Cullen Rowena J
School of Information Management, Victoria University of Wellington, New Zealand.
J Med Libr Assoc. 2002 Oct;90(4):370-9.
The aim of the study was to determine the extent of use of the Internet for clinical information among family practitioners in New Zealand, their skills in accessing and evaluating this information, and the ways they dealt with patient use of information from the Internet.
A random sample of members of the Royal New Zealand College of General Practitioners was surveyed to determine their use of the Internet as an information source and their access to MEDLINE. They were asked how they evaluated and applied the retrieved information and what they knew about their patients' use of the Internet. Structured interviews with twelve participants focused in more depth on issues such as the physicians' skills in using MEDLINE and in evaluating retrieved material, their searches for evidence-based information, their understanding of critical appraisal, their patients' use of the Internet, and the ways they handle this use.
More than 80% (294/363) of members in the sample completed and returned the questionnaire. Of these, 48.6% reported that they used the Internet to look for clinical information. Gender and age were more significant in determining use than practice type or location. Information was primarily sought on rare diseases, updates on common diseases, diagnosis, and information for patients. MEDLINE was the most frequently accessed source. Search skills were basic, and abstracts were commonly used if the full text of an item was not readily available. Most reported that up to 10% of patients bring information from the Internet to consultations. Both Internet users and non-Internet users encouraged patients to search the Web. Internet users were more likely to recommend specific sites.
Practitioners urgently need training in searching and evaluating information on the Internet and in identifying and applying evidence-based information. Portals to provide access to high-quality, evidence-based clinical and patient information are needed along with access to the full text of relevant items.
本研究旨在确定新西兰家庭医生利用互联网获取临床信息的程度、他们获取和评估此类信息的技能,以及他们处理患者使用互联网信息的方式。
对新西兰皇家全科医生学院成员进行随机抽样调查,以确定他们将互联网作为信息来源的使用情况以及对医学文献数据库(MEDLINE)的访问情况。询问他们如何评估和应用检索到的信息,以及他们对患者使用互联网的了解程度。对12名参与者进行结构化访谈,更深入地聚焦于诸如医生使用MEDLINE和评估检索材料的技能、他们对循证信息的搜索、他们对批判性评价的理解、患者对互联网的使用,以及他们处理这种使用的方式等问题。
样本中超过80%(294/363)的成员完成并返回了问卷。其中,48.6%报告称他们使用互联网查找临床信息。在决定是否使用互联网方面,性别和年龄比执业类型或地点更具显著性。主要查找的信息是罕见疾病、常见疾病的最新情况、诊断以及患者信息。MEDLINE是最常访问的来源。搜索技能较为基础,如果无法轻易获取某项的全文,则通常使用摘要。大多数人报告称,高达10%的患者会在就诊时带来从互联网上获取的信息。互联网用户和非互联网用户都鼓励患者在网上搜索。互联网用户更有可能推荐特定网站。
从业者迫切需要接受关于在互联网上搜索和评估信息以及识别和应用循证信息方面的培训。需要提供高质量循证临床和患者信息的门户网站,以及获取相关项目全文的途径。