Increasing the quantity and quality of searching for current best evidence to answer clinical questions: protocol and intervention design of the MacPLUS FS Factorial Randomized Controlled Trials

Implementation Science

R Brian Haynes⁶  Alfonso Iorio⁶  Nancy L Wilczynski⁶  Eleanor Pullenayegum⁴  Rick Parrish⁶  Chris Cotoi⁶  Miguel Perez¹  Pavel S Roshanov³  Adam Cohen⁵  Natasha Cohen²  Nicholas Hobson⁶  Emma Iserman⁶  Thomas Agoritsas⁶ 

[1] Formerly with the HiRU, Department of Clinical Epidemiology and Biostatistics, McMaster University, Faculty of Health Sciences, Hamilton, ON, Canada;Department of Surgery, McMaster University, Hamilton, ON, Canada;Schulich School of Medicine and Dentistry, Western University, London, ON, Canada;Child Health Evaluative Sciences, Hospital for Sick Children, Toronto; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada;Adam Cohen Web Designs, Hamilton, ON, Canada;Health Information Research Unit (HiRU), CRL Building, #135, Department of Clinical Epidemiology and Biostatistics, McMaster University, Faculty of Health Sciences, 1280 Main Street West, Hamilton L8S 4 K1, ON, Canada

关键词: Search engines;    Web-based resources;    Audit and feedback;    Knowledge translation;    Evidence retrieval;    Evidence-based medicine;   

Others  :  1164487
DOI  :  10.1186/s13012-014-0125-9

 received in 2014-07-04, accepted in 2014-09-04,  发布年份 2014

【 摘 要 】

Background & aims

Finding current best evidence for clinical decisions remains challenging. With 3,000 new studies published every day, no single evidence-based resource provides all answers or is sufficiently updated. McMaster Premium LiteratUre Service ¿ Federated Search (MacPLUS FS) addresses this issue by looking in multiple high quality resources simultaneously and displaying results in a one-page pyramid with the most clinically useful at the top. Yet, additional logistical and educational barriers need to be addressed to enhance point-of-care evidence retrieval. This trial seeks to test three innovative interventions, among clinicians registered to MacPLUS FS, to increase the quantity and quality of searching for current best evidence to answer clinical questions.

Methods & design

In a user-centered approach, we designed three interventions embedded in MacPLUS FS: (A) a web-based Clinical Question Recorder; (B) an Evidence Retrieval Coach composed of eight short educational videos; (C) an Audit, Feedback and Gamification approach to evidence retrieval, based on the allocation of `badges¿ and `reputation scores.¿

We will conduct a randomized factorial controlled trial among all the 904 eligible medical doctors currently registered to MacPLUS FS at the hospitals affiliated with McMaster University, Canada. Postgraduate trainees (n?=?429) and clinical faculty/staff (n?=?475) will be randomized to each of the three following interventions in a factorial design (A x B x C). Utilization will be continuously recorded through clinicians¿ accounts that track logins and usage, down to the level of individual keystrokes. The primary outcome is the rate of searches per month per user during the six months of follow-up. Secondary outcomes, measured through the validated Impact Assessment Method questionnaire, include: utility of answers found (meeting clinicians¿ information needs), use (application in practice), and perceived usefulness on patient outcomes.

Discussion

Built on effective models for the point-of-care teaching, these interventions approach evidence retrieval as a clinical skill. If effective, they may offer the opportunity to enhance it for a large audience, at low cost, providing better access to relevant evidence across many top EBM resources in parallel.

Trial registration

ClinicalTrials.Gov NCT02038439 webcite.

【 授权许可】

   
2014 Agoritsas et al.; licensee BioMed Central Ltd.

【 图 表 】

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