre-anesthesia services and educational content provided to them at the pre-anesthesia clinic (PAC) of the National Guard Hospital (NGH) in Riyadh, Saudi Arabia. The information gathered will be used to design and develop an electronic patient education system that will allow patients to access personalized, evidence-based pre-anesthesia information relevant to their upcoming surgeries. METHODS Quantitative research methods are used to collect relevant information from patients using a closed-ended questionnaire. The questionnaire includes items on demographics, patients’ perceptions and concerns regarding anesthesia, and the assessment of pre-anesthesia information adequacy. RESULTS Our results showed that 94% of the participants consider the PAC very important, and more than half of the participants (56%) were interested in receiving additional educational information about anesthesia via mobile applications. While 100% of the participants were satisfied with the information and services provided at the clinic, the assessment of this information and service adequacy indicated that participants were not adequately informed about anesthesia. Among the most common anesthesia-related concerns were the inability to wake up after anesthesia, becoming paralyzed after spinal anesthesia, the possibility of staying in the ICU after the surgery and developing back pain. CONCLUSIONS This gathered information will be used to design and develop an educational intervention that will deliver evidence-based, personalized and easy to understand educational instructions to patients to better prepare them for their upcoming surgery. The proposed system will overcome the problems of (i) the spread of generalized unrelated educational information and instructions, (ii) patients forgetting or misunderstanding the given instructions, (iii) issues with the accessibility of information, and (iv) a lack of communication and interaction between patients and their anesthetist.

scholarly journals Luteal Phase Support in IVF: Comparison Between Evidence-Based Medicine and Real-Life Practices

2020 ◽  
Vol 11 ◽  
Author(s):  
Federica Di Guardo ◽  
Habib Midassi ◽  
Annalisa Racca ◽  
Herman Tournaye ◽  
Michel De Vos ◽  
...  
Keyword(s):  
Evidence Based Medicine ◽  
Luteal Phase ◽  
Real Life ◽  
Evidence Based ◽  
Luteal Phase Support ◽  
Based Medicine

scholarly journals Pediatric Residents and Interns in an Italian Hospital Perform Improved Bibliographic Searches when Assisted by a Biomedical Librarian

2013 ◽  
Vol 8 (1) ◽  
pp. 76
Author(s):  
Mathew Stone
Keyword(s):  
Teaching Hospital ◽  
Assessment Tool ◽  
Controlled Trial ◽  
Intervention Group ◽  
Real Life ◽  
Boolean Logic ◽  
Bibliographic Databases ◽  
Control Group ◽  
Pediatric Residents ◽  
Clinical Scenarios

A Review of: Gardois, P., Calabrese, R., Colombi, N., Lingua, C., Longo, F., Villanacci, M., Miniero, R., & Piga, A. (2011). Effectiveness of bibliographic searches performed by paediatric residents and interns assisted by librarian. A randomised controlled trial. Health Information and Libraries Journal, 28(4), 273-284. doi: 10.1111/j.1471-1842.2011.00957.x Objective – To establish whether the assistance of an experienced biomedical librarian delivers an improvement in the searching of bibliographic databases as performed by medical residents and interns. Design – Randomized controlled trial. Setting – The pediatrics department of a large Italian teaching hospital. Subjects – 18 pediatric residents and interns. Methods – 23 residents and interns from the pediatrics department of a large Italian teaching hospital were invited to participate in this study, of which 18 agreed. Subjects were then randomized into two groups and asked to spend between 30 and 90 minutes searching bibliographic databases for evidence to answer a real-life clinical question which was randomly allocated to them. Each member of the intervention group was provided with an experienced biomedical librarian to provide assistance throughout the search session. The control group received no assistance. The outcome of the search was then measured using an assessment tool adapted for the purpose of this study from the Fresno test of competence in evidence based medicine. This adapted assessment tool rated the “global success” of the search and included criteria such as appropriate question formulation, number of PICO terms translated into search terms, use of Boolean logic, use of subject headings, use of filters, use of limits, and the percentage of citations retrieved that matched a gold standard set of citations found in a prior search by two librarians (who were not involved in assisting the subjects) together with an expert clinician. Main Results – The intervention group scored a median average of 73.6 points out of a possible 100, compared with the control group which scored 50.4. The difference of 23.2 points in favour of the librarian assisted group was a statistically significant result (p value = 0.013) with a 95% confidence interval of between 4.8 and 33.2. Conclusion – This study presents credible evidence that assistance provided by an experienced biomedical librarian improves the quality of the bibliographic database searches performed by residents and interns using real-life clinical scenarios.

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