A review of online evidence-based practice point-of-care information summary providers

Abstract

Background: Busy clinicians need easy access to evidence-based information to inform their clinical practice. Publishers and organizations have designed specific tools to meet doctors' needs at the point of care.

Objective: The aim of this study was to describe online point-of-care summaries and evaluate their breadth, content development, and editorial policy against their claims of being "evidence-based."

Methods: We searched Medline, Google, librarian association websites, and information conference proceedings from January to December 2008. We included English Web-based point-of-care summaries designed to deliver predigested, rapidly accessible, comprehensive, periodically updated, evidence-based information to clinicians. Two investigators independently extracted data on the general characteristics and content presentation of summaries. We assessed and ranked point-of-care products according to: (1) coverage (volume) of medical conditions, (2) editorial quality, and (3) evidence-based methodology. We explored how these factors were associated.

Results: We retrieved 30 eligible summaries. Of these products, 18 met our inclusion criteria and were qualitatively described, and 16 provided sufficient data for quantitative evaluation. The median volume of medical conditions covered was 80.6% (interquartile range, 68.9%-84.2%) and varied for the different products. Similarly, differences emerged for editorial policy (median 8.0, interquartile range 5.8-10.3) and evidence-based methodology scores (median 10.0, interquartile range 1.0-12.8) on a 15-point scale. None of these dimensions turned out to be significantly associated with the other dimensions (editorial quality and volume, Spearman rank correlation r = -0.001, P = .99; evidence-based methodology and volume, r = -0.19, P = .48; editorial and evidence-based methodology, r = 0.43, P =.09).

Conclusions: Publishers are moving to develop point-of-care summary products. Some of these have better profiles than others, and there is room for improved reporting of the strengths and weaknesses of these products.

Figure 1

The ‘‘5S’’ levels of organization of evidence from health care research (adapted from Haynes [6])

Figure 2

Flow diagram of the EBP point-of-care summary providers included in the analysis

Figure 3

EBP point-of-care summary provider volume estimated on four random chapters of the ICD-10 classification

Figure 4

EBP point-of-care summary provider ranking for volume, editorial quality and evidence-based methodology. (Black represents the bottom quartile; dark grey represents the low intermediate quartile; light grey represent the high intermediate quartile; and white represents the top quartile.)