A review of online evidence-based practice point-of-care information summary providers: an update

Article type
Authors
Moja L1, Gonzalez Lorenzo M2, Tagliabue L3, Banzi R4
1University of Milan; IRCCS Galeazzi Orthopedic Institute, Italy
2Department of Biomedical Sciences for Health, University of Milan, Italy
3Istituto Auxologico Italiano, Italy
4Mario Negri Institute for Pharmacological Research, Italy
Abstract
Background: Reliable information to solve clinical doubts at the point-of-care is a pillar of modern practice. In 2008, a previous study assessing online evidence-based practice (EBP) point-of-care summaries showed that most products were deficient in respect to at least one dimension in breadth, content development, and editorial policy.

Objectives: To review online EBP point-of-care summaries against their claims of being ‘evidence-based’ and assess whether there has been progress in 2012.

Methods: We searched Medline, Google, and other sources from January 2009 to August 2012. We included English web-based point-of-care summaries designed to deliver pre-digested, rapidly accessible, comprehensive, periodically updated, and evidence-based information to clinicians. We independently extracted data on the general characteristics and content presentation of summaries. We assessed and ranked point-of-care products according to three desirable dimensions for medical information: coverage (volume) of conditions, evidence-based methodology, and editorial quality. We explored how these factors were associated.

Results: We retrieved 42 eligible summaries; 21 products met our inclusion criteria, six of which were new products. Most summaries (n = 15) were produced in United States, a minority (n = 5) in Europe, one in Australia, and none in developing or poorest countries. Products top-ranked for desirable dimensions in 2008, again, scored among the best: Dynamed, EBM guidelines and UpToDate. Best Practice (formerly Clinical Evidence) largely improved its volume. The association between editorial quality and evidence-based methodology was statistically significant (p=0.0093), whereas the other associations were not.

Conclusions: The quality of medical information by point-of-care services improved over time, although many products are still unsatisfactory in basic desirable criteria. Publishers have the responsibility of providing users with the highest standard of editorial contents without over claiming their quality features. These results may have implications when developing new products, including the Cochrane Clinical answers.