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Related Experiment Videos

Using a systematic review in clinical decision making: a pilot parallel, randomized controlled trial.

Laure Perrier1, Nav Persaud2, Kevin E Thorpe3

  • 1Institute of Health Management, Policy and Evaluation, University of Toronto, 155 College Street, Toronto, ON, M5T 3M6, Canada. l.perrier@utoronto.ca.

Implementation Science : IS
|August 16, 2015
PubMed
Summary

Physicians infrequently use systematic reviews. A pilot study tested two shortened formats to improve clinical decision-making, finding investigator agreement satisfactory and a full-scale trial feasible despite low response rates.

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Area of Science:

  • Medical Informatics
  • Evidence-Based Medicine
  • Clinical Decision Support

Background:

  • Physicians underutilize systematic reviews in clinical practice.
  • Filtered, concise resources may improve the uptake of evidence.
  • Two novel shortened systematic review formats were developed.

Purpose of the Study:

  • To pilot test methods for a full-scale trial on shortened systematic review formats.
  • To assess the feasibility of recruiting physicians for a systematic review study.
  • To evaluate the usability and impact of shortened systematic review formats on clinical decision-making.

Main Methods:

  • Physicians in family medicine/general internal medicine were recruited via email.
  • Participants were randomized to read either a shortened or full-length systematic review.
  • Physicians' ability to extract the clinical bottom line and apply it to a scenario was assessed.

Main Results:

  • Fifty-six clinicians completed the pilot study over two months.
  • Investigator agreement on assessing participant responses was 100% (kappa = 1.00).
  • The pilot study achieved its recruitment goals within the timeframe, though response rates were low (4.3%).

Conclusions:

  • Investigator agreement in evaluating participant responses is excellent.
  • Conducting a full-scale trial is feasible, but strategies to improve physician recruitment response rates are needed.
  • Shortened systematic review formats show promise for enhancing clinical decision-making.