Haynes R Brian, Cotoi Chris, Holland Jennifer, Walters Leslie, Wilczynski Nancy, Jedraszewski Dawn, McKinlay James, Parrish Richard, McKibbon K Ann
Health Information Research Unit, Department of Clinical Epidemiology and Biostatistics, Michael G. DeGroote School of Medicine, McMaster University, Faculty of Health Sciences, Hamilton, Ontario, Canada.
JAMA. 2006 Apr 19;295(15):1801-8. doi: 10.1001/jama.295.15.1801.
Most articles in clinical journals are not appropriate for direct application by individual clinicians.
To create a second order of clinical peer review for journal articles to determine which articles are most relevant for specific clinical disciplines.
A 2-stage prospective observational study in which research staff reviewed all issues of over 110 (number has varied slightly as new journals were added or discarded from review but number has always been over 110) clinical journals and selected each article that met critical appraisal criteria from January 2003 through the present. Practicing physicians were recruited from around the world, excluding Northern Ontario, to the McMaster Online Rating of Evidence (MORE) system and registered as raters according to their clinical disciplines. An automated system assigned each qualifying article to raters for each pertinent clinical discipline, and recorded their online assessments of the articles on 7-point scales (highest score, 7) of relevance and newsworthiness (defined as useful new information for physicians). Rated articles fed an online alerting service, the McMaster Premium Literature Service (PLUS). Physicians from Northern Ontario were invited to register with PLUS and then receive e-mail alerts about articles according to MORE system peer ratings for their own discipline. Online access by PLUS users of PLUS alerts, raters' comments, article abstracts, and full-text journal articles was automatically recorded.
Clinical rater recruitment and performance. Relevance and newsworthiness of journal articles to clinical practice in the discipline of the rating physician.
Through October 2005, MORE had 2139 clinical raters, and PLUS had 5892 articles with 45 462 relevance ratings and 44 724 newsworthiness ratings collected since 2003. On average, clinicians rated systematic review articles higher for relevance to practice than articles with original evidence and lower for useful new information. Primary care physicians rated articles lower than did specialists (P<.05). Of the 98 physicians who registered for PLUS, 88 (90%) used it on 3136 occasions during an 18-month test period.
This demonstration project shows the feasibility and use of a post-publication clinical peer review system that differentiates published journal articles according to the interests of a broad range of clinical disciplines.
临床期刊上的大多数文章并不适合临床医生直接应用。
为期刊文章创建二级临床同行评审，以确定哪些文章与特定临床学科最为相关。
一项两阶段前瞻性观察性研究，研究人员审查了110多种（随着新期刊的增加或从审查中剔除，数量略有变化，但始终超过110种）临床期刊的所有期次，并挑选出从2003年1月至今符合关键评估标准的每篇文章。从世界各地（不包括安大略省北部）招募执业医师加入麦克马斯特证据在线评级（MORE）系统，并根据他们的临床学科注册为评分者。一个自动化系统将每篇合格文章分配给每个相关临床学科的评分者，并记录他们在7分制（最高分7分）上对文章相关性和新闻价值（定义为对医生有用的新信息）的在线评估。被评级的文章为在线警报服务——麦克马斯特高级文献服务（PLUS）提供信息。邀请安大略省北部的医生注册PLUS，然后根据MORE系统对其自身学科的同行评级接收有关文章的电子邮件警报。PLUS用户对PLUS警报、评分者评论、文章摘要和全文期刊文章的在线访问情况会自动记录下来。
临床评分者的招募与表现。期刊文章与评分医生所在学科临床实践的相关性和新闻价值。
截至2005年10月，MORE有2139名临床评分者，PLUS有5892篇文章，自2003年以来共收集到45462个相关性评级和44724个新闻价值评级。平均而言，临床医生对系统评价文章与实践相关性的评分高于有原始证据的文章，但对有用新信息的评分较低。初级保健医生对文章的评分低于专科医生（P<0.05）。在注册PLUS的98名医生中，88名（90%）在18个月的测试期内使用了3136次。
该示范项目表明了一种出版后临床同行评审系统的可行性和实用性，该系统可根据广泛临床学科的兴趣对已发表的期刊文章进行区分。
