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

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Presentation on theme: "Information Use Behavior of Clinicians in Evidence-Based Medicine (EBM) Process in Thailand by Somrux Sahapong Sawasdee Kha."— Presentation transcript:

1 Information Use Behavior of Clinicians in Evidence-Based Medicine (EBM) Process in Thailand by Somrux Sahapong lissh@mahidol.ac.th Sawasdee Kha

2 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)

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

4 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

5 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

6 Demographic Characteristics General profile Computer and Internet literacy Online database literacy

7 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 %

8 TechnologyUniversity hospitals (Percentage)Non-university hospitals (Percentage) (n=157) expertgoodfairnovicenot use expertgoodfairnovicenot use Computer15.650.030.02.2 13.450.732.83.10.0100.0 Internet15.648.931.12.2 19.444.831.34.50.0100.0 Computer include Internet 17.850.027.82.2 14.946.332.86.00.0100.0 Computer and Internet Literacy

9 DatabasesUniversity public hospitals(Percentage)Non-university public hospitals (Percentage) (n=157) expertgoodfairnovicenot use expertgoodfairnovicenot use PubMed (Clinical Queries) 20.0 47.825.63.3 12.546.728.13.19.4100.0 UpToDate5.718.230.75.739.87.831.326.03.132.8100.0 Cochrane Library 13.533.738.25.69.01.530.840.04.623.1100.0 ACP Journal Club 8.012.530.78.040.90.012.529.74.753.1100.0 EBM Journal Website 10.312.533.86.240.04.615.433.38.035.6100.0 Online Database Literacy

10 The clinicians use EBM process in clinical practice

11 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

12 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

13 Frequency of usePercentage (n= 157 ) Everyday26.5 2-3 days a week60.5 2-3 days a month11.6 Not use1.4 Frequency

14 PurposesPercentage of use (n= 157 ) mostmoderateseldomleast Medical care14.252.330.33.2 Continuing medical education and news medical information 39.550.310.20.0 Supporting their teaching and learning process 48.443.37.70.6 Purposes

15 Information was obtained Percentage of use (n= 157 ) mostmoderateseldomleast Clinicians searching by themselves 64.329.43.82.5 Clinicians asking for advice from (MIPs) 1.910.937.849.4 MIPs searching for clinicians2.69.030.158.9 Colleague searching for clinicians 3.828.043.924.2 Nurse searching for clinicians3.95.213.577.4 How information obtained MIPs = medical informational professionals

16 Types of information in clinical practice Percentage of use (n = 157) mostmoderateseldomleast Best research 33.357.19.00.6 Medical record 19.138.234.48.3 Information from clinical expert 14.247.734.23.9 Medical textbook and reference book 21.259.617.91.3 Medical Journal 33.356.49.01.3 Systematic review 32.151.314.12.6 Proceeding 11.546.239.13.2 EBM Database 18.852.624.04.5 The types of information used in clinical practice

17 Resources for information searching Percentage of use (n= 157 ) mostmoderateseldomleast Medical record unit 7.734.246.511.6 Laboratory 3.929.948.7 17.5 Museum 1.49.1533.855.6 Library inside the hospital 19.254.519.26.4 Library outside the hospital 5.823.741.728.8 Foreign library 7.919.523.748.9 Patient’s profile 9.933.137.119.9 Patient’s cousin 3.325.844.426.5 Expert in clinical practice 7.252.631.67.9 Internet 33.850.313.22.6 Resources for information searching

18 Tools for information searching Percentage of use (n= 157 ) mostmoderateseldomleast PubMed58.131.6 7.13.2 UpToDate12.321.932.333.5 Ovid16.828.436.023.9 Embase5.29.743.941.3 Cochrane library14.741.730.812.8 ACP Journal Club5.218.738.737.4 OPAC of the library inside the hospital or medical school 5.314.534.845.4 CD-Rom3.225.238.732.9 Search engine30.535.122.112.3 Index database5.914.239.230.7 Bibliographic database3.919.642.534.0 Tools for information searching

19 Strategy in searchingPercentage of use (n= 157 ) mostmoderateseldomleast Use keyword45.250.31.92.5 Consult the expert6.521.945.825.8 Use similar medical term24.851.019.74.5 Use medical subject heading (MeSH) 29.942.718.58.9 Use boolean operator (AND, OR, NOT) 35.041.415.38.3 Use clinical queries in PubMed 24.835.928.111.1 Strategy in searching

20 Factors affecting the use of EBM process

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

22 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.

23 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

24 Thank You Very Much Merci Beaucoup Sawasdee Kha

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