To list server,
Alper BS, White DS, Ge B. Physicians answer more clinical questions and
>> change clinical decisions more often with synthesized evidence: a
> randomizedtrial in primary care. Ann Fam Med. 2005 Nov-Dec;3(6):507-13.
>>
>> PURPOSE: Clinicians need evidence in a format that rapidly answers their
>> questions. DynaMed is a database of synthesized evidence. We investigated
>> whether primary care clinicians would answer more clinical questions,change
>> clinical decision making, and alter search time using DynaMed in addition to
>> their usual information sources. METHODS: Fifty-two primary care
> clinicians naive to DynaMed searched for answers to 698 of their own clinical
> questions using the Internet. On a per-question basis, participants were
randomized to have access to DynaMed (A) or not (N) in addition to their usual
> information sources. Outcomes included proportions of questions answered,
proportions of questions with answers that changed clinical decision making, and
median search times. The statistical approach of per-participant analyses of
>> clinicians who asked questions in both A and N states was decided before
>> data collection.
RESULTS: Among 46 clinicians in per-participant
analyses, 23 (50%) answered a greater proportion of questions during A than
N, and 13 (28.3%) answered more questions during N than A (P = .05).
Finding answers that changed clinical decision making occurred more often
during A (25 clinicians, 54.3%) than during N (13 clinicians, 28.3%) (P =
.01).
Search times did not differ significantly. Overall, participants found
answers for 263 (75.8%) of 347 A questions and 250 (71.2%) of 351 N
questions.
Answers changed clinical decision making for 224 (64.6%) of the A questions
and 209 (59.5%) of the N questions.
CONCLUSIONS: Using DynaMed, primary care
>> clinicians answered more questions and changed clinical decisions more
>> often, without increasing overall search time. Synthesizing results of
>> systematic evidence surveillance is a feasible method for meeting
Clinical information needs in primary care.
>>
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