Use of on-line evidence-based resources at the point of care.
OBJECTIVE
The utility of on-line evidence-based summary databases for answering clinical questions at the point of care is not well understood. Our objectives were to determine if family physician faculty could answer their questions using on-line resources and the proportion of answers that influenced patient care.


METHODS
This was a prospective study in which clinical faculty in an urban residency training office recorded their clinical questions and their search results.


RESULTS
Faculty asked 92 questions. Therapy, prognosis, and epidemiology questions were the most common types of inquiries. Fifty-four percent of the questions were fully or partially answered by use of an on-line resource; obtaining an answer required 5-10 minutes of searching. Physicians reported that 62% of the obtained answers modified their opinion, influenced the care of the current patient 56% of the time, and would affect the care of future patients 70% of the time. Slow Internet connection and interruptions were the most frequent barriers reported.


CONCLUSIONS
Practicing physicians inexperienced in the use of on-line evidence-based resources answered a proportion of their clinical questions that was comparable to reports of more-experienced searchers; however, the time required to find answers limits the practical use of these databases during patient care time. On-line summary databases such as those used in this study show promise in providing answers that influence care during the patient's visit. With faster Internet connection (or handheld devices) and improved navigability, such resources have the potential to optimize health care in the primary care setting.
Division of Practice-based Research, Department of Family Medicine, Wayne State University, Detroit, MI 48201, USA. kensch@med.wayne.edu
Kendra
K
Schwartz
Justin
J
Northrup
Nejla
N
Israel
Karen
K
Crowell
Nehman
N
Lauder
Anne Victoria
AV
Neale
D002983:Clinical Competence; D019992:Databases as Topic / Q000706:statistics & numerical data; D016208:Databases, Factual / Q000706:statistics & numerical data; D005180:Faculty, Medical; D005194:Family Practice; D006801:Humans; D020407:Internet; D009862:Online Systems / Q000706:statistics & numerical data; D010820:Physicians / Q000706:statistics & numerical data; D011446:Prospective Studies