Evaluating the use of a comprehensive pretravel database by travel medicine experts and novices for advice building.
BACKGROUND
The practice of travel medicine is particularly dependent on knowledge that must be continuously updated, and that can be found in professional electronic documents (PEDs), as specialized websites or comprehensive off-line databases. In this study, we show to what extent the use of a comprehensive pretravel database can compensate for a lack of knowledge in travel medicine during advice building, despite inexperience in using such systems.


METHODS
Sixteen physicians, novices and experts in travel medicine, were solicited for building adequate recommendations about real cases of international travel with the help of a specialized PED. The physician's verbalizations, browsing in the documentation and final recommendations have been analyzed for the purpose of identifying and counting the requests addressed to the system and the informative elements in the recommendations.


RESULTS
Novices make 2.5 times as many requests for information as experts (p=.0009), and look for a greater variety of information, specifically connected to health precautions (p=.0012), immunizations (p=.0001), health care resources (p=.0037) and climate (p=.019), whereas experts focus their requests mainly on health risks (64.81% of requests, p5.0009). The recommendations from the two groups included equivalent quantities of about 12 pieces of information, but experts used 92.34% of the information found in the documentation, whereas novices used 72.37% (p=.00005). The most used informative elements, whatever the expertise level is, are related to immunizations and health precautions, but experts include more information about health risks (p=0.017), drug characteristics (p=0.014) and chemoprophylaxis (p=0.026).


CONCLUSIONS
The PED actually increases the novices' travel medicine expertise, and is particularly efficient for immunizations and health precautions. The PED helps a novice to build advice that is, on the whole, equivalent to an expert's in terms of nature, if not of quality. Implications for the benefits of comprehensive PEDs in the practice of travel medicine are discussed.
Chaudet
Hervé
H
UPRES EA 2672, UFR de Médecine, Université de la Méditerranée, 27 Boulevard Jean Moulin, 13385 Marseille Cedex 5, France.
Pellegrin
Liliane
L
Boureau
Cyril
C
Delmont
Jean
J
D002983:Clinical Competence; D003140:Communicable Disease Control; D016208:Databases, Factual / Q000706:statistics & numerical data*; D005602:France / Q000453:epidemiology; D006801:Humans; D020407:Internet; D010353:Patient Education as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D040442:Public Health Informatics; D011795:Surveys and Questionnaires; D014195:Travel