Laval University, Département de médecine familiale et de médecine d'urgence, Hôpital St-François d'Assise, D6-728, 10 rue de l'Espinay, Quebec city, QC G1L 3L5.
Can Fam Physician. 2013 Oct;59(10):1084-94.
To compare the ability of users of 2 medical search engines, InfoClinique and the Trip database, to provide correct answers to clinical questions and to explore the perceived effects of the tools on the clinical decision-making process.
Randomized trial.
Three family medicine units of the family medicine program of the Faculty of Medicine at Laval University in Quebec city, Que.
Fifteen second-year family medicine residents.
Residents generated 30 structured questions about therapy or preventive treatment (2 questions per resident) based on clinical encounters. Using an Internet platform designed for the trial, each resident answered 20 of these questions (their own 2, plus 18 of the questions formulated by other residents, selected randomly) before and after searching for information with 1 of the 2 search engines. For each question, 5 residents were randomly assigned to begin their search with InfoClinique and 5 with the Trip database.
The ability of residents to provide correct answers to clinical questions using the search engines, as determined by third-party evaluation. After answering each question, participants completed a questionnaire to assess their perception of the engine's effect on the decision-making process in clinical practice.
Of 300 possible pairs of answers (1 answer before and 1 after the initial search), 254 (85%) were produced by 14 residents. Of these, 132 (52%) and 122 (48%) pairs of answers concerned questions that had been assigned an initial search with InfoClinique and the Trip database, respectively. Both engines produced an important and similar absolute increase in the proportion of correct answers after searching (26% to 62% for InfoClinique, for an increase of 36%; 24% to 63% for the Trip database, for an increase of 39%; P = .68). For all 30 clinical questions, at least 1 resident produced the correct answer after searching with either search engine. The mean (SD) time of the initial search for each question was 23.5 (7.6) minutes with InfoClinique and 22.3 (7.8) minutes with the Trip database (P = .30). Participants' perceptions of each engine's effect on the decision-making process were very positive and similar for both search engines.
Family medicine residents' ability to provide correct answers to clinical questions increased dramatically and similarly with the use of both InfoClinique and the Trip database. These tools have strong potential to increase the quality of medical care.
比较 2 款医学搜索引擎（InfoClinique 和 Trip 数据库）的用户提供临床问题正确答案的能力，并探讨工具对临床决策过程的潜在影响。
随机试验。
魁北克市拉瓦尔大学医学系家庭医学计划的 3 个家庭医学单位。
15 名家庭医学二年级住院医师。
住院医师根据临床就诊情况生成 30 个关于治疗或预防治疗的结构化问题（每位住院医师 2 个问题）。使用专为该试验设计的互联网平台，每位住院医师在使用 1 款搜索引擎搜索信息之前和之后回答其中的 20 个问题（他们自己的 2 个问题，加上其他 18 个随机选择的由其他住院医师提出的问题）。对于每个问题，随机将 5 名住院医师分配到 InfoClinique 开始搜索，5 名住院医师分配到 Trip 数据库开始搜索。
由第三方评估确定的住院医师使用搜索引擎提供临床问题正确答案的能力。回答完每个问题后，参与者完成一份调查问卷，评估他们对引擎在临床实践中决策过程的影响的看法。
在 300 个可能的答案对（搜索前 1 个，搜索后 1 个）中，有 14 名住院医师提供了 254 对答案（52%）。其中，132 对（52%）和 122 对（48%）答案分别与最初分配给 InfoClinique 和 Trip 数据库的搜索问题相关。在搜索后，这两个引擎都显著且相似地提高了正确答案的比例（InfoClinique 从 26%增加到 62%，增加了 36%；Trip 数据库从 24%增加到 63%，增加了 39%；P =.68）。对于所有 30 个临床问题，至少有 1 名住院医师在使用任何搜索引擎搜索后都给出了正确答案。每个问题的初始搜索平均（SD）时间分别为 23.5（7.6）分钟（InfoClinique）和 22.3（7.8）分钟（Trip 数据库）（P =.30）。参与者对每个引擎对决策过程影响的看法非常积极，并且对这两种搜索引擎的看法相似。
家庭医学住院医师提供临床问题正确答案的能力通过使用 InfoClinique 和 Trip 数据库都得到了显著且相似的提高。这些工具具有提高医疗质量的巨大潜力。
