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Evidence‐based practice is gaining support amongst health professionals. However, the major barrier remains the lack of time to read the literature. There are also problems with the take‐up and use of evidence‐based information sources such as Cochrane reviews and Effective Health Care bulletins. If such evidence is to be incorporated into local guidelines and used in day‐to‐day practice, practitioners request that these and other reliable publications be further summarized in short packages and available within seconds. The Health Evidence Bulletins Wales offer a model for this approach. The Bulletins have gone through several developmental stages leading to a novel two‐column format. In the first column, brief statements summarize the best available evidence within a topic area. In the second, full details are provided of the supporting publications (and the evidence type, or research design) with links to the full text of documents, where possible from the electronic versions of each Bulletin. Results from a questionnaire study using a random sample and unsolicited feedback suggest that this ‘two‐tier’ approach to information provision is valued by users and has implications for information services currently under development to support clinical governance. 相似文献
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Dario SAMBUNJAK Mirjana HUIĆ Darko HREN Milica KATIĆ Ana MARUŠIĆ Matko MARUŠIĆ 《Learned Publishing》2009,22(1):57-70
Scholarly journals, especially in non‐English‐speaking countries, may perform very different functions depending on whether they are published for national or international audiences. Four hundred and sixty‐six academic physicians and non‐academic general practitioners in Croatia were surveyed on their knowledge about two Croatian medical journals: Lije?ni?ki vjesnik (published in Croatian) and Croatian Medical Journal (published in English). The physicians were also surveyed about the importance of all national and international journals published in Croatia, and the types of articles they thought should be published in these journals. More respondents rated national (n = 329, 72.6%) than international journals (n = 275, 63.5%, P < 0.001, Wilcoxon test) as very important for the medical profession. On the other hand, publishing in international journals was more often rated as important than publishing in national journals (n = 184, 42.5% vs. n = 125, 27.8%; P < 0.001, Wilcoxon test). Guidelines for clinical practice were rated as the most important publication item in national journals, and original scientific articles in international journals. 相似文献
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Objectives: What does the publicly available literature tell us about the attitudes of health care staff to the development of information technology in practice, including the factors which influence them and the factors which may be used to change these attitudes? Methods: Twelve databases were searched for literature published between 2000 and 2005 that identified research related to information technology (IT), health professionals and attitude. English language studies were included which described primary research relating to the attitudes of one or more health care staff groups towards IT. Letters, personal viewpoints, reflections and opinion pieces were not included. Results: Complex factors contribute to the formation of attitudes towards IT. Many of the issues identified were around the flexibility of the systems and whether they were ‘fit for purpose’, along with the confidence and experience of the IT users. The literature suggests that attitudes of practitioners are a significant factor in the acceptance and efficiency of use of IT in practice. The literature also suggested that education and training was a factor for encouraging the use of IT systems. Conclusions: A range of key issues, such as the need for flexibility and usability, appropriate education and training and the need for the software to be ‘fit for purpose’, showed that organizations need to plan carefully when proposing the introduction of IT‐based systems into work practices. The studies reviewed did suggest that attitudes of health care professionals can be a significant factor in the acceptance and efficiency of use of IT in practice. Further qualitative and quantitative research is needed into the approaches that have most effect on the attitudes of health care staff towards IT. 相似文献
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Background: Systematic review articles support the advance of science and translation of research evidence into healthcare practice. Inaccurate retrieval from medline could limit access to reviews. Objective: To determine the quality of indexing systematic reviews and meta‐analyses in medline . Methods: The Clinical Hedges Database, containing the results of a hand search of 161 journals, was used to test medline indexing terms for their ability to retrieve systematic reviews that met predefined methodologic criteria (labelled as ‘pass’ review articles) and reviews that reported a meta‐analysis. Results: The Clinical Hedges Database contained 49 028 articles; 753 were ‘pass’ review articles (552 with a meta‐analysis). In total 758 review articles (independent of whether they passed) reported a meta‐analysis. The search strategy that retrieved the highest number of ‘pass’ systematic reviews achieved a sensitivity of 97.1%. The publication type ‘meta analysis’ had a false positive rate of 5.6% (95% CI 3.9 to 7.6), and false negative rate of 0.31% (95% CI 0.26 to 0.36) for retrieving systematic reviews that reported a meta‐analysis. Conclusions: Inaccuracies in indexing systematic reviews and meta‐analyses in medline can be partly overcome by a 5‐term search strategy. Introducing a publication type for systematic reviews of the literature could improve retrieval performance. 相似文献
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临床试验注册的目的是减少临床试验报告的偏倚,提高研究的透明度和科学性。本研究调查了我国258种医学核心期刊的稿约,57种(22.1%)期刊稿约中要求遵循临床试验注册制度,其中50种期刊提出了具体的著录要求。进一步深入探讨各期刊发表的随机对照试验(RCT)中临床试验注册号著录格式及内容的一致性和准确性,以及RCT撰写遵循CONSORT报告指南是否对著录注册号有影响。本研究结果表明目前我国医学期刊对临床试验注册和报告指南的遵循情况并不理想,报告注册的RCT仅占17.2%,仍存在对注册制度重视不足及执行不严格等问题,而期刊要求遵循CONSORT声明可能对RCT的注册有积极的影响。建议医学期刊遵循临床试验注册制度,提高对其的正确认识和重视,这需要期刊审稿人、编辑及作者的共同参与,通过提高临床试验注册的比例,进而提升研究的透明度。 相似文献
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Background: Point of care resources make it easier for clinicians to find answers to questions that arise during a clinical encounter. In order to make informed purchase decisions in times of tight budgets, librarians need to have a better understanding of which resources will meet their patrons’ clinical information needs. Objectives: The goal of this study was to assess the content, interface and usability of three point‐of‐care tools: BMJ Point‐of‐Care, Clin‐eguide and Nursing Reference Centre. Methods: A questionnaire designed to gather quantitative and qualitative data was created using Survey Monkey. The survey was distributed to healthcare practitioners in Alberta’s two largest health regions, and the data were analysed for emergent themes. Results: The themes that arose – ease of use, validated content, relevancy to practice – generally echoed those stated in the literature. No one database fared significantly better, due to differing features, content and client preference. Conclusions: Despite the limitations of the survey, the themes that emerged provide a springboard for future research on the efficacy of information resources used at the point of care, and the need for deeper analysis of these recent additions to the medical information market. 相似文献
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N S Stearns 《Bulletin of the Medical Library Association》1986,74(2):100-103
Tufts University School of Medicine's new health sciences education building, the Arthur M. Sackler Center for Health Communications, will house a modern medical library and computer center, classrooms, auditoria, and media facilities. The building will also serve as the center for an information and communication network linking the medical school and adjacent New England Medical Center, Tufts' primary teaching hospital, with Tufts Associated Teaching Hospitals throughout New England. Ultimately, the Tufts network will join other gateway networks, information resource facilities, health care institutions, and medical schools throughout the world. The center and the network are intended to facilitate and improve the education of health professionals, the delivery of health care to patients, the conduct of research, and the implementation of administrative management approaches that should provide more efficient utilization of resources and save dollars. A model and scenario show how health care delivery and health care education are integrated through better use of information transfer technologies by health information specialists, practitioners, and educators. 相似文献
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This study investigates attitudes to ‘lay’ or ‘plain‐English’ summaries of open access (OA) journal articles in the context of engaging the public with medical research. It places lay summaries in the wider contexts of patients' information‐seeking behaviour and OA publishing activities. It reports the results of qualitative research involving two stakeholder groups: employees of organizations with a stake in communicating OA medical research to the public, and members of the public who have experience of accessing online medical research. It shows that patient access to the research literature is seen as one of a number of important sources of information that can help them manage their health conditions as ‘informed patients‘. However, accessing the literature was reported to be problematical, particularly because of paywalls, and there were also difficulties in using it, including language barriers. Lay summaries were seen to make a helpful contribution to improving patient access to information. There is, however, a clear need to gather more evidence about the costs and benefits of such an approach and also on the potential ways in which OA can create benefits for the general public. 相似文献
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基层医务工作者是直接与广大人民群众接触,提供预防、医疗、保健、康复服务的人员。提高基层医务工作者的专业素养及救治能力,才能真正贯彻和落实我国的新医改政策。医学期刊在此方面可以开展一些工作——面向基层读者、作者进行选题策划,栏目建设,通过线上线下的宣传扩大发行、增加与读者的互动;组织适合基层医务工作者的学术活动以及科研思维与写作投稿宣讲活动;举办面向基层的科普宣传、义诊活动。通过这些实践整体更新和提高基层医务工作者的理论知识、临床诊治的专业技能,提高为基层群众服务的医疗能力和水平。 相似文献
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由于国内医学期刊来稿中真正具有创新性的研究成果匮乏,加之国外著名医学期刊均采用创新性与实用性并重的办刊策略,而且实用性强的研究才有助于解决临床问题,所以我们要适时调整办刊策略,实施创新性与实用性并重的办刊策略。同时,医学期刊的编辑要充分发挥自己的作用,致力于引导作者进行科学性强的实用性研究。 相似文献
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Objectives: For general practitioners (GPs), an important obstacle to practising evidence‐based medicine is lack of time. An evidence‐based answering service was developed that took over searching and appraisal of medical evidence from the GPs. GPs sent in questions, and the informationist formulated the answers. Our objectives were to find out if such an evidence‐based answering service was feasible, including assessing the effect of the answers on GPs and their patients, as reported by the GPs. Methods: After attending a workshop on building well‐formulated questions from daily practice, the GPs sent in questions to the informationist. The literature was searched, the relevant information was appraised, and the answers to the questions were formulated. With a questionnaire, the effect of the answers on the GP and the patient was assessed, as well as the perceived barriers to implementing the answers. Results: From 26 GPs, 61 questions were received. For 12% of questions, information was found with the highest evidence level, while for 36%, no information was found. However, for 89% of the questions for which no information could be found, the answer ‘no information found’ did have an effect on the GP concerned. In total, 81% of all the answers had an effect on the GP, and, according to the GP, 52% had an effect on the patient. Few barriers to implementing the evidence were perceived. Most of the answers were found in Pubmed/Medline, the Cochrane Library and Embase. Conclusions: This study indicates that an evidence‐based answering service can have an impact on GPs and their patients. Librarians can provide an evidence‐based answering service for GPs and their patients. The evidence‐based answering service for GPs in this study had an impact on 81% of the GPs and on 52% of their patients. Although for one‐third of the questions no evidence‐based answer was found, this message in itself had an impact on 89% of the GPs. An informationist as mediator between medical information and doctors can save doctors’ time. 相似文献
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Elizabeth A. Barley Joanna Murray Rachel Churchill 《Health information and libraries journal》2009,26(4):298-306
Background and objectives: Clinicians report difficulties using research in their practices. The aim of the study was to describe needs and preferences for a mental health clinical question‐answering service designed to assist this process. Method: Multi‐disciplinary clinicians participated in a focus group; users of the service supplied feedback. Results: Fifty‐four clinicians received answers to 84 questions about mental health treatments. User ratings showed that the answers had multiple uses: informing health care (43), education (22), staff development (28) and research (12), and were considered useful, clear, relevant and helpful. Focus group participants appreciated critically appraised summaries of evidence and stressed the time‐saving benefit of the service. Clinicians without a medical training were least confident in applying evidence. Attitudes to research were positive, but concern was expressed about its potential misuse for political purposes. This appeared to arise from an ambiguity around the term ‘insufficient evidence’, which participants felt is widely misinterpreted as ‘evidence of no effect’. Conclusions: A highly valued, responsive service has been developed. A range of clinicians find critically appraised summaries of research useful. Education about the use of research may help clinicians to be more evidence based. 相似文献
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Paula Younger 《Health information and libraries journal》2010,27(1):2-10
Background: Reviews of how doctors and nurses search for online information are relatively rare, particularly where research examines how they decide whether to use Internet‐based resources. Original research into their online searching behaviour is also rare, particularly in real world clinical settings. as is original research into their online searching behaviour. This review collates some of the existing evidence, from 1995 to 2009. Objectives: To establish whether there are any significant differences in the ways and reasons why doctors and nurses seek out online information; to establish how nurses and doctors locate information online; to establish whether any conclusions can be drawn from the existing evidence that might assist health and medical libraries in supporting users. Methods: An initial scoping literature search was carried out on PubMed and CINAHL to identify existing reviews of the subject area and relevant original research between 1995 and 2009. Following refinement, further searches were carried out on Embase (Ovid), LISA and LISTA. Following the initial scoping search, two journals were identified as particularly relevant for further table of contents searching. Articles were exclused where the main focus was on patients searching for information or where the focus was the evaluation of online‐based educational software or tutorials. Articles were included if they were review or meta‐analysis articles, where they reported original research, and where the primary focus of the online search was for participants’ ongoing Continuing Professional Development (CPD). The relevant articles are outlined, with details of numbers of participants, response rates, and the user groups. Results: There appear to be no significant differences between the reasons why doctors and nurses seek online Internet‐based evidence, or the ways in which they locate that evidence. Reasons for searching for information online are broadly the same: primarily patient care and CPD (Continuing Professional Development). The perceived barriers to accessing online information are the same in both groups. There is a lack of awareness of the library as a potential online information enabler. Conclusions: Libraries need to examine their policy and practice to ensure that they facilitate access to online evidence‐based information, particularly where users are geographically remote or based in the community rather than in a hospital setting. Librarians also need to take into account the fact that medical professionals on duty may not be able to take advantage of the academic model of online information research. Further research is recommended into the difference between the idealised academic model of searching and real world practicalities; and how other user groups search, for example patients. 相似文献
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Characteristics of early adopters of end-user online searching in the health professions 总被引：1，自引：0，他引：1
J G Marshall 《Bulletin of the Medical Library Association》1989,77(1):48-55
This paper examines end-user, online searching using data from a questionnaire mailed to 150 Canadian health professionals in practice settings. The response rate was 83% (n = 124). The data provide a demographic profile of early adopters of end-user searching in the health care community. Positive correlations with the user's level of implementation of end-user searching were found for the following variables: amount of time spent in research activities, amount of system training received, and use of Medical Subject Headings (MeSH). There was a negative association between the amount of time spent in patient care and implementation level. General practitioners and family physicians had lower implementation levels than physicians in other specialties. Successful implementers were more likely to be computer literate and to place a high value on formal information sources such as books, journals, and libraries. Health professionals using so-called "user-friendly" or menu-based software had lower levels of personal commitment to using online databases, as measured by a combination of continuance of use, willingness to pay personally, type of recommendations made to colleagues, and hardware ownership. 相似文献
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Heidi J. Mortensen Jeffrey L. Alexander Guy M. Nehrenz Cynthia Porter 《Health information and libraries journal》2013,30(1):23-34
Objectives
The aims of this study were to: 1) establish whether infection control professionals (ICPs) who had access to and utilised medical librarian services for evidence‐based medicine (EBM) research perceived this assistance to be useful and 2) to establish whether ICPs who used electronic or hard copy resources for EBM research perceived that those resources had a significant impact on their work.Methods
Convenience sampling was used to collect quantitative data via a questionnaire. Study participants were members of South‐west and Western chapters of the Association for Professionals in Infection Control and Epidemiology. There were 264 questionnaires distributed in this study; 179 participants completed the questionnaire. The response rate for eligible respondents was 59.5% (157).Results
Results indicated 56.7% (51) of the ICPs with librarian access reported requesting assistance from their work facility librarian. In reference to locating infection control information, 77.9% (95), 87.3% (124) and 93.3% (138) of ICPs found textbooks, journals and the Internet ‘very useful’ or ‘useful’, respectively.Conclusion
Study results indicated ICPs who used the assistance of medical librarians and/or hard copy or electronic resources for EBM research perceived such sources to be valuable for obtaining infection control information. 相似文献18.
临床实践指南(简称指南)和专家共识(简称共识)作为医疗实践的重要指导性文件,可以规范医务人员的诊疗行为,提升医疗服务质量、降低医疗成本,是医务人员进行决策的准则和依据。指南/共识的规范化报告有助于提升其学术质量、权威性和透明性,可以促进其有效传播与实施,因此提升指南/共识报告质量具有重要现实意义。本文分析了目前我国医学科技期刊指南/共识的报告现状及存在问题,并从出台相关政策、开展培训、宣传推广等方面提出相应建议与对策,以期为提升我国指南/共识报告质量提供思路,推进医学期刊高质量发展。 相似文献
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Sue Lacey Bryant 《Health information and libraries journal》2000,17(2):83-90
General practitioners play a central role in primary care. Clinical Governance and advances in Information and Communications Technology dominate the agenda for change. The aim of this literature review is to indicate publications that have made a significant contribution to understanding of the information wants, needs, behaviour and preferences of family physicians and to identify areas in which there is scope for further research. Concentrating on material published in the 1990s, this review looks at the information needs of family doctors and at their information seeking behaviour. Work on the needs of General Medical Practices and of Primary Care Groups is included. The review discusses studies of information gatekeepers and projects intended to augment access to information services. A few texts are recommended as essential reading. 相似文献