JMIR Publications

ABSTRACT

Background:

In this paper we describe a study to understand the impact of using a scientific medical literature search system on clinical decision making. Further, to understand the impact of realistic time pressures on clinicians, we vary the search time available to find clinical answers. Finally, we assess the impact of improvements in search system effectiveness on the same clinical decisions. Many clinical questions arise during patient encounters which clinicians are unable to answer. An evidence-based medicine approach expects that clinicians will seek and apply the best available evidence to answer clinical questions. One commonly used source of such evidence is scientific literature, such as that available through MEDLINE and PubMed. Clinicians report that two key reasons why they don’t use search systems to answer questions is that it takes too much time and that they don’t expect to find a definitive answer. So, the question remains about how effectively scientific literature search systems support time-pressured clinicians in making better clinical decisions. The results of this study are important because they can help clinicians and healthcare organisations to better assess their needs with respect to clinical decision support systems and evidence sources. The results and data captured will contribute a significant data collection to inform the design of future clinical decision support systems to better meet the needs of time-pressured, practicing clinicians.

Objective:

The overall aim of this study is to examine the suitability of using a search engine to search scientific literature to enable time-pressured, clinicians to make better clinical decisions

Methods:

In this study, 96 practising clinicians and final year medical students are presented with sixteen clinical questions which they must answer without access to any external resource. The same questions are then re-presented to the clinicians however, in this part of the study, the clinicians can use a scientific literature search engine to find evidence to support their answers. The time pressures of practising clinicians are simulated by limiting answer time to one of 3, 6 or 9 minutes per question. The correct answer rate is reported both before and after search to assess the impact of the search system and the time constraint. Additionally, two search systems that use the same user-interface, but which vary widely in their search effectiveness, are employed so that the impact of changes in search system effectiveness on clinical decision making can also be assessed.

Results:

Recruiting began for the study in June 2018. As of the 4 April 2019 there were 69 participants enrolled. The study is expected to close by 30 May 2019 with results to be published in July.

Conclusions:

N/A