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. michel.labrecque@mfa.ulaval.ca.
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.
Notes
Cites: Bull Med Libr Assoc. 2000 Oct;88(4):323-3111055299
Cites: BMJ. 2011;343:d585621948588
Cites: J Am Med Inform Assoc. 2002 May-Jun;9(3):283-9311971889
Cites: J Am Board Fam Pract. 2004 Jan-Feb;17(1):59-6715014055
Cites: J Contin Educ Health Prof. 2004 Winter;24(1):50-615069912
Cites: JAMA. 1993 Dec 1;270(21):2598-6018230645
Cites: J Fam Pract. 1994 Nov;39(5):489-997964548
Cites: Med Decis Making. 1995 Apr-Jun;15(2):113-97783571
Cites: BMJ. 1999 Aug 7;319(7206):358-6110435959
Cites: J Am Med Inform Assoc. 2005 May-Jun;12(3):315-2115684126
Cites: Int J Med Inform. 2005 Sep;74(9):745-6815996515
Cites: Ann Fam Med. 2005 Nov-Dec;3(6):507-1316338914