Information Use Behavior of Clinicians in Evidence-Based Medicine (EBM) Process in Thailand by Somrux Sahapong Sawasdee Kha

Background “Evidence-based medicine (EBM) the conscious, explicit and judicious use of current best evidence in making decisions about the care of individual patients” (Sackett et al., 1996)

Background EBM is involved in : –The use of the best current available evidence –Life-long learning –Medical education –Modern clinical practice

Methodology Survey research Closed-end questionnaires in EBM process and information usage 198 questionnaires were sent to Thai clinicians using EBM process (University and Non-university hospitals) The data were analyzed : –Mean –Standard deviation –Percentage –Factor analysis

Results 157 questionnaires (79.3 %) were returned Demographic characteristics The use of EBM process in clinical practice The use of information in EBM process : –Frequency –Purposes –How information obtained –Type –Resources –Tools –Strategy The factors affecting the use of EBM process

Demographic Characteristics General profile Computer and Internet literacy Online database literacy

General Profile Sex –Male 66.2 % –Female 33.8 % Duration of EBM experience –MEAN 8.1 SD 5.2 (1-30) years Hospital –University 57.3 % –Non-university 42.7 %

TechnologyUniversity hospitals (Percentage)Non-university hospitals (Percentage) (n=157) expertgoodfairnovicenot use expertgoodfairnovicenot use Computer Internet Computer include Internet Computer and Internet Literacy

DatabasesUniversity public hospitals(Percentage)Non-university public hospitals (Percentage) (n=157) expertgoodfairnovicenot use expertgoodfairnovicenot use PubMed (Clinical Queries) UpToDate Cochrane Library ACP Journal Club EBM Journal Website Online Database Literacy

The clinicians use EBM process in clinical practice

Levels of EBM usage (score)Percentage (n=157) Low level of EBM usage (24-38)5.7 Moderate level of EBM usage (39-53)41.4 High level of EBM usage (54-68)52.9 Total100.0 Mean=52.7 S.D.=8.4 Min = 24.0 Max = 68.0 Level of EBM usage of Thai clinicians

The use of information in EBM process Frequency Purposes How information obtained The types of information used in clinical practice Resources for information searching Tools for information searching Strategy in searching

Frequency of usePercentage (n= 157 ) Everyday days a week days a month11.6 Not use1.4 Frequency

PurposesPercentage of use (n= 157 ) mostmoderateseldomleast Medical care Continuing medical education and news medical information Supporting their teaching and learning process Purposes

Information was obtained Percentage of use (n= 157 ) mostmoderateseldomleast Clinicians searching by themselves Clinicians asking for advice from (MIPs) MIPs searching for clinicians Colleague searching for clinicians Nurse searching for clinicians How information obtained MIPs = medical informational professionals

Types of information in clinical practice Percentage of use (n = 157) mostmoderateseldomleast Best research Medical record Information from clinical expert Medical textbook and reference book Medical Journal Systematic review Proceeding EBM Database The types of information used in clinical practice

Resources for information searching Percentage of use (n= 157 ) mostmoderateseldomleast Medical record unit Laboratory Museum Library inside the hospital Library outside the hospital Foreign library Patient’s profile Patient’s cousin Expert in clinical practice Internet Resources for information searching

Tools for information searching Percentage of use (n= 157 ) mostmoderateseldomleast PubMed UpToDate Ovid Embase Cochrane library ACP Journal Club OPAC of the library inside the hospital or medical school CD-Rom Search engine Index database Bibliographic database Tools for information searching

Strategy in searchingPercentage of use (n= 157 ) mostmoderateseldomleast Use keyword Consult the expert Use similar medical term Use medical subject heading (MeSH) Use boolean operator (AND, OR, NOT) Use clinical queries in PubMed Strategy in searching

Factors affecting the use of EBM process

Six variables were correlated with information use in EBM process –Information usage –EBM usage –Experience –Organization –Competency –Educational background

Conclusion Most Thai clinicians in this study use the EBM process in their daily practice. Thai clinicians have good computer / Internet literacy and online database literacy. Thai clinicians can search information by themselves. Six variables were correlated with information use in EBM process.

Suggestions More studies on the knowledge, attitude and practice of clinicians on information behaviors are needed. EBM training is necessary for MIPs in Thailand. MIPs should be trained to assist or facilitate clinicians in information searching and use. Collaboration between clinicians and MIPs should be much more closer. MIPs should make clinicians accept their competency in EBM information service. MIPs = medical informational professionals

Thank You Very Much Merci Beaucoup Sawasdee Kha