Hauser Susan E, Demner-Fushman Dina, Jacobs Joshua L, Humphrey Susanne M, Ford Glenn, Thoma George R
Lister Hill National Center for Biomedical Communications, National Library of Information, 8600 Rockville Pike, Bethesda, MD 20894, USA.
J Am Med Inform Assoc. 2007 Nov-Dec;14(6):807-15. doi: 10.1197/jamia.M2424. Epub 2007 Aug 21.
To evaluate: (1) the effectiveness of wireless handheld computers for online information retrieval in clinical settings; (2) the role of MEDLINE in answering clinical questions raised at the point of care.
A prospective single-cohort study: accompanying medical teams on teaching rounds, five internal medicine residents used and evaluated MD on Tap, an application for handheld computers, to seek answers in real time to clinical questions arising at the point of care.
All transactions were stored by an intermediate server. Evaluators recorded clinical scenarios and questions, identified MEDLINE citations that answered the questions, and submitted daily and summative reports of their experience. A senior medical librarian corroborated the relevance of the selected citation to each scenario and question.
Evaluators answered 68% of 363 background and foreground clinical questions during rounding sessions using a variety of MD on Tap features in an average session length of less than four minutes. The evaluator, the number and quality of query terms, the total number of citations found for a query, and the use of auto-spellcheck significantly contributed to the probability of query success.
Handheld computers with Internet access are useful tools for healthcare providers to access MEDLINE in real time. MEDLINE citations can answer specific clinical questions when several medical terms are used to form a query. The MD on Tap application is an effective interface to MEDLINE in clinical settings, allowing clinicians to quickly find relevant citations.
评估:(1)无线手持计算机在临床环境中进行在线信息检索的有效性;(2)医学索引数据库(MEDLINE)在回答即时医疗问题方面的作用。
一项前瞻性单队列研究:在内科教学查房中跟随医疗团队,五名内科住院医师使用并评估了一款适用于手持计算机的名为“MD on Tap”的应用程序,以实时查找即时医疗中出现的临床问题的答案。
所有交易均由中间服务器存储。评估人员记录临床场景和问题,识别能回答问题的医学索引数据库(MEDLINE)文献,并提交每日及总结性的经验报告。一位资深医学图书馆员证实了所选文献与每个场景和问题的相关性。
在查房期间,评估人员使用“MD on Tap”的各种功能,在平均时长不到四分钟的查房时段内,回答了363个背景和前景临床问题中的68%。评估人员、检索词的数量和质量、为一次检索找到的文献总数以及自动拼写检查的使用,对检索成功的可能性有显著影响。
可接入互联网的手持计算机是医疗服务提供者实时访问医学索引数据库(MEDLINE)的有用工具。当使用多个医学术语形成检索时,医学索引数据库(MEDLINE)文献可以回答特定的临床问题。“MD on Tap”应用程序是临床环境中访问医学索引数据库(MEDLINE)的有效界面,使临床医生能够快速找到相关文献。