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Taking Bruce's penultimate sentence - every physician is already answering all those questions but they just dont necessarily use the best sources BUT they do use the most practical (colleagues,books and memory). Our job is to develop, test and provide systems that do supply answers that are available just as quickly and evidence transparent. As medicine becomes more complex and as the knowledge increases we need systems to deal with this. The systems are not here today but they will come. It will need collaboration between publishers of books (on line or paper) and journals, researchers, academics and clinicians. As a lot of answers need to be context specific, eventually everyone is involved - even the dinosaurs. Martin ----- Original Message ----- From: "Bruce Arroll" <[log in to unmask]> To: <[log in to unmask]> Sent: Friday, July 15, 2005 5:38 AM Subject: Re: Efficient retrieval - a means to "close evidence gap"? Dear all I think we need to seriously consider the evidence based electronic textbooks and teach our students to know what is high quality evidence and what is not. As a clinician in primary care I need answers in minutes. It is not possible to spend hours trying to find an answer when I can go to www.dynamicmedical.com or uptodate.com and get an evidence based answer within minutes. Front line clinicians need comprehensive information (the answer needs to have a high probability of being there), that is quick and high quality. They also need critical appraisal skills to know what is good but it is dinosaur country to expect front line clinicians to spend hours looking for answers. That approach does not fit the workplace ok for teaching but no go in the everyday world Regards Bruce Arroll University of Auckland -----Original Message----- From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of Dean Giustini Sent: Friday, 15 July 2005 11:53 a.m. To: [log in to unmask] Subject: Efficient retrieval - a means to "close evidence gap"? Dear list, We are currently doing some research on the most efficient means of closing the evidence to practice gap. Specifically we are interesting in exploring whether efficient retrieval (or lack thereof) is a significant barrier to evidence based practice. Your thoughts please.....! Health librarians are arguably the experts at locating the right information, at the right time, in the right format for users. (ie. See: W Summerskill "Literature searches: look before you leap." Lancet. 2005 Jul 2;366(9479):13-4.) The question is: how practical is it to involve librarians in answering ALL clinical questions? Is it likely that clinicians can learn these skills and should librarians continue to teach them - or could there be a better way? One suggestion is that Google & Google Scholar might be ONE way. (I use these examples of free, unfettered and currently unwieldy tools because they are the most popular). Clinicians often begin their search for best evidence with a tool that consumes the least amount of time (ie. ease of use "availability heuristics"), and produces satisfactory, high quality evidence. If Google and Google Scholar's search features were optimized and improved, and indexed content included the world's evidence, wouldn't this be a step forward for the EBM movement? Are librarians afraid of letting the search giant take on this role? Dean Giustini University of British Columbia UBC Biomedical librarian Vancouver Canada