McMaster PLUS: a cluster randomized clinical trial of an intervention to accelerate clinical use of evidence-based information from digital libraries.
BACKGROUND
Physicians have difficulty keeping up with new evidence from medical research.


METHODS
We developed the McMaster Premium LiteratUre Service (PLUS), an internet-based addition to an existing digital library, which delivered quality- and relevance-rated medical literature to physicians, matched to their clinical disciplines. We evaluated PLUS in a cluster-randomized trial of 203 participating physicians in Northern Ontario, comparing a Full-Serve version (that included alerts to new articles and a cumulative database of alerts) with a Self-Serve version (that included a passive guide to evidence-based literature). Utilization of the service was the primary trial end-point.


RESULTS
Mean logins to the library rose by 0.77 logins/month/user (95% CI 0.43, 1.11) in the Full-Serve group compared with the Self-Serve group. The proportion of Full-Serve participants who utilized the service during each month of the study period showed a sustained increase during the intervention period, with a relative increase of 57% (95% CI 12, 123) compared with the Self-Serve group. There were no differences in these proportions during the baseline period, and following the crossover of the Self-Serve group to Full-Serve, the Self-Serve group's usage became indistinguishable from that of the Full-Serve group (relative difference 4.4 (95% CI -23.7, 43.0). Also during the intervention and crossover periods, measures of self-reported usefulness did not show a difference between the 2 groups.


CONCLUSIONS
A quality- and relevance-rated online literature service increased the utilization of evidence-based information from a digital library by practicing physicians.
Haynes
R Brian
RB
McMaster University, Epidemiology and Biostatistics, McMaster Health Sciences Centre, 1200 Main St West, Rm 2C10b, Hamilton, Ontario, Canada. bhaynes@mcmaster.ca
Holland
Jennifer
J
Cotoi
Chris
C
McKinlay
R James
RJ
Wilczynski
Nancy L
NL
Walters
Leslie A
LA
Jedras
Dawn
D
Parrish
Rick
R
McKibbon
K Ann
KA
Garg
Amit
A
Walter
Stephen D
SD
D019317:Evidence-Based Medicine; D006801:Humans; D020407:Internet; D046609:Libraries, Digital / Q000706:statistics & numerical data*; D007999:Library Services; D039781:PubMed