Fontelo Paul, Liu Fang, Uy Raymonde C
National Library of Medicine, Bethesda, Maryland, USA.
Evid Based Med. 2015 Oct;20(5):156-61. doi: 10.1136/ebmed-2015-110250. Epub 2015 Sep 2.
In 1998, the “Evidence Cart” was introduced to provide decision-support tools at the point of care. A recent study showed that a majority of doctors who previously stated that evidence was not needed sought it nevertheless when it was easily available. In this study, invited clinicians were asked to rate the usefulness of evidence provided as abstracts and “the bottom-line summaries” (TBL) using a modified version of a Web app for searching PubMed and then specify reasons how it might affect their clinical decision-making. The responses were captured in the server’s log. One hundred and one reviews were submitted with 22 reviews for abstracts and 79 for TBLs. The overall usefulness Likert score (1=least useful, 7=most useful) was 5.02±1.96 (4.77±2.11 for abstracts and 5.09±1.92 for TBL). The basis for scores was specified in only about half (53/101) of reviews. The most frequent single reason (32%) was that it led to a new skill, diagnostic test, or treatment plan. Two or more reasons were given in 16 responses (30.2%). Two-thirds more responders used TBL summaries than abstracts confirming further that clinicians prefer convenient easy-to-read evidence at the point of care. This study seems to show similar results as the Evidence Cart study on the usefulness of evidence in clinical decision-making.
1998年，引入了“证据推车”以在护理现场提供决策支持工具。最近一项研究表明，大多数此前表示不需要证据的医生，在证据容易获取时还是会去寻找。在这项研究中，受邀临床医生被要求使用一个经修改的用于搜索PubMed的网络应用程序，对以摘要和“要点总结”（TBL）形式提供的证据的有用性进行评分，然后具体说明其可能影响临床决策的原因。回复被记录在服务器日志中。共提交了101条评论，其中22条针对摘要，79条针对TBL。总体有用性李克特评分（1 =最无用，7 =最有用）为5.02±1.96（摘要为4.77±2.11，TBL为5.09±1.92）。只有约一半（53/101）的评论中说明了评分依据。最常见的单一原因（32%）是它带来了新技能、诊断测试或治疗方案。16条回复（30.2%）给出了两个或更多原因。使用TBL总结的回复者比使用摘要的多三分之二，这进一步证实临床医生在护理现场更喜欢方便易读的证据。这项研究在证据对临床决策有用性方面似乎显示出与“证据推车”研究相似的结果。
