When less is more: a practical approach to searching for evidence-based answers

The information needs of practicing clinicians are distinct from the needs of students, researchers, or nonclinical personnel. Clinicians seek information to stay current with new relevant medical developments and to find answers to patient-specific questions. The volume of available information makes clinicians' tasks of rapidly identifying high-quality studies daunting. New tools evaluate the rigor and relevance of information and summarize it in the form of synthesized clinical answers. These sources have the opposite focus of many other information tools in that they strive to provide less information rather than more. With the development of these sources of validated and refined information, a new search approach is needed to locate clinical information in which speed is the benchmark. The existing medical literature, including these new refinement tools, can be conceptualized as a pyramid, with the most useful information, based on validity and relevance, placed at the apex. Use of this hierarchy allows searchers to drill down through progressive layers until they find their answers. Librarians can play a significant role in evaluating the ever-increasing variety of these synthesized resources, placing them into the searching hierarchy, and training clinicians to search from the top down.