OTseeker helps library and allied health professionals to find quality evidence efficiently

Background: Research is essential for evidence‐based practice yet many health professionals do not have enough time to find research. Studies relevant to occupational therapists can be particularly difficult to find. Most search engines are broad and return a large number of irrelevant articles. Occupational Therapy Systematic Evaluation of Evidence (OTseeker) is an occupational therapy database available at http://www.otseeker.com . Developed by Australian occupational therapists, the resource aims to increase access to research and support clinical decision making. This discipline‐specific database contains pre‐appraised information from a variety of sources and decreases the time required to locate best evidence. Objectives: The aims of this paper are to: (i) describe how health librarians can use OTseeker to help allied health students, researchers and practitioners, particularly in occupational therapy, to find quality evidence; (ii) provide a teaching resource for health librarians based around the OTseeker evidence database; and (iii) highlight new features contained on the OTseeker database. Methods: A case study is provided which focuses on searching for evidence on the effectiveness of upper limb rehabilitation after stroke using OTseeker. Conclusion: This paper may increase the knowledge, skills and competencies of health librarians, helping them to access evidence‐based databases, and educate other professionals.     

Evidence in seconds? Format and design considerations in the provision of reliable information to support evidence‐based practice

Evidence‐based practice is gaining support amongst health professionals. However, the major barrier remains the lack of time to read the literature. There are also problems with the take‐up and use of evidence‐based information sources such as Cochrane reviews and Effective Health Care bulletins. If such evidence is to be incorporated into local guidelines and used in day‐to‐day practice, practitioners request that these and other reliable publications be further summarized in short packages and available within seconds. The Health Evidence Bulletins Wales offer a model for this approach. The Bulletins have gone through several developmental stages leading to a novel two‐column format. In the first column, brief statements summarize the best available evidence within a topic area. In the second, full details are provided of the supporting publications (and the evidence type, or research design) with links to the full text of documents, where possible from the electronic versions of each Bulletin. Results from a questionnaire study using a random sample and unsolicited feedback suggest that this ‘two‐tier’ approach to information provision is valued by users and has implications for information services currently under development to support clinical governance.     

Research governance: implications for health library and information professionals

The Research Governance Framework for Health and Social Care published by the Department of Health in 2001 provides a model of best practice and a framework for research in the health and social care sector. This article reviews the Department of Health Research Governance Framework, discusses the implications of research governance for library and information professionals undertaking research in the health- and social-care sector and recommends strategies for best practice within the information profession relating to research governance. The scope of the Framework document that covers both clinical and non-clinical research is outlined. Any research involving, amongst other issues, patients, NHS staff and use or access to NHS premises may require ethics committee approval. Particular reference is made to the roles, responsibilities and professional conduct and the systems needed to support effective research practice. Issues such as these combine to encourage the development of a quality research culture which supports best practice. Questions arise regarding the training and experience of researchers, and access to the necessary information and support. The use of the Framework to guide research practice complements the quality issues within the evidence-based practice movement and supports the ongoing development of a quality research culture. Recommendations are given in relation to the document's five domains of ethics, science, information, health and safety and finance and intellectual property. Practical recommendations are offered for incorporating research governance into research practice in ways which conform to the Framework's standards and which are particularly relevant for research practitioners in information science. Concluding comments support the use of the Research Governance Framework as a model for best practice.     

Optimising the retrieval of information on adverse drug effects

Pharmaceutical interventions have brought about many benefits to health, improving the population's well‐being and life expectancy. However, these interventions are not without potential harmful side‐effects and yet searching for the evidence on adverse effects is challenging. This article summarises a PhD whose main aim was to develop a better understanding of the implications of using different sources and approaches to identifying relevant data on adverse effects. The author is Su Golder, who has recently completed her PhD at the University of York and who has already published several articles on specific aspects of her research, including this journal. This article is the first in the Dissertations into Practice series to report on a PhD study, and it summarises her research in a way which emphasises the implications for practice. AM     

Using scientific evidence to improve information practice

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Measuring the value and impact of health library and information services: past reflections, future possibilities

Objectives: To summarize the context, history and results of research studies conducted on the value and impact of health library and information services by the author since 1975 and to use this as a basis for examining ongoing developments related to evaluation research. To provide a comprehensive bibliography of library value and impact studies. Methods: Literature review and background based on personal involvement in the studies under discussion. Results: The author's studies demonstrate an ongoing evolution of value and impact studies since the mid‐1970s. In health sciences libraries, the approach taken to measuring value and impact has been strongly influenced by the type of research being conducted in the health sciences field as a whole. As a result, health sciences library researchers have become early adopters of methods that incorporate outcome and impact measures and rigorous research designs, and the concept of evidence‐based library and information practice. The paper recommends that a range of research approaches from various disciplines be used to guide future evaluation research. Conclusions: Value and impact studies will continue to be important resources for evidence‐based practice as health information professionals deal with evolving user needs and new ways of delivering information to a variety of audiences.     

Applying evidence in the real world: a case study in library and information practice

Background/objectives: Methodological decisions made during the research process can influence generalizability of findings to real world practice. The aims of this study were to explore the impact of decisions made in the development of a palliative care search filter and to consider the implications for implementation. Methods: Three elements of the original study methodology were explored: (i) choice of OVID medline field delimiters; (ii) use of the general medical literature to evaluate the filter's performance; and (iii) use of the OVID interface. Sensitivity, specificity, accuracy and precision rates of variant search strategies were compared to consider each issue. Results: The delimiter .af. outperformed the alternatives of .tw. or .mp. in OVID medline , improving sensitivity from 45.4 to 46.2%. Applying the filter in the specialist palliative literature resulted in 87.5% (692/791) of articles being retrieved using either .tw. or .mp., increasing to 100% (791/791) with the .af. delimiter. Finally, a PubMed version of the filter was successfully validated. Conclusions: Reviewing three methodological decisions that preserved validity in an original study led to the improved utility of a search filter in practice. Generating high‐quality evidence is only part of evidence‐based practice: consideration of generalizability issues can inform further research and effective evidence implementation.     

The Map of Medicine: a review of evidence for its impact on healthcare

Objectives: Map of Medicine is an evidence‐based online clinical knowledge resource. Procured at significant cost by healthcare providers in the UK, Sweden and Denmark, it is important to establish the beneficial impact that investment has had on healthcare practise and, ultimately, on patient outcomes. The objective of this study is to review the evidence for the impact of the Map of Medicine on clinical practice. Methods: A systematic review of peer‐reviewed and grey literature was conducted. Nine healthcare databases, Google Scholar and Google were searched for articles containing the terms ‘map of medicine’. Results: The search identified 133 articles. Eleven of the articles identified met the inclusion criteria. The main finding of the study is the paucity of evidence available on the impact of the Map of Medicine and the variable quality of that which does exist. There are some encouraging early indications for the Map of Medicine as a tool within service redesign, leading to an increase in appropriate referrals to secondary care, decreased patient waiting times and considerable cost savings. Conclusion: Further research with study designs that can generate high quality evidence for the impact of Map of Medicine is essential in order to support policy decisions.     

Genetic research and genetic information: a health information professional's perspective on the benefits and risks

BACKGROUND: The completion of the Human Genome Project, and recent breakthroughs in identifying the genes both directly responsible for and contributing to the severity of specific diseases and disabilities in humans offer great potential for future health care. AIM: The aim of the paper is to inform the health information community of these developments in order to foster debate over their wide-reaching implications. METHODS: The article outlines recent research in this area and explains how our growing understanding opens the way for improved diagnosis of disease, detection of possible predisposition to specific diseases, the interaction between genetics and environmental aspects such as diet, as well as enabling gene therapy and preventative actions. This new knowledge also opens the way for the use of pharmacogenetic information to enhance the efficacy of pharmaceuticals and to avoid toxic reactions. RESULTS: These advances have significant social, legal and ethical implications. Most countries have limited legislative control over the use and protection of genetic information about individuals. CONCLUSION: There is a role for health information professionals to play in promoting wider public knowledge of genetic research and its implications, in fostering public debate on key issues, and in seeking clearer policies in the health sector concerning the use of genetic information about individuals.     

Achieving change through mutual development: supported online learning and the evolving roles of health and information professionals

Introduction: Major changes in health care, within an information‐ and technology‐rich age, are impacting significantly on health professionals and upon their education and training. Health information professionals—in both the National Health Service (NHS) and higher education (HE) contexts—are consequently developing their roles, skills and partnerships to meet the needs of flexible education and training. This article explores one facet of this—supported online learning and its impact on role development. Methodology: A case study approach was taken, aiming to explore how academics, health information professionals and learning technologists are developing supported online learning to explicitly address the e‐literacy and information needs of health students within the context of NHS frameworks for education. This was contextualized by a literature review. Results: The case study explores and discusses three dynamics—(i) The use of supported online learning tools by future health‐care professionals throughout their professional training to ensure they have the appropriate e‐literacy skills; (ii) the use of supported online learning by current health professionals to enable them to adapt to the changing environment; (iii) the development of the health information professional, and particularly their role within multi‐disciplinary teams working with learning technologists and health professionals, to enable them to design and deliver supported online learning. Conclusions: The authors argue that, in this specific case study, health information professionals are key to the development of supported online learning. They are working successfully in collaboration and their roles are evolving to encompass learning and teaching activities in a wider context. There are consequently several lessons to be drawn in relation to professional education and role development.     

The value and impact of information provided through library services for patient care: a systematic review

OBJECTIVE: An updated systematic review was carried out of research studies looking at the value and impact of library services on health outcomes for patients and time saved by health professionals. METHODS: A comprehensive systematic search was undertaken of the published literature to September 2003 in ERIC, LISA, MEDLINE, PREMEDLINE, EMBASE, the Cochrane Controlled Trials Register and Google. Some handsearching was carried out, reference lists were scanned and experts in the field were contacted. Twenty-eight research studies of professionally led libraries for health-care staff, including clinical librarian projects, met the inclusion criterion of at least one health or 'time saved' outcome. Papers were critically appraised using internationally accepted criteria. Data were extracted and results were summarised using a narrative format as the studies were heterogeneous and precluded a statistical analysis. RESULTS: There is evidence of impact from both traditional and clinical librarian services. The higher quality studies of traditional services measured impacts of 37-97% on general patient care, 10-31% on diagnosis, 20-51% on choice of tests, 27-45% on choice of therapy and 10-19% on reduced length of stay. Four studies of clinical librarian projects suggested that professionals saved time as a result of clinical librarian input, and two of these studies showed evidence of cost-effectiveness. However, the clinical librarian studies were generally smaller, with poorer quality standards. CONCLUSIONS: Research studies suggest that professionally led library services have an impact on health outcomes for patients and may lead to time savings for health-care professionals. The available studies vary greatly in quality but the better quality studies also suggest positive impacts. Good practice can be gathered from these studies to guide the development of a pragmatic survey for library services that includes the direct effects for patients among the outcome measures.     

The state of consumer health information: an overview

Background: Consumer health information is becoming increasingly important and health policy in the UK is beginning to reflect this. This has implications for information producers, providers and users, with the move towards a more patient‐centred health service. Objectives: This review aims to provide a broad overview of the current state of consumer health information in the UK. It examines the changing roles of information producers, providers and users, exploring the impact of health literacy and new technologies. It features some of the current library and consumer health information projects taking place in the UK and discusses the role that libraries may play in the future. Methods: The article focuses on consumer health information in a policy context. It is based on the experiences of the authors' work for the Patient Information Forum and knowledge of consumer health information. A number of library and information professionals were consulted regarding the library and information projects. Conclusions: Communication between health professionals and patients, and between health educators and the public, is key in order for consumer health information to have the ability to improve health outcomes. Further, especially local, investment into the production, distribution and delivery of consumer health information is recommended.     

Medical journals and effective dissemination of health research

Clinical medical journals have not been effective in meeting the information needs of practitioners and bridging the gap between clinical research and practice. The slow adoption of results of clinical research is at least partly due to the failure of clinical journals to disseminate information in a way that would motivate practitioners to change practice. Although implementation is primarily a local process, medical journals are in a unique position to advance implementation by modifying their focus and adjusting their contents. Strategies that may be useful include publication of pre‐appraised evidence summaries and ‘clinical bottom‐lines’ and giving importance to systematic reviews and large evaluative research articles as they represent higher levels of evidence and have greater potential to change practice. Clinical journals should encourage researchers to consider how and by whom the findings will be used and provide information on implications for implementation such as possible strategies that may work, cost‐effectiveness, side‐effects and potential barriers to implementation. Medical journal publishers should explore ways to cooperate so that findings of landmark clinical trials could be shared thus reducing the ‘scatter’ of medical information. Electronic media offers numerous advantages such as quick accessibility and linking of information, and medical journals should capitalize on such innovations. There is a paradigm shift in health care practice as evidence is consciously and explicitly incorporated into individual patient care. Medical journals need to change to reflect this change in practice and provide practitioners with valid and relevant information.     

Internet‐based information‐seeking behaviour amongst doctors and nurses: a short review of the literature

Background: Reviews of how doctors and nurses search for online information are relatively rare, particularly where research examines how they decide whether to use Internet‐based resources. Original research into their online searching behaviour is also rare, particularly in real world clinical settings. as is original research into their online searching behaviour. This review collates some of the existing evidence, from 1995 to 2009. Objectives: To establish whether there are any significant differences in the ways and reasons why doctors and nurses seek out online information; to establish how nurses and doctors locate information online; to establish whether any conclusions can be drawn from the existing evidence that might assist health and medical libraries in supporting users. Methods: An initial scoping literature search was carried out on PubMed and CINAHL to identify existing reviews of the subject area and relevant original research between 1995 and 2009. Following refinement, further searches were carried out on Embase (Ovid), LISA and LISTA. Following the initial scoping search, two journals were identified as particularly relevant for further table of contents searching. Articles were exclused where the main focus was on patients searching for information or where the focus was the evaluation of online‐based educational software or tutorials. Articles were included if they were review or meta‐analysis articles, where they reported original research, and where the primary focus of the online search was for participants’ ongoing Continuing Professional Development (CPD). The relevant articles are outlined, with details of numbers of participants, response rates, and the user groups. Results: There appear to be no significant differences between the reasons why doctors and nurses seek online Internet‐based evidence, or the ways in which they locate that evidence. Reasons for searching for information online are broadly the same: primarily patient care and CPD (Continuing Professional Development). The perceived barriers to accessing online information are the same in both groups. There is a lack of awareness of the library as a potential online information enabler. Conclusions: Libraries need to examine their policy and practice to ensure that they facilitate access to online evidence‐based information, particularly where users are geographically remote or based in the community rather than in a hospital setting. Librarians also need to take into account the fact that medical professionals on duty may not be able to take advantage of the academic model of online information research. Further research is recommended into the difference between the idealised academic model of searching and real world practicalities; and how other user groups search, for example patients.     

Who shares health and medical scholarly articles on Facebook?

Over a million journal articles had been shared on public Facebook pages by 2017, but little is known about who is sharing (posting links to) these papers and whether mention counts could be an impact indicator. This study classified users who had posted about 749 links on Facebook before October 2017 mentioning 500 medical and health‐related research articles, obtained using altmetric.com data. Most accounts (68%) belonged to groups, including online communities, journals, academic organizations, and societies. Of individual profiles, academics accounted for only 4%, but the largest group were health care professionals (16%). More than half (58%) of all Facebook accounts examined were not academic. The non‐academic dominance suggests that public Facebook posts linking to health‐related articles are mostly used to facilitate scientific knowledge flow between non‐academic professionals and the public. Therefore, Facebook mention counts may be a combined academic and non‐academic attention indicator in the health and medical domains.     

Engaging in research: challenges and opportunities for health library and information professionals

This year's virtual issue (the 6th in the series) has been published to coincide with the European Association for Health Information and Libraries’ (EAHIL) 2015 workshop (10–12 June, Edinburgh): Research‐Minded: Understanding, Supporting, Conducting Research. This event is being run in collaboration with the International Conference of Animal Health Information Specialists and the International Clinical Librarian Conference. Although research has always been a central part of any librarian's role, until recently health librarians and library users and funding bodies assumed that librarians were ‘midwives’ – there to assist students, clinicians, academics and managers set up and carry out their research. The notion of the librarian as a professional with a research agenda, who understands research methods, submits research grants, and publishes, is a relatively new perspective. If librarians are to take an evidence‐based approach to their profession they need to acquire research skills. This is the rationale for the 2015 EAHIL workshop. To support the workshop, this virtual issue contains six original articles published in Health Information and Libraries Journal over the last 2 years that demonstrate the range of research activities carried out by health librarians, as well as a review article and articles from each of the three feature columns. All articles included in this virtual issue are available free online.     

The information trail of the 'Freshman 15'--a systematic review of a health myth within the research and popular literature

Question: How does health misinformation become part of the American and Canadian vernacular? Data sources and selection: Twenty‐three databases were searched for articles discussing university freshmen weight gain. Research articles were examined for methodology, number and gender of the participants and weight gain. Popular press articles were reviewed for the types of information published: expert/anecdotal, weight gain, nutrition, exercise, health and alcohol. A timeline of article publication dates was generated. Results: Twenty peer‐reviewed, 19 magazine, 146 newspaper, and 141 university newspaper articles were discovered. Appearance of media articles about the ‘Freshman 15’ mirrored the peer‐reviewed articles, yet the information did not reliably depict the research. Research indicated a weight gain of less than five pounds (2.268 kg), while half of the popular press publications claimed a 15‐pound (6.804 kg) weight gain. The misinformation was frequently accompanied by information about achieving weight control through diet, exercise, stress reduction and alcohol avoidance. Conclusion: Understanding of how the concept of the ‘Freshman 15’ developed indicates that remediation efforts are needed. Collaborative efforts between health science and academic librarians, faculty and journalists to construct new paradigms for the translation of scientific evidence into information that individuals can use for decisions about health and well‐being is suggested.     

Facilitating research amongst radiographers through information literacy workshops

Background:Despite a strong research presence in Lancashire Teaching Hospitals National Health Service (NHS) Foundation Trust (LTHTR), allied health professionals from the organization are underrepresented in developing and publicizing research that is inspired by day-to-day clinical practice and staff experiences. Two LTHTR departments, Library and Knowledge Services (LKS) and Research and Innovation (R&I), came together to enable a group of staff to develop the knowledge and skills that they needed to access information and create new “home grown” research.Case Presentation:A clinical librarian and an academic research nurse created a research engagement program in the diagnostic radiography department at LTHTR, which included the development, delivery, and evaluation of 6 workshops. Sixteen individuals took part in these workshops, and data were collected on library usage, self-efficacy in information literacy, and research output before and after their delivery. Library membership increased by 50% among diagnostic radiography staff, literature search requests from this department increased by 133%, and all participants who attended at least 1 workshop reported an increased Information Literacy Self Efficacy Scale (ILSES) score. An increase in research activity and outputs was also attributed to the program.Conclusions:This project has resulted in a set of freely available workshop plans and support resources that can be customized for other health care professionals and has won several awards for its innovative use of departmental collaboration. Through the evaluation of the program from workshop attendees and non-attenders, we have identified impacts, outputs, and barriers to engagement in order to continue to deliver this content to other departments and embed a home grown research culture at LTHTR.     

Quality and clarity of health information on Q&A sites

This study investigated the quality and clarity of health information from a total of 238 (126 English and 112 Chinese) answers retrieved from Yahoo!Answers sites. Registered nurses and library professionals judged information quality based on 8 criteria: accuracy, completeness, relevance, readability, verifiability, professional advice, usefulness and non-commercialization. Writing clarity was assessed through rhetorical structure analysis. Results showed that 46% of answers were of poor quality. Furthermore, many Q&A site users were unable to distinguish adequately between high- and low-quality answers. Only 60% of their selected best-answers corresponded to those of the health professionals. These results indicate that the reliability of health information on Q&A sites is questionable. This unreliability may partially be due to the fact that Q&A site answers contain both medical information and social support. Although both are important, they are not always compatible. It may even be dangerous to mistakenly present social support as objective medical information. This research suggests that medical advice and social support should be separated. This has a further advantage in that medical advice could be subjected to stringent, necessary quality assurance measures, without interfering with social support.