Computerized literature searching in the ambulatory setting using PaperChase

Area of Science:

• Medical Informatics
• Health Services Research

Background:

• Accessing current medical information is crucial for effective patient care.
• Physicians traditionally rely on textbooks and librarian-assisted searches.
• Self-service computerized literature search (SSCLS) systems offer an alternative for information retrieval.

Purpose of the Study:

• To compare the cost-effectiveness and user acceptance of PaperChase (a SSCLS) against conventional methods for accessing medical literature.
• To evaluate the impact of SSCLS on physician attitudes, search costs, and search frequency.

Main Methods:

• A randomized controlled trial involving 57 physicians over one year.
• The experimental group used PaperChase, while the control group used conventional resources (manual searches, librarian-assisted MEDLINE).
• User attitudes were assessed via pre- and post-intervention surveys; costs and search numbers were electronically monitored and recorded.

Main Results:

• PaperChase was cost-effective compared to librarian searches.
• Physician attitudes towards SSCLS did not improve; preference for SSCLS over textbooks and perceived utility in outpatient settings worsened.
• The frequency of all literature searches increased in the experimental group.
• PaperChase searches occasionally altered physicians' perceptions of patient treatment and outcomes.

Conclusions:

• SSCLS, like PaperChase, can be a cost-effective alternative to librarian-assisted searches for medical information.
• Despite cost benefits and increased usage, SSCLS did not enhance physician attitudes and other resources remain important.
• Computerized literature searches may play a role in outpatient settings, though adoption varies among physicians.