A comparison of the accuracy of clinical decisions based on full-text articles and on journal abstracts alone: a study among residents in a tertiary care hospital.
BACKGROUND
Many clinicians depend solely on journal abstracts to guide clinical decisions.


OBJECTIVE
This study aims to determine if there are differences in the accuracy of responses to simulated cases between resident physicians provided with an abstract only and those with full-text articles. It also attempts to describe their information-seeking behaviour.


METHODS
Seventy-seven resident physicians from four specialty departments of a tertiary care hospital completed a paper-based questionnaire with clinical simulation cases, then randomly assigned to two intervention groups-access to abstracts-only and access to both abstracts and full-text. While having access to medical literature, they completed an online version of the same questionnaire.


RESULTS
The average improvement across departments was not significantly different between the abstracts-only group and the full-text group (p=0.44), but when accounting for an interaction between intervention and department, the effect was significant (p=0.049) with improvement greater with full-text in the surgery department. Overall, the accuracy of responses was greater after the provision of either abstracts-only or full-text (p<0.0001). Although some residents indicated that 'accumulated knowledge' was sufficient to respond to the patient management questions, in most instances (83% of cases) they still sought medical literature.


CONCLUSIONS
Our findings support studies that doctors will use evidence when convenient and current evidence improved clinical decisions. The accuracy of decisions improved after the provision of evidence. Clinical decisions guided by full-text articles were more accurate than those guided by abstracts alone, but the results seem to be driven by a significant difference in one department.
National Telehealth Center, University of the Philippines, Manila, Philippines.
Alvin
A
Marcelo
Alex
A
Gavino
Iris Thiele
IT
Isip-Tan
Leilanie
L
Apostol-Nicodemus
Faith Joan
FJ
Mesa-Gaerlan
Paul Nimrod
PN
Firaza
John Francis
JF
Faustorilla
Fiona M
FM
Callaghan
Paul
P
Fontelo
D000043:Abstracting and Indexing; D022126:Access to Information; D000328:Adult; D002983:Clinical Competence; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D010506:Periodicals as Topic; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers