title: Formative evaluation of a patient-specific clinical knowledge summarization tool.
abstract: OBJECTIVE
  To iteratively design a prototype of a computerized clinical knowledge summarization (CKS) tool aimed at helping clinicians finding answers to their clinical questions; and to conduct a formative assessment of the usability, usefulness, efficiency, and impact of the CKS prototype on physicians' perceived decision quality compared with standard search of UpToDate and PubMed.
  
  
  METHODS
  Mixed-methods observations of the interactions of 10 physicians with the CKS prototype vs. standard search in an effort to solve clinical problems posed as case vignettes.
  
  
  RESULTS
  The CKS tool automatically summarizes patient-specific and actionable clinical recommendations from PubMed (high quality randomized controlled trials and systematic reviews) and UpToDate. Two thirds of the study participants completed 15 out of 17 usability tasks. The median time to task completion was less than 10s for 12 of the 17 tasks. The difference in search time between the CKS and standard search was not significant (median=4.9 vs. 4.5m in). Physician's perceived decision quality was significantly higher with the CKS than with manual search (mean=16.6 vs. 14.4; p=0.036).
  
  
  CONCLUSIONS
  The CKS prototype was well-accepted by physicians both in terms of usability and usefulness. Physicians perceived better decision quality with the CKS prototype compared to standard search of PubMed and UpToDate within a similar search time. Due to the formative nature of this study and a small sample size, conclusions regarding efficiency and efficacy are exploratory.
authors.affiliation: Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, USA. Electronic address: guilherme.delfiol@utah.edu.
authors.forename: Guilherme
authors.initials: G
authors.lastname: Del Fiol
authors.affiliation: School of Information and Library Science (SILS), University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Javed
authors.initials: J
authors.lastname: Mostafa
authors.affiliation: School of Information and Library Science (SILS), University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Dongqiuye
authors.initials: D
authors.lastname: Pu
authors.affiliation: School of Information and Library Science (SILS), University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Medlin
authors.affiliation: Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, USA.
authors.forename: Stacey
authors.initials: S
authors.lastname: Slager
authors.affiliation: Division of Health and Biomedical Informatics, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Siddhartha R
authors.initials: SR
authors.lastname: Jonnalagadda
authors.affiliation: Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, USA; Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA.
authors.forename: Charlene R
authors.initials: CR
authors.lastname: Weir
mesh_terms: D020000:Decision Support Systems, Clinical / Q000706:statistics & numerical data*; D006801:Humans; D058436:Knowledge Management / Q000592:standards*; D008498:Medical Record Linkage; D066230:Patient-Specific Modeling; D010363:Pattern Recognition, Automated; D011340:Problem Solving; D018511:Systems Integration
keywords: Clinical decision support; Information needs; Information seeking and retrieval; Online information resources