Getting answers to physicians' clinical questions

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This post courtesy of Anne Taylor-Vaisey: Just by chance, this abstract from the latest issue of JAMIA just popped up in my e-mail. The authors of this study asked practicing physicians what there information needs are. They asked them for their recommendations, and these are available in an appendix. The bottom line is, physicians seeking answers to questions at point of care don't have time for literature searching. They need immediate answers and want to see resources developed that provide those answers.

Of course, this scenario differs from that of the health care provider or researcher who is doing in-depth literature searching for a self-directed learning project or for publication. What is the best way to teach searching skills to that kind of learner?

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Ely JW, Osheroff JA, Chambliss ML, Ebell MH, Rosenbaum ME. Answering physicians' clinical questions: obstacles and potential solutions. J Am Med Inform Assoc 2005; 12(2):217-224.

OBJECTIVE: To identify the most frequent obstacles preventing physicians from answering their patient-care questions and the most requested improvements to clinical information resources.

DESIGN: Qualitative analysis of questions asked by 48 randomly selected generalist physicians during ambulatory care.

MEASUREMENTS: Frequency of reported obstacles to answering patient-care questions and recommendations from physicians for improving clinical information resources.

RESULTS: The physicians asked 1,062 que! stions but pursued answers to only 585 (55%). The most commonly reported obstacle to the pursuit of an answer was the physician's doubt that an answer existed (52 questions, 11%). Among pursued questions, the most common obstacle was the failure of the selected resource to provide an answer (153 questions, 26%). During audiotaped interviews, physicians made 80 recommendations for improving clinical information resources. For example, they requested comprehensive resources that answer questions likely to occur in practice with emphasis on treatment and bottom-line advice. They asked for help in locating information quickly by using lists, tables, bolded subheadings, and algorithms and by avoiding lengthy, uninterrupted prose.

CONCLUSION: Physicians do not seek answers to many of their questions, often suspecting a lack of usable information. When they do seek answers, they often cannot find the information they need. Clinical resource developers could use the recommendations made by practicing physicians to provide resources that are more useful for answering clinical questions.

PubMed link

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