Missouri University Informatics Institute, Columbia, MO 65211, USA.
Appl Clin Inform. 2012 Sep 6;3(3):326-33. doi: 10.4338/ACI-2012-06-RA-0024. Print 2012.
Smartphones are increasingly important for clinical decision support, but smartphone and Internet use are limited by cost or coverage in many settings. txt2MEDLINE provides access to published medical evidence by text messaging. Previous studies have evaluated this approach, but we found no comparisons with other tools in this format.
To compare txt2MEDLINE with other databases for answering clinical queries by text messaging in low-resource settings.
Using varied formats, we searched txt2MEDLINE and five other search portals (askMEDLINE, Cochrane, DynaMed, PubMed PICO, and UpToDate) to develop optimal strategies for each. We then searched each database again with five benchmark queries, using the customized search-optimization formats. We truncated the results to less than 480 characters each to simulate delivering them to a maximum of three text messages. Clinicians with practice experience in low-resource areas scored the results on a 5-point Likert scale.
Median scores and standard deviations from 17 reviewers were: txt2M2MEDLINE, 3.2±0.82 (control); askMEDLINE, 3.2±0.90 (p = 0.918); Cochrane, 3.8±0.58 (p = 0.073); DynaMed, 3.6±0.65 (p = 0.105); PubMed PICO, 3.6±0.82 (p = 0.005); and UpToDate, 4.0±0.52 (p = 0.002). Our sample size was sufficiently powered to find differences of 1.0 point.
Comparing several possible sources for texting-based clinical-decision-support information, our results did not demonstrate one-point differences in usefulness on a scale of 1 to 5. PubMed PICO and UpToDate were significantly better than txt2MEDLINE, but with relatively small improvements in Likert score (0.4 and 0.8, respectively). In a texting-only setting, txt2MEDLINE is comparable to simulated alternatives based on established reference sources.
智能手机在临床决策支持方面变得越来越重要，但在许多环境中，智能手机和互联网的使用受到成本或覆盖范围的限制。txt2MEDLINE 通过短信提供已发表的医学证据。先前的研究已经评估了这种方法，但我们没有发现与其他格式的工具的比较。
在资源匮乏的环境中，通过短信比较 txt2MEDLINE 与其他数据库来回答临床查询。
我们使用不同的格式搜索 txt2MEDLINE 和其他五个搜索门户（askMEDLINE、Cochrane、DynaMed、PubMed PICO 和 UpToDate），为每个门户制定最佳策略。然后，我们使用定制的搜索优化格式再次使用五个基准查询搜索每个数据库。我们将结果截断为每个不到 480 个字符，以模拟将它们发送到最多三个短信。在资源匮乏地区有实践经验的临床医生使用 5 分李克特量表对结果进行评分。
17 名评审员的中位数评分和标准差为：txt2M2MEDLINE，3.2±0.82（对照）；askMEDLINE，3.2±0.90（p=0.918）；Cochrane，3.8±0.58（p=0.073）；DynaMed，3.6±0.65（p=0.105）；PubMed PICO，3.6±0.82（p=0.005）；UpToDate，4.0±0.52（p=0.002）。我们的样本量足以发现 1.0 点的差异。
在比较几种基于短信的临床决策支持信息的可能来源时，我们的结果并没有显示在 1 到 5 的有用性评分上有 1.0 点的差异。PubMed PICO 和 UpToDate 明显优于 txt2MEDLINE，但在李克特评分上仅略有提高（分别为 0.4 和 0.8）。在仅短信的环境中，txt2MEDLINE 与基于既定参考源的模拟替代方案相当。
