Fozi K, Teng C L, Krishnan R, Shajahan Y
Klinik Pesakit Luar, Hospital Kangar, 10000 Kangar.
Med J Malaysia. 2000 Dec;55(4):486-92.
This is a prospective study of clinical questions generated in primary care consultations and a comparison of two approaches to answering those clinical questions. Twenty-one doctors in a university-based primary care clinic submitted 78 clinical questions arising from patient consultations during 24 clinic days (0.01 question per patient encounter). These doctors subsequently found answers to 40% of their questions but were satisfied with only 67% of these answers. The investigators were able to provide answers for 95% of the questions asked and the doctors rated these answers as satisfactory in 86% of instances. Answers obtained by investigators had significantly higher satisfaction score than those obtained by doctors' search (p = 0.002). The two main findings of this study are (1) almost all questions arising in clinic setting could be answered by intensive search; (2) answers found by intensive searches were judged to be more satisfactory than those found routinely by doctors. Provision of an information retrieval service in addition to training in the searching and appraisal of medical literature are possible solutions to the information needs of busy clinicians.
这是一项关于基层医疗会诊中产生的临床问题的前瞻性研究，以及对回答这些临床问题的两种方法的比较。一所大学附属基层医疗诊所的21名医生在24个诊日期间提交了78个源于患者会诊的临床问题（每次患者会诊产生0.01个问题）。这些医生随后找到了40%问题的答案，但对其中仅67%的答案感到满意。研究人员能够为95%的所提问题提供答案，医生在86%的情况下将这些答案评为满意。研究人员获得的答案的满意度得分显著高于医生自行搜索获得的答案（p = 0.002）。本研究的两个主要发现是：（1）几乎所有在临床环境中产生的问题都可以通过深入搜索得到答案；（2）深入搜索找到的答案被认为比医生常规找到的答案更令人满意。除了对医学文献搜索和评估进行培训外，提供信息检索服务可能是满足忙碌临床医生信息需求的解决方案。
