Characterizing physicians' information needs related to a gap in knowledge unmet by current evidence

被引:5
|
作者
Ostropolets, Anna [1 ]
Chen, RuiJun [1 ]
Zhang, Linying [1 ]
Hripcsak, George [1 ,2 ]
机构
[1] Columbia Univ, Dept Biomed Informat, Med Ctr, 622 West 168th St,PH-20, New York, NY 10027 USA
[2] NewYork Presbyterian Hosp, New York, NY USA
基金
美国国家卫生研究院;
关键词
evidence-based medicine; information needs; clinical decision support system; observational studies; PRIMARY-CARE PHYSICIANS; CLINICAL QUESTIONS; PATIENT-CARE; SEEKING BEHAVIOR; BARRIERS; DOCTORS; MEDICINE; POINT;
D O I
10.1093/jamiaopen/ooaa012
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objective: The study sought to explore information needs arising from a gap in clinicians' knowledge that is not met by current evidence and identify possible areas of use and target groups for a future clinical decision support system (CDSS), which will guide clinicians in cases where no evidence exists. Materials and Methods: We interviewed 30 physicians in a large academic medical center, analyzed transcripts using deductive thematic analysis, and developed a set of themes of information needs related to a gap in knowledge unmet by current evidence. We conducted additional statistical analyses to identify the correlation between clinical experience, clinical specialty, settings of clinical care, and the characteristics of the needs. Results: This study resulted in a set of themes and subthemes of information needs arising from a gap in current evidence. Experienced physicians and inpatient physicians had more questions and the number of questions did not decline with clinical experience. The main areas of information needs included patients with comorbidities, elderly and children, new drugs, and rare disorders. To address these questions, clinicians most often used a commercial tool, guidelines, and PubMed. While primary care physicians preferred the commercial tool, specialty physicians sought more in-depth knowledge. Discussion: The current medical evidence appeared to be inadequate in covering specific populations such as patients with multiple comorbidities and elderly, and was sometimes irrelevant to complex clinical scenarios. Our findings may suggest that experienced and inpatient physicians would benefit from a CDSS that generates evidence in real time at the point of care. Conclusions: We found that physicians had information needs, which arose from the gaps in current medical evidence. This study provides insights on how the CDSS that aims at addressing these needs should be designed.
引用
收藏
页码:281 / 289
页数:9
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