Clinical information seeking behavior of physicians: A systematic review

INTRODUCTION Physicians encounter a large number of questions during patient care. Therefore, finding high-quality evidence provides a good opportunity to improve patient care and continue learning. OBJECTIVES The present study aims to obtain a comprehensive understanding of the physicians' clinical information-seeking behavior. METHODS A systematic review was conducted according to the PRISMA guidelines. The Web of Science, PubMed, Scopus, ProQuest, Emerald, Wiley Online Library, Science Direct, Cochrane Library, and Embase databases were systematically searched based on the defined criteria. The inclusion criteria were the original articles in the context of patient care and full-text articles published in English from 2002 to 2017. The articles were reviewed, selected, and analyzed in group discussions. RESULTS Seventy-three articles met the study criteria. Therapy, diagnosis, and epidemiology ranked the highest ones among physicians' information needs. The mean frequency of questions raised during patient care was varied from 0.18 to 1.5 per patient, and the percentage of questions answered ranged between 22.8 and 93 %. The time taken to find the answers to the questions was between 2 to 32 min. Consultation with colleagues, alongside reviewing journal articles, Internet websites, textbooks, and MEDLINE/PubMed were the most frequently used sources reported in the retrieved articles. Further, common search strategies used by physicians included keywords, Boolean operators, similar medical terms, and advanced search. In addition, lack of time, and information searching skills and the unawareness of accessible sources were the most frequent barriers while easily searching and finding information and summaries and synthesized evidence-based materials mainly facilitated information seeking. CONCLUSIONS Physicians increasingly encounter clinical point-of-care questions. However, the facilitation of accessing online information sources has not enabled the physicians to find answers to many of their questions. Considering the fact that they often refer to colleagues, Internet websites, and databases to find answers, the quality of information should be improved by evaluating the physicians' information-seeking behavior in the first stage, and developing information technology in a point-of-care environment, integrating EHR systems to communicate with colleagues, and accessing databases in the second stage.

[1]  Clarence D Kreiter,et al.  An evaluation of information-seeking behaviors of general pediatricians. , 2004, Pediatrics.

[3]  Farah Magrabi,et al.  General practitioners' use of online evidence during consultations , 2005, Int. J. Medical Informatics.

[4]  Ruth Holst,et al.  Vital pathways for hospital librarians: present and future roles. , 2009, Journal of the Medical Library Association : JMLA.

[5]  J. Whitcombe,et al.  How doctors make use of online, point-of-care clinical decision support systems: a case study of UpToDate©. , 2013, Health information and libraries journal.

[6]  Mary Moore,et al.  An Introduction to Clinical Decision Support Systems , 2011 .

[7]  Vimla L. Patel,et al.  Understanding the nature of information seeking behavior in critical care: Implications for the design of health information technology , 2013, Artif. Intell. Medicine.

[8]  P. Gorman,et al.  Clinical questions raised by clinicians at the point of care: a systematic review. , 2014, JAMA internal medicine.

[9]  Debra S. Ketchell,et al.  Application of Information Technology: PrimeAnswers: A Practical Interface for Answering Primary Care Questions , 2005, J. Am. Medical Informatics Assoc..

[10]  Donna M Perzeski.  Information-seeking behaviors of podiatric physicians. , 2012, Journal of the American Podiatric Medical Association.

[11]  Florence Gonod Boissin.  Information-seeking behaviour and use of the Internet by French general practitioners: a qualitative study. , 2005, Health information and libraries journal.

[12]  Martin Dawes,et al.  Information Needs and Information-Seeking Behavior of Primary Care Physicians , 2007, The Annals of Family Medicine.

[13]  Joi L. Moore,et al.  “I Don't Have Time to Dig Back Through This”: The Role of Semantic Search in Supporting Physician Information Seeking in an Electronic Health Record , 2014 .

[14]  S. Naeem,et al.  Clinical information needs and access in primary health care: a comparative cross-sectional study of rural and non-rural primary care physicians. , 2015, Health information and libraries journal.

[15]  Khamis Elessi,et al.  Awareness, attitudes and knowledge about evidencebased medicine among doctors in Gaza: a crosssectional survey. , 2017, Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit.

[16]  Joanne L. Callen,et al.  Clinical information sources used by hospital doctors in Mongolia , 2008, Int. J. Medical Informatics.

[17]  E. Lwoga,et al.  Information seeking behaviour of physicians in Tanzania , 2013 .

[18]  A. Oussalah,et al.  Information-seeking Behavior During Residency Is Associated With Quality of Theoretical Learning, Academic Career Achievements, and Evidence-based Medical Practice , 2015, Medicine.

[19]  K. Ramos,et al.  Real-time information-seeking behavior of residency physicians. , 2003, Family medicine.

[20]  Pradeep Kumar Ray,et al.  Ontological specification of quality of chronic disease data in EHRs to support decision analytics: a realist review , 2014, Decis. Anal..

[21]  J. Søndergaard,et al.  Variation in general practitioners’ information-seeking behaviour – a cross-sectional study on the influence of gender, age and practice form , 2016, Scandinavian journal of primary health care.

[22]  Martin Dawes,et al.  Knowledge management in clinical practice: a systematic review of information seeking behavior in physicians , 2003, Int. J. Medical Informatics.

[23]  Pradeep Kumar Ray,et al.  Towards an ontology for data quality in integrated chronic disease management: A realist review of the literature , 2013, Int. J. Medical Informatics.

[24]  Chuck Norlin,et al.  Unanswered questions prompted during pediatric primary care visits. , 2007, Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association.

[25]  D. Moher,et al.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement , 2009, BMJ : British Medical Journal.

[26]  S. Eslami,et al.  Medical Information Sources Used by Specialists and Residents in Mashhad, Iran , 2016 .

[27]  M. Ebell,et al.  Obstacles to answering doctors' questions about patient care with evidence: qualitative study , 2002, BMJ : British Medical Journal.

[28]  Jamileh Mahdi Zadeh,et al.  Evaluation of Organizational Readiness in Clinical Settings for Social Supporting Evidence-Based Information Seeking Behavior after Introducing IT in a Developing Country , 2015, Journal of evidence-informed social work.

[29]  K. Schwartz,et al.  Use of on-line evidence-based resources at the point of care. , 2003, Family medicine.

[30]  Robert Kristofco,et al.  Physician internet medical information seeking and on‐line continuing education use patterns , 2002, The Journal of continuing education in the health professions.

[31]  Nicolas Griffon,et al.  Behavior and attitudes of residents and general practitioners in searching for health information: From intention to practice , 2016, Int. J. Medical Informatics.

[32]  S. Sahapong,et al.  Information use behavior of clinicians in evidence-based medicine process in Thailand. , 2009, Journal of the Medical Association of Thailand = Chotmaihet thangphaet.

[33]  J. Kosteniuk,et al.  Use and perceptions of information among family physicians: sources considered accessible, relevant, and reliable. , 2013, Journal of the Medical Library Association : JMLA.

[34]  Alireza Rahimi,et al.  Evaluating digital libraries: a systematised review , 2018, Health information and libraries journal.

[35]  K. Davies,et al.  The information-seeking behaviour of doctors: a review of the evidence. , 2007, Health information and libraries journal.

[36]  M. Dawes.  Critically appraised topics and evidence-based medicine journals. , 2005, Singapore medical journal.

[37]  Khalil Kimiafar,et al.  Physicians' Use of Online Clinical Evidence in Mashhad University of Medical Sciences, Iran , 2017, eHealth.

[38]  M. A. Akewukereke,et al.  Physicians utilisation of internet medical databases at the tertiary health institutions in Osun State, south west, Nigeria. , 2011, Health information and libraries journal.

[39]  Amit X. Garg,et al.  Impact of PubMed search filters on the retrieval of evidence by physicians , 2012, Canadian Medical Association Journal.

[40]  P. Devi,et al.  Drug information needs of physicians treating diabetic nephropathy in a tertiary care hospital. , 2008, Kathmandu University medical journal.

[41]  R. Surtees,et al.  Understanding the Information Needs of General Practitioners Managing a Rare Genetic Disorder (Osteogenesis Imperfecta) , 2006, Public Health Genomics.

[42]  Michael L. Green,et al.  Why Do Residents Fail to Answer Their Clinical Questions? A Qualitative Study of Barriers to Practicing Evidence-Based Medicine , 2005, Academic medicine : journal of the Association of American Medical Colleges.

[43]  N. Bennett,et al.  Physicians' Internet information‐seeking behaviors , 2004, The Journal of continuing education in the health professions.

[44]  Peggy Kingsley,et al.  An analysis of patient care questions asked by pediatricians at an academic medical center. , 2004, Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association.

[45]  Dave Davis,et al.  Bmc Medical Informatics and Decision Making Challenges in Multidisciplinary Cancer Care among General Surgeons in Canada , 2022 .

[46]  Robert Kristofco,et al.  Information‐seeking behaviors and reflective practice , 2006, The Journal of continuing education in the health professions.

[47]  T. Prendiville,et al.  The information-seeking behaviour of paediatricians accessing web-based resources , 2009, Archives of Disease in Childhood.

[48]  Cathy M Perley,et al.  Physician use of the curbside consultation to address information needs: report on a collective case study. , 2006, Journal of the Medical Library Association : JMLA.

[49]  Bridget C. O’Brien,et al.  Characterizing physicians’ information needs at the point of care , 2014, Perspectives on medical education.

[50]  K. Fisher,et al.  Theories of information behavior , 2005 .

[51]  Seher Korkmaz,et al.  Physicians' reported needs of drug information at point of care in Sweden. , 2012, British journal of clinical pharmacology.

[52]  H. Ahmadi,et al.  A Review on Information Seeking Behaviour Literature in Iran , 2014 .

[53]  Sue Lacey Bryant,et al.  The information needs and information seeking behaviour of family doctors. , 2004, Health information and libraries journal.

[54]  Karen Davies,et al.  Information Needs and Barriers to Accessing Electronic Information: Hospital-Based Physicians Compared to Primary Care Physicians , 2011 .

[55]  B. Shakiba,et al.  Sources of knowledge in clinical practice in postgraduate medical students and faculty members: a conceptual map. , 2007, Journal of evaluation in clinical practice.

[56]  F. van Dijk,et al.  Occupational physicians: what are their questions in daily practice? An observation study. , 2006, Occupational medicine.

[57]  Kristy Lundahl,et al.  Residents’ Patient-Specific Clinical Questions: Opportunities for Evidence-Based Learning , 2005, Academic medicine : journal of the Association of American Medical Colleges.

[58]  A. Petros Kostagiolas,et al.  Linking physicians' medical practice information needs, resources and barriers to job satisfaction: A moderated mediation model , 2016, J. Documentation.

[59]  Wendy Novicoff,et al.  Information exchange in the NICU: what sources of patient data do physicians prefer to use? , 2004, Int. J. Medical Informatics.

[60]  Jeannette Murphy,et al.  A survey of the information management and technology training needs of doctors in an acute NHS trust in the United Kingdom. , 2004, Health information and libraries journal.

[61]  S. Vadaparampil,et al.  HPV vaccine information-seeking behaviors among US physicians: government, media, or colleagues? , 2011, Vaccine.

[62]  Douglas B. Fridsma,et al.  Research Paper: Effectiveness of Clinician-selected Electronic Information Resources for Answering Primary Care Physicians' Information Needs , 2006, J. Am. Medical Informatics Assoc..

[63]  P. Warde,et al.  National survey addressing the information needs of primary care physicians: Side effect management of patients on androgen deprivation therapy. , 2014, Canadian Urological Association journal = Journal de l'Association des urologues du Canada.

[64]  Chih-Cheng Hsu,et al.  Physicians' characteristics in the usage of online database: A representative nationwide survey of regional hospitals in Taiwan , 2009, Informatics for health & social care.

[65]  Guilherme Del Fiol,et al.  Physicians’ pharmacogenomics information needs and seeking behavior: a study with case vignettes , 2017, BMC Medical Informatics and Decision Making.

[66]  Stephen B. Johnson,et al.  Voice capture of medical residents' clinical information needs during an inpatient rotation. , 2009, Journal of the American Medical Informatics Association : JAMIA.

[67]  Paul A. Fontelo,et al.  Evaluation of generic medical information accessed via mobile phones at the point of care in resource-limited settings , 2014, J. Am. Medical Informatics Assoc..

[68]  Haleh Ayatollahi,et al.  Information needs of clinicians and non-clinicians in the Emergency Department: a qualitative study. , 2013, Health information and libraries journal.

[69]  Thomas D. Wilson,et al.  Human Information Behavior , 2000, Informing Sci. Int. J. an Emerg. Transdiscipl..

[70]  C. Havens,et al.  Facilitating physician access to medical reference information. , 2005, The Permanente journal.

[71]  Saverio M. Maviglia,et al.  Research Paper: Patient-Care Questions that Physicians Are Unable to Answer , 2007, J. Am. Medical Informatics Assoc..

[72]  G. Ajuwon,et al.  Use of the Internet for health information by physicians for patient care in a teaching hospital in Ibadan, Nigeria , 2006, Biomedical digital libraries.

[73]  David A Cook,et al.  Barriers and decisions when answering clinical questions at the point of care: a grounded theory study. , 2013, JAMA internal medicine.

[74]  Giulio Formoso,et al.  Knowledge transfer: what drug information would specialist doctors need to support their clinical practice? Results of a survey and of three focus groups in Italy , 2016, BMC Medical Informatics and Decision Making.

[75]  Erik Bernard,et al.  Internet use for information seeking in clinical practice: A cross-sectional survey among French general practitioners , 2012, Int. J. Medical Informatics.

[76]  Patrick Mikalef,et al.  Online information search behaviour of physicians , 2017, Health information and libraries journal.

[77]  J. Zell,et al.  Information needs of oncologists, general practitioners and other professionals caring for patients with cancer. , 2016, European journal of cancer care.

[78]  Guilherme Del Fiol,et al.  Formative evaluation of a patient-specific clinical knowledge summarization tool , 2016, Int. J. Medical Informatics.

[79]  S. Alghanim.  Information needs and seeking behavior among primary care physicians in Saudi Arabia: Implications for policy and practice , 2011 .

[80]  Trends in Physician Preferences for and Use of Sources of Medical Information in Response to Questions Arising at the Point of Care: 2009–2013 , 2014, The Journal of continuing education in the health professions.

[81]  S. Clark,et al.  Differences in Pediatric Drug Information Sources Used by General Versus Subspecialist Pediatricians , 2010, Clinical pediatrics.

[82]  R. Shaw,et al.  The information needs and media preferences of Canadian cancer specialists regarding breast cancer treatment related arm morbidity. , 2014, European journal of cancer care.

[83]  Linda L. Casebeer,et al.  Family physicians' information seeking behaviors: A survey comparison with other specialties , 2005, BMC Medical Informatics Decis. Mak..

[84]  C. McGuinness,et al.  Hospital clinicians' information behaviour and attitudes towards the 'Clinical Informationist': an Irish survey. , 2011, Health information and libraries journal.

[85]  Ahmad Papi,et al.  Determining the level of awareness of the physicians in using the variety of electronic information resources and the effecting factors , 2015, Journal of education and health promotion.