Using a systematic review in clinical decision making: a pilot parallel, randomized controlled trial.
BACKGROUND
Evidence suggests that systematic reviews are used infrequently by physicians in clinical decision-making. One proposed solution is to create filtered resources so that information is validated and refined in order to be read quickly. Two shortened systematic review formats were developed to enhance their use in clinical decision-making.


METHODS
To prepare for a full-scale trial, we conducted a pilot study to test methods and procedures in order to refine the processes. A recruitment email was sent to physicians practicing full- or part-time in family medicine or general internal medicine. The pilot study took place in an online environment and eligible physicians were randomized to one of the systematic review formats (shortened or full-length) and instructed to read the document. Participants were asked to provide the clinical bottom line and apply the information presented to a clinical scenario. Participants' answers were evaluated independently by two investigators against "gold standard" answers prepared by an expert panel.


RESULTS
Fifty-six clinicians completed the pilot study within a 2-month period with a response rate of 4.3 %. Agreement between investigators in assessing participants' answers was determined by calculating a kappa statistic. Two questions were assessed separately, and a kappa statistic was calculated at 1.00 (100 % agreement) for each.


CONCLUSIONS
Agreement between investigators in assessing participants' answers is satisfactory. Although recruitment for the pilot study was completed in a reasonable time-frame, response rates were low and will require large numbers of contacts. The results indicate that conducting a full-scale trial is feasible.


BACKGROUND
ClinicalTrials.gov NCT02414360 .
Institute of Health Management, Policy and Evaluation, University of Toronto, 155 College Street, Toronto, ON, M5T 3M6, Canada. l.perrier@utoronto.ca.
Laure
L
Perrier
Department of Family and Community Medicine, Li Ka Shing Knowledge Institute, University of Toronto, St. Michael's Hospital, 30 Bond Street, Toronto, Canada. nav.persaud@utoronto.ca.
Nav
N
Persaud
Dalla Lana, School of Public Health, Applied Health Research Centre, Keenan Research Centre, Li Ka Shing Knowledge Institute, University of Toronto, St. Michael's Hospital, 30 Bond Street, Toronto, Canada. kevin.thorpe@utoronto.ca.
Kevin E
KE
Thorpe
Faculty of Medicine, Keenan Research Centre, Li Ka Shing Knowledge Institute, University of Toronto, St. Michael's Hospital, 30 Bond Street, Toronto, Canada. sharon.straus@utoronto.ca.
Sharon E
SE
Straus
D006801:Humans; D000066491:Clinical Decision-Making / Q000379:methods; D019317:Evidence-Based Medicine / Q000379:methods; D010865:Pilot Projects; D000078202:Systematic Reviews as Topic