Internet access, awareness and utilization of web-based evidence: A survey of Australian, New Zealand and Singaporean radiation oncology registrars*

Increasing utilization of Internet-based resources following efforts to promote evidence-based medicine: a national study in Taiwan

Background

Since the beginning of 2007, the National Health Research Institutes has been promoting the dissemination of evidence-based medicine (EBM). The current study examined longitudinal trends of behaviors in how hospital-based physicians and nurses have searched for medical information during the spread of EBM.

Methods

Cross-sectional postal questionnaire surveys were conducted in nationally representative regional hospitals of Taiwan thrice in 2007, 2009, and 2011. Demographic data were gathered concerning gender, age, working experience, teaching appointment, academic degree, and administrative position. Linear and logistic regression models were used to examine predictors and changes over time.

Results

Data from physicians and nurses were collected in 2007 (n = 1156), 2009 (n = 2975), and 2011 (n = 3999). There were significant increases in the use of four Internet-based resources – Web portals, online databases, electronic journals, and electronic books – across the three survey years among physicians and nurses (p < 0.001). Access to textbooks and printed journals, however, did not change over the 4-year study period. In addition, there were significant relationships between the usage of Internet-based resources and users’ characteristics. Age and faculty position were important predictors in relation to the usage among physicians and nurses, while academic degree served as a critical factor among nurses only.

Conclusions

Physicians and nurses used a variety of sources to look for medical information. There was a steady increase in use of Internet-based resources during the diffusion period of EBM. The findings highlight the importance of the Internet as a prominent source of medical information for main healthcare professionals.

Online medical literature consultation habits of academic teaching physicians in the EU and CIS countries: a cross-sectional study

BACKGROUND

Both in the Commonwealth of Independent States (CIS) and in the European Union (EU2004), ample availability of up to date medical scientific literature is important for progress in medical science and for the education of the next generation of healthcare workers. The aim of this research is to assess if the use of online medical literature among academic teaching (AT) physicians is at the same level in the CIS as in the EU2004.

METHODOLOGY/PRINCIPAL FINDINGS

In the capital cities of the CIS and the EU2004 member states, AT physicians holding an academic position at least equivalent to an associate professor and performing the three classical tasks in academic medicine (teaching, research and patient care) were interviewed about their use of and familiarity with the Internet and 9 online literature services, including journals and bibliographical databases such as PubMed (Medline), The Cochrane Library and Web of Science. Library staff members were interviewed about the availability of these online literature services at their libraries. About 750 physicians and 40 library staff members were invited for participation. Eventually 124 AT physicians and 22 library staff members participated. Internet was everywhere available, but used daily by more AT physicians in the EU2004 (71% versus 48% in the CIS, P = .005). AT physicians in the EU2004 accessed a higher percentage of all articles online (74% versus 43% in the CIS, P<.001). PubMed (P<.001), The Cochrane Library (P<.001) and Web of Science (P<.003) were used more frequently in the EU2004. In the EU2004 more AT physicians were familiar with Open Access journals (89% versus 51% in the CIS, P<.001).

CONCLUSIONS/SIGNIFICANCE

AT physicians in the CIS use online medical literature less than in the EU2004. It is recommended that the awareness of freely available online literature services such as Open Access journals is enhanced among AT physicians and library staff members, especially in the CIS.

eviQ cancer treatments online: how does the web-based protocol system fare in a comprehensive quality assessment?

AIMS

There have been few evaluations of the quality of computerized decision support tools in medical oncology despite their widespread use in clinical practice. In this article, we provide an in-depth quality assessment of eviQ, an Australian web-based protocol system.

METHODS

We used the Appraisal of Guidelines for Research and Evaluation (AGREE-II) instrument to examine the quality of eviQ chemotherapy protocols across six domains: scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability, editorial independence and overall quality rating. Domain scores were categorized as high quality (scores of >70%), moderate quality (30-70%), and low quality (<30%).

RESULTS

eviQ was rated highly with respect to articulating its scope and purpose, clarity of presentation, applicability and on the overall rating item (scores of 72-80%). Domains addressing the involvement of stakeholders in the development process and the rigor with which protocols were developed were of moderate quality (scores of 34-37%) and the management of editorial independence and conflict of interest issues were rated in the low quality range (22%).

CONCLUSION

Our evaluation demonstrated the eviQ protocol system is generally of high quality. However, we identified a number of areas in which eviQ could improve either its development processes or the means by which these processes are communicated to end-users. This research represents the first comprehensive evaluation of oncology protocols and paves the way for continued quality assurance research to ensure that these tools meet their objective of facilitating evidence-based medicine, standardizing treatment and, ultimately, improving patient outcomes.

The quality of web-based oncology guidelines and protocols: how do international sites stack up?

BACKGROUND

The Internet is a popular medium for disseminating information relevant to oncology practitioners. Despite the widespread use of web-based guidelines and protocols, the quality of these resources has not been evaluated. This study addresses this gap.

METHODS

The Appraisal of Guidelines for Research and Evaluation (AGREE-II) instrument was used to assess the quality of breast and sarcoma guidelines and protocols according to six independent domains. The oncology resources were selected from eight websites developed for healthcare settings in North America, the United Kingdom, Europe, and Australia.

RESULTS

Mean quality scores across domains were highly variable for both guidelines (29-73%) and protocols (31-71%). Guidelines scored highly in terms of articulating their Scope and Purpose (72.6 ± 11.2%) but poorly with respect to Applicability in clinical practice (29.0 ± 17.3%). Protocols scored highly on Clarity of Presentation (70.6 ± 17.6%) but poorly in terms of the processes used to synthesise underlying evidence, develop, and update recommendations (30.8 ± 20.0%).

CONCLUSION

Our evaluation provides a quick reference tool for clinicians about the strengths and limitations of oncology resources across several major websites. Further, it supports resource developers in terms of where to direct efforts to enhance guideline and protocol development processes or the communication of these processes to end-users.

Physicians' characteristics in the usage of online database: a representative nationwide survey of regional hospitals in Taiwan

Physicians have to deal with a broad range of medical problems in clinical practice, thus making the timely acquisition of relevant information is a critical skill for physicians to improve care quality. The current national study investigates how physicians search for medical information and analyses how they use online medical databases. A structured questionnaire survey was conducted, with 457 valid returns collected. Internet-based resources (Web portals, online databases, and electronic journals) were more often accessed by physicians to look for medical information than personal or paper ones. Almost universally, physicians have accessed online databases. MEDLINE was the most frequently accessed database. Furthermore, physicians under 50 years old tended to access online databases more often than their elder colleagues (OR = 5.27, 95% CI = 1.96-14.14 for age <35; OR = 4.68, 95% CI = 2.07-10.60 for ages 35-50). In addition, physicians with faculty position were more often accessing online databases (OR = 3.32; 95% CI = 1.75-6.30). Other factors - including clinical experience, administrative position, gender, academic degree, and professional specialty - carried no significant differences. These data may assist in determining how to promote the use of online evidence-based medical information for clinical services.

Radiation therapists and the Internet: a perspective from Australia

The Internet is an important information source for health practitioners; yet little is known of how radiation therapists (RTs) are currently using this vast information resource for their professional learning. In 2007, a four-page postal survey was sent to a random sample of 1,142 Medical Radiation Science practitioners with a response rate of 32.8%, which included 76 RTs. This paper reports and analyses the questionnaire responses from RTs on the use of the Internet to update their professional knowledge and issues affecting accessibility to the Internet in the workplace. This research provides an initial data set on the professional use of Internet-based tools and resources by Australian RTs. It has been shown that the Internet is an important information source widely used by RTs as they search the Internet (89%), access specific web pages (85%), use e-mail (84%) and listservs (49%) to update their professional knowledge. Although all RTs reported Internet access within their workplace, a number of factors have been identified which at present limit accessibility of current quality health and medical information through the Internet to RTs. A large number of RTs were unaware of Internet-based resources, such as Cochrane Library (48%) and GoogleScholar (42%), which support evidence-based practice (EBP) and research. RTs in teaching environments had greater access to computers with Internet access than their colleagues in non-teaching environments (p = 0.044). More RTs in the private sector (22%) reported they had ‘no’ access to the Internet in their workplace than their public sector colleagues (4%, p = 0.037). In addition, RTs in metropolitan workplaces had greater access to protected time during work hours for professional reading or study than their non-metropolitan colleagues (p = 0.000). These issues of non-uniformity of resources across workplaces and knowledge gaps within the profession must be addressed so that all RTs can avail themselves of high quality resources available through the Internet that support them in implementing EBP and meeting the mandatory requirement of updating their professional knowledge.

The information-seeking behaviour of doctors: a review of the evidence

This paper provides a narrative review of the available literature from the past 10 years (1996-2006) that focus on the information seeking behaviour of doctors. The review considers the literature in three sub-themes: Theme 1, the Information Needs of Doctors includes information need, frequency of doctors' questions and types of information needs; Theme 2, Information Seeking by Doctors embraces pattern of information resource use, time spent searching, barriers to information searching and information searching skills; Theme 3, Information Sources Utilized by Doctors comprises the number of sources utilized, comparison of information sources consulted, computer usage, ranking of information resources, printed resource use, personal digital assistant (PDA) use, electronic database use and the Internet. The review is wide ranging. It would seem that the traditional methods of face-to-face communication and use of hard-copy evidence still prevail amongst qualified medical staff in the clinical setting. The use of new technologies embracing the new digital age in information provision may influence this in the future. However, for now, it would seem that there is still research to be undertaken to uncover the most effective methods of encouraging clinicians to use the best evidence in everyday practice.