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. 2011 Sep 23:343:d5856.
doi: 10.1136/bmj.d5856.

Speed of updating online evidence based point of care summaries: prospective cohort analysis

Rita Banzi  1 , Michela Cinquini, Alessandro Liberati, Ivan Moschetti, Valentina Pecoraro, Ludovica Tagliabue, Lorenzo Moja
Affiliations

Speed of updating online evidence based point of care summaries: prospective cohort analysis

Rita Banzi et al. BMJ. .

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.

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Conflict of interest statement

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.

Figures

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Fig 1 Updating curves for relevant evidence (128 systematic reviews) by point of care information summaries (log rank χ2=404, P<0.001)
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Fig 2 Updating curves of Cochrane reviews (n=60) by point of care information summaries (log rank χ2=300, P<0.001)
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Fig 3 Updating curves of non-Cochrane reviews (n=68) by point of care information summaries (log rank χ2=188, P<0.001)
See this image and copyright information in PMC

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