Speed of updating online evidence based point of care summaries: prospective cohort analysis
BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d5856 (Published 23 September 2011) Cite this as: BMJ 2011;343:d5856
- Rita Banzi, researcher12,
- Michela Cinquini, statistician2,
- Alessandro Liberati, associate professor13,
- Ivan Moschetti, general practitioner1,
- Valentina Pecoraro, researcher1,
- Ludovica Tagliabue, medical resident14,
- Lorenzo Moja, assistant professor14
- 1Italian Cochrane Centre, Mario Negri Institute for Pharmacological Research, Milan, Italy
- 2Mario Negri Institute for Pharmacological Research, Milan
- 3Department of Oncology, Hematology and Respiratory Diseases, University of Modena and Reggio Emilia, Modena
- 4Department of Public Health, Microbiology and Virology, University of Milan, Milan
- Correspondence to: Rita Banzi Mario Negri Institute for Pharmacological Research, Via G. La Masa 19, 20156 Milan, Italy rita.banzi{at}marionegri.it
- Accepted 5 August 2011
Abstract
Objective To evaluate the ability of international point of care information summaries to update evidence relevant to medical practice.
Design Prospective cohort bibliometric analysis.
Setting Top five point of care information summaries (Clinical Evidence, EBMGuidelines, eMedicine, Dynamed, UpToDate) ranked for coverage of medical conditions, editorial quality, and evidence based methodology.
Main outcome measures From June 2009 to May 2010 we measured the incidence of research findings relating to potentially eligible newsworthy evidence. As samples, we chose systematic reviews rated as relevant by international research networks (such as, Evidence-Based Medicine, ACP Journal Club, and the Cochrane Collaboration). Every month we assessed whether each sampled review was cited in at least one chapter of the five summaries. The cumulative updating rate was analysed with Kaplan-Meier curves.
Results From April to December 2009, 128 reviews were retrieved; 53% (68) from the literature surveillance journals and 47% (60) from the Cochrane Library. At nine months, Dynamed had cited 87% of the sampled reviews, while the other summaries had cited less than 50%. The updating speed of Dynamed clearly led the others. For instance, the hazard ratios for citations in EBM Guidelines and Clinical Evidence versus the top performer were 0.22 (95% confidence interval 0.17 to 0.29) and 0.03 (0.01 to 0.05).
Conclusions Point of care information summaries include evidence relevant to practice at different speeds. A qualitative analysis of updating mechanisms is needed to determine whether greater speed corresponds to more appropriate incorporation of new information.
Footnotes
We thank Richard Smith for helpful discussion in devising the study and Judith Baggott for editing.
Contributors: RB, AL, LM, and IM devised and designed the study; RB, VP, and LT extracted data; MC, RB, and LM analysed and interpreted data; RB and LM wrote the first draft; all authors contributed to subsequent versions and approved the final article. LM is guarantor.
Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. It was part of the AIFA’s contract to run a series of investigations about point of care products, and this is one of the studies that have emerged from this activity.
Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work. In 2003-8 the Italian Cochrane Centre received grants from the Italian Medicines Agency (AIFA) for the Italian translations of one of the products assessed in the study (Clinical Evidence). The Italian Cochrane Centre is part of the Cochrane Collaboration, which forms a publishing partnership with Wiley-Blackwell to deliver the Cochrane Library through Wiley InterScience. The content of the paper does not represent any official view of the Cochrane Collaboration but solely that of the authors.
Ethical approval: Not required.
Data sharing: The dataset is available from the corresponding author at rita.banzi{at}marionegri.it.
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