Verhoeven Anita A H, Schuling Jan
University Library and Department of General Practice, University of Groningen, Ant. Deusinglaan 1, 9713 AV Groningen, The Netherlands.
Health Info Libr J. 2004 Sep;21 Suppl 2:27-35. doi: 10.1111/j.1740-3324.2004.00524.x.
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.
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.
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.
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.
对于全科医生而言，实施循证医学的一个重要障碍是时间不足。为此开发了一项循证应答服务，该服务从全科医生手中接管了医学证据的检索和评估工作。全科医生提交问题，信息专家撰写答案。我们的目的是了解这样一项循证应答服务是否可行，包括评估答案对全科医生及其患者的影响，这由全科医生报告。
在参加了一个关于从日常实践中构建规范问题的研讨会后，全科医生向信息专家提交问题。检索文献，评估相关信息，并撰写问题答案。通过问卷调查评估答案对全科医生和患者的影响，以及实施答案所感知到的障碍。
共收到26位全科医生提交的61个问题。12%的问题找到了证据等级最高的信息，36%的问题未找到信息。然而，对于89%未找到信息的问题，“未找到信息”这一答案对相关全科医生产生了影响。总体而言，所有答案中有81%对全科医生产生了影响，并且据全科医生称，52%的答案对患者产生了影响。实施证据所感知到的障碍很少。大多数答案来自PubMed/Medline、考克兰图书馆和Embase。
本研究表明，循证应答服务可对全科医生及其患者产生影响。图书馆员可为全科医生及其患者提供循证应答服务。本研究中的全科医生循证应答服务对81%的全科医生及其52%的患者产生了影响。尽管三分之一的问题未找到循证答案，但这一信息本身对89%的全科医生产生了影响。信息专家作为医学信息与医生之间的调解人可以节省医生的时间。
