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

BMJ - Tập 18 Số 2 - Trang 48-53 - 2013
Alvin Marcelo1,2, Alex Gavino3, Iris Thiele Isip-Tan4, Leilanie Apostol-Nicodemus5, Faith Joan Mesa-Gaerlan6, Paul Nimrod Firaza2, John Francis Faustorilla2, Fiona Callaghan3, Paul Fontelo3
1Department of Surgery, Philippine General Hospital, Manila, Philippines
2National Telehealth Center, University of the Philippines, Manila, Philippines
3National Library of Medicine, National Institutes of Health, Bethesda, Maryland, USA
4Department of Medicine, Philippine General Hospital, Manila, Philippines
5Department of Family and Community Medicine, Philippine General Hospital, Manila, Philippines
6Department of Emergency Medicine, Philippine General Hospital, Manila, Philippines

Tóm tắt

BackgroundMany clinicians depend solely on journal abstracts to guide clinical decisions.ObjectivesThis 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.MethodsSeventy-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.FindingsThe 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.ConclusionsOur 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.

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BMJ

Tập 18 Số 2

48-53

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