Appl Clin Inform 2012; 03(03): 326-333
DOI: 10.4338/ACI-2012-06-RA-0024
Research Article
Schattauer GmbH

Usability of Selected Databases for Low-Resource Clinical Decision Support

L. Sheets
1  University of Missouri Informatics Institute
2  National Library of Medicine
,
F. Callaghan
2  National Library of Medicine
,
A. Gavino
2  National Library of Medicine
,
F. Liu
2  National Library of Medicine
,
P. Fontelo
2  National Library of Medicine
› Author Affiliations
Further Information

Correspondence to:

Lincoln Sheets, MD
Missouri University Informatics Institute
EBW 241
Columbia MO 65211
USA

Publication History

received: 18 June 2012

accepted: 27 August 2012

Publication Date:
16 December 2017 (online)

 

Summary

Background: Smartphones are increasingly important for clinical decision support, but smartphone and Internet use are limited by cost or coverage in many settings. txt2MEDLINE provides access to published medical evidence by text messaging. Previous studies have evaluated this approach, but we found no comparisons with other tools in this format.

Objectives: To compare txt2MEDLINE with other databases for answering clinical queries by text messaging in low-resource settings.

Methods: Using varied formats, we searched txt2MEDLINE and five other search portals (askMED-LINE, Cochrane, DynaMed, PubMed PICO, and UpToDate) to develop optimal strategies for each. We then searched each database again with five benchmark queries, using the customized search-optimization formats. We truncated the results to less than 480 characters each to simulate delivering them to a maximum of three text messages. Clinicians with practice experience in low-resource areas scored the results on a 5-point Likert scale.

Results: Median scores and standard deviations from 17 reviewers were: txt2MEDLINE, 3.2±0.82 (control); askMEDLINE, 3.2±0.90 (p = 0.918); Cochrane, 3.8±0.58 (p = 0.073); DynaMed, 3.6±0.65 (p = 0.105); PubMed PICO, 3.6±0.82 (p = 0.005); and UpToDate, 4.0±0.52 (p = 0.002). Our sample size was sufficiently powered to find differences of 1.0 point.

Conclusions: Comparing several possible sources for texting-based clinical-decision-support information, our results did not demonstrate one-point differences in usefulness on a scale of 1 to 5. PubMed PICO and UpToDate were significantly better than txt2MEDLINE, but with relatively small improvements in Likert score (0.4 and 0.8, respectively). In a texting-only setting, txt2MEDLINE is comparable to simulated alternatives based on established reference sources.


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Conflict of Interest

The authors declare that they have no conflicts of interest in the research.


Correspondence to:

Lincoln Sheets, MD
Missouri University Informatics Institute
EBW 241
Columbia MO 65211
USA