Just in time information for clinicians: a questionnaire evaluation of the ATTRACT projectBMJ 2001; 322 doi: https://doi.org/10.1136/bmj.322.7285.529 (Published 03 March 2001) Cite this as: BMJ 2001;322:529
Question No of times question accessed Is there any link between gout and diet? 1483 Is there any general information about the effectiveness of Xenical? 616 Which is the best depression scoring system? 588 What are the risks of flying while pregnant? 581 Do decongestants help in people with eustachian tube dysfunction? 574 Are there any effective treatments for proctalgia fugax? 464 What is the effectiveness of combined paracetamol and opiates? 459*Which questions were viewed the most by visitors to the now defunct TRIP website. The TRIP website was accessible to anyone with access to the internet.
Three main databases were used to search:
· The Cochrane Library (based on desktop computer)
· TRIP Database (www.tripdatabase.com)
· PubMed (www.ncbi.nlm.nih.gov/entrez/query.fcgi)
If necessary, other sources were used but only if suitable answers weren’t found with the above. Other sources included Best Evidence, Cinahl, and general internet search engines.
On receipt of the question appropriate search terms were selected and used in the databases. In the case of PubMed, "Related articles" was used for any article found that helped answer the question. This could significantly increase the number of relevant "hits." PubMed was searched only if suitable recent articles were not found in the first two databases.
All the articles found underwent a rapid appraisal process. In the case of material from the Cochrane Library all systematic reviews and entries from the Centre for Reviews and Dissemination had already been critically appraised, as was the case for material on the TRIP Database. This reliance on articles already critically appraised underpinned the rapid nature of the ATTRACT service.
However, all relevant articles found were appraised with regard to the following questions:
· Does it help answer the question?
· Date of publication?
· Sample size?
· Location—geographic and sector (primary versus secondary care)?
· Length of follow up?
· Drop out rates?
· Outcomes used?
· What were the results?
All the information received was read and appraised simultaneously and relevant notes made based on the appraisal technique outlined above. The notes were then written up in the form of a summary. In the summary a paper might receive the following comment:
"This 1997 randomised controlled trial examined 66 patients with chronic fatigue syndrome. The study, based in a UK hospital, saw half the patients receive graded aerobic exercise and the other half flexibility exercises and relaxation therapy. In the latter group crossover to exercise was allowed. In total 4 patients in the exercise group and three in the flexibility group dropped out. The primary outcome was a self-reported self-rated clinical global impression change score, ‘very much better’ or ‘much better’ being considered as clinically important. In the exercise group 17/33 patients reported being better compared with 9/33 in the relaxation group (based on an intention to treat analysis). The author concluded that ‘These findings support the use of appropriately prescribed graded aerobic exercise in the management of patients with the chronic fatigue syndrome.’"
This summary is based on the paper: Fulcher KY, White PD. Randomised controlled trial of graded exercise in patients with the chronic fatigue syndrome. BMJ 1997;314:1647-52.
This process was repeated for all the articles used, and the resulting material was faxed to the requester with a list of references.
- Clinical Review Published: 13 October 2005; BMJ 331 doi:10.1136/bmj.331.7521.892
- Letter Published: 21 July 2001; BMJ 323 doi:10.1136/bmj.323.7305.167/a
- Letter Published: 21 July 2001; BMJ 323 doi:10.1136/bmj.323.7305.166
- BMA demands urgent meeting with health secretary over GP appointments rowBMJ May 18, 2021, 373 n1276; DOI: https://doi.org/10.1136/bmj.n1276
- Rammya Mathew: Digital access has opened the floodgates to patient demandBMJ May 18, 2021, 373 n1246; DOI: https://doi.org/10.1136/bmj.n1246
- Helen Salisbury: GPs deserve better than this micromanagementBMJ May 18, 2021, 373 n1256; DOI: https://doi.org/10.1136/bmj.n1256
- Chloramphenicol eye drops: GPs criticise lack of guidance over use in under 2sBMJ May 14, 2021, 373 n1252; DOI: https://doi.org/10.1136/bmj.n1252
- GPs should return to offering face-to-face appointments without prior triage, says NHSBMJ May 14, 2021, 373 n1251; DOI: https://doi.org/10.1136/bmj.n1251
- Answering medical questions at the point of care: a cross-sectional study comparing rapid decisions based on PubMed and Epistemonikos searches with evidence-based recommendations developed with the GRADE approach
- Impact of a GRADE-based medical question answering system on physician behaviour: a randomised controlled trial
- Decision making in family medicine: Randomized trial of the effects of the InfoClinique and Trip database search engines
- Impact of short evidence summaries in discharge letters on adherence of practitioners to discharge medication. A cluster-randomised controlled trial
- The wisdom of Archimedes
- How computers can help to share understanding with patients
- ISABEL: a web-based differential diagnostic aid for paediatrics: results from an initial performance evaluation
- A comparative case study of two models of a clinical informaticist service
- A clinical informaticist to support primary care decision making
- Spirit of collaboration needs fostering
- Code of conduct is needed for publishing raw data