Clinical decision support tools: analysis of online drug information databases.
BACKGROUND
Online drug information databases are used to assist in enhancing clinical decision support. However, the choice of which online database to consult, purchase or subscribe to is likely made based on subjective elements such as history of use, familiarity, or availability during professional training. The purpose of this study was to evaluate clinical decision support tools for drug information by systematically comparing the most commonly used online drug information databases.


METHODS
Five commercially available and two freely available online drug information databases were evaluated according to scope (presence or absence of answer), completeness (the comprehensiveness of the answers), and ease of use. Additionally, a composite score integrating all three criteria was utilized. Fifteen weighted categories comprised of 158 questions were used to conduct the analysis. Descriptive statistics and Chi-square were used to summarize the evaluation components and make comparisons between databases. Scheffe's multiple comparison procedure was used to determine statistically different scope and completeness scores. The composite score was subjected to sensitivity analysis to investigate the effect of the choice of percentages for scope and completeness.


RESULTS
The rankings for the databases from highest to lowest, based on composite scores were Clinical Pharmacology, Micromedex, Lexi-Comp Online, Facts & Comparisons 4.0, Epocrates Online Premium, RxList.com, and Epocrates Online Free. Differences in scope produced three statistical groupings with Group 1 (best) performers being: Clinical Pharmacology, Micromedex, Facts & Comparisons 4.0, Lexi-Comp Online, Group 2: Epocrates Premium and RxList.com and Group 3: Epocrates Free (p < 0.05). Completeness scores were similarly stratified. Collapsing the databases into two groups by access (subscription or free), showed the subscription databases performed better than the free databases in the measured criteria (p < 0.001).


CONCLUSIONS
Online drug information databases, which belong to clinical decision support, vary in their ability to answer questions across a range of categories.
Clauson
Kevin A
KA
Nova Southeastern University, College of Pharmacy--West Palm Beach, Palm Beach Gardens, FL 33410, USA. clauson@nsu.nova.edu
Marsh
Wallace A
WA
Polen
Hyla H
HH
Seamon
Matthew J
MJ
Ortiz
Blanca I
BI
D016208:Databases, Factual / Q000592:standards*; D020000:Decision Support Systems, Clinical / Q000592:standards*; D004346:Drug Information Services / Q000592:standards*; D006801:Humans