title: McMaster PLUS: a cluster randomized clinical trial of an intervention to accelerate clinical use of evidence-based information from digital libraries.
abstract: 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.
authors.affiliation: McMaster University, Epidemiology and Biostatistics, McMaster Health Sciences Centre, 1200 Main St West, Rm 2C10b, Hamilton, Ontario, Canada. bhaynes@mcmaster.ca
authors.forename: R Brian
authors.initials: RB
authors.lastname: Haynes
authors.forename: Jennifer
authors.initials: J
authors.lastname: Holland
authors.forename: Chris
authors.initials: C
authors.lastname: Cotoi
authors.forename: R James
authors.initials: RJ
authors.lastname: McKinlay
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Wilczynski
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Walters
authors.forename: Dawn
authors.initials: D
authors.lastname: Jedras
authors.forename: Rick
authors.initials: R
authors.lastname: Parrish
authors.forename: K Ann
authors.initials: KA
authors.lastname: McKibbon
authors.forename: Amit
authors.initials: A
authors.lastname: Garg
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Walter
mesh_terms: D019317:Evidence-Based Medicine; D006801:Humans; D020407:Internet; D046609:Libraries, Digital / Q000706:statistics & numerical data*; D007999:Library Services; D039781:PubMed