循证数据库与医学原始文献：关于其最佳使用的内部调查
Evidence-based databases versus primary medical literature: an in-house investigation on their optimal use.
作者信息
Koonce Taneya Y, Giuse Nunzia Bettinsoli, Todd Pauline
机构信息
Eskind Biomedical Library, Vanderbilt University Medical Center, 220 Garland Avenue, Nashville, Tennessee 37232-8340, USA.
出版信息
J Med Libr Assoc. 2004 Oct;92(4):407-11.
OBJECTIVE
The objective is to investigate the effectiveness of evidence-based medicine (EBM) resources in providing evidence for complex clinical questions versus general care management questions to identify situations for their optimal use.
METHODS
In this investigation, forty complex clinical questions were randomly selected from an in-house archival database of questions received by librarians during clinical rounds. An additional forty questions were selected from a list of general care management questions received by the library from Pathways teams. To measure the effectiveness of resources in answering the questions, a team of librarians was asked to search UpToDate, the Cochrane Database of Systematic Reviews, and HealthGate Clinical Guidelines (formerly, EBM Solutions). The team then established consensus on whether a question was fully or partially answered by one of the above-mentioned EBM resources and was instructed to record the instances in which the primary literature needed to be used to answer the question completely.
RESULTS
The study found that the EBM resources completely answered 20.0% of the 40 complex clinical questions and 47.5% of the 40 general care management questions, partially answered 40.0% of the complex clinical questions and 22.5% of the general care management questions, and did not answer 40.0% of the complex clinical questions and 30.0% of the general care management questions.
CONCLUSION
The pervasive use of EBM resources in answering clinical questions is making it imperative for information specialists to develop an expertise on their appropriate use. By exploring their use in answering complex clinical questions and general care management questions, this paper underlines the strengths and weakness of EBM resources and provides information specialists with some basic knowledge about how these resources can be combined with the primary literature to strengthen their effectiveness.
目的
本研究旨在探讨循证医学（EBM）资源在为复杂临床问题提供证据与为一般护理管理问题提供证据方面的有效性，以确定其最佳使用情况。
方法
在本次调查中，从图书馆员在临床查房期间收到的内部问题存档数据库中随机抽取40个复杂临床问题。另外40个问题则从图书馆从Pathways团队收到的一般护理管理问题列表中选取。为衡量资源回答问题的有效性，要求一组图书馆员检索UpToDate、Cochrane系统评价数据库和HealthGate临床指南（原EBM Solutions）。然后，该团队就是否有上述EBM资源之一完全或部分回答了某个问题达成共识，并被要求记录需要使用原始文献才能完全回答问题的情况。
结果
研究发现，EBM资源完全回答了40个复杂临床问题中的20.0%以及40个一般护理管理问题中的47.5%，部分回答了40.0%的复杂临床问题和22.5%的一般护理管理问题，未回答40.0%的复杂临床问题和30.0%的一般护理管理问题。
结论
在回答临床问题时广泛使用EBM资源使得信息专家必须掌握其恰当的使用方法。通过探讨EBM资源在回答复杂临床问题和一般护理管理问题中的应用，本文强调了EBM资源的优势与不足，并为信息专家提供了一些关于如何将这些资源与原始文献相结合以增强其有效性的基础知识。
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