Answering clinical questions at the point of care using Cochrane evidence

Article type
Authors
Urquhart B1, MacLehose H2
1Wiley-Blackwell, Chichester, West Sussex, UK
2Cochrane Editorial Unit, London, UK
Abstract
Background: Many summaries and commentaries of Cochrane Reviews are available, but what doctors and other healthcare professionals need at the point of care (before/during/after a patient encounter) is answers to clinical questions. Objectives: To develop new Cochrane content—the ‘‘Cochrane Clinical Answer’’ (CCA), based largely upon the PICO (patient, intervention, comparison, outcome) format. To generate a number of CCAs to assess how easy it is to create this content, to develop the template for this content, and to validate the CCA format via user testing to inform further content generation and product development. Methods: The Cochrane Editorial Unit developed a CCA template and co-ordinated a pilot project inviting a small number of Cochrane entities to write CCAs. All participating entities were asked to provide feedback on the time taken to create a CCA and provide feedback for template development. Members of the Nordic Cochrane Centre designed the user testing plan, and Wiley – Blackwell co-ordinated the first phase of iterative qualitative user testing, conducting one-to-one interviews with physicians during March 2010. Results: 13 CCAs were submitted by 7 different entities, answering clinical questions in the areas of asthma, malaria, tuberculosis rheumatoid arthritis, transplantation and neonatal medicine. The median time taken to produce a CCA was 2.5 (range 1–10) hours. Results from user testing will be included when complete. Conclusions: CCAs have been received positively within The Cochrane Collaboration, but there are still challenges in the creation of this content for use by physicians at the point of care. In the future the template will be revised in response to user testing and author feedback, with the aim of creating a new Cochrane product optimised to translate Cochrane evidence into practice at the point of care.