Online Tools Can Answer Point-of-Care Clinical Questions
SAN FRANCISCO — Finding key clinical information at the point of care has never been easier thanks to e-mail alerts and online search tools, Scott M. Strayer, M.D., said at the annual meeting of the American Academy of Family Physicians.
A robust industry has developed to make clinical decision support available by computer or PDA, said Dr. Strayer, of the department of family medicine at the University of Virginia Health System, Charlottesville.
The new tools come in two categories—“foraging” tools allow physicians to keep up to date on the latest research and clinical guidelines and “hunting” tools allow them to search for specific clinical information.
Taken together, the tools not only provide physicians with information during a clinical encounter, but, if used widely, are likely to move evidence into practice faster as well, he said.
“Without both, you really don't know that new information is available, and you can't find it when you do,” Dr. Strayer said.
Some examples of available foraging tools include:
▸ InfoPoems (www.infopoems.com
▸ Journal Alerts (www.globalfamilydoctor.com/journalalerts/journalalerts.asp
Hunting tools include:
▸ InfoPoems (www.infopoems.com
▸ Up to Date (www.uptodateonline.com
▸ DynaMed (www.dynamicmedical.com
Dr. Strayer, who did not disclose any financial relationships with the products discussed, said physicians should be aware that not all of these tools are created equal.
When evaluating clinical decision support tools, it's important to see how the information is filtered. Is the information patient oriented or disease oriented? Is it specialty specific? Is it comprehensive? Which journals does it scan? Will the information change your practice or is it simply news?
Physicians also need to consider whether the information provided is valid, he said.
Dr. Strayer recommended looking for labels with the level of evidence used.
And physicians should beware of “Trojan horse” sites that look independent but are sponsored by drug companies, for example. When using these tools, physicians should be aware if there is any bias to the information, he said.
Before committing to a product, physicians should also determine how well the information is summarized, Dr. Strayer said. The summary should be accurate, provide context, and be more comprehensive than just an abstract.
