Answers to Questions Posed During Daily Patient Care Are More Likely to Be Answered by UpToDate Than PubMed

Abstract

BackgroundUpToDate and PubMed are popular sources for medical information. Data regarding the efficiency of PubMed and UpToDate in daily medical care are lacking.Objective The purpose of this observational study was to describe the percentage of answers retrieved by these information sources, comparing search results with regard to different medical topics and the time spent searching for an answer.Methods A total of 40 residents and 30 internists in internal medicine working in an academic medical center searched PubMed and UpToDate using an observation portal during daily medical care. The information source used for searching and the time needed to find an answer to the question were recorded by the portal. Information was provided by searchers regarding the topic of the question, the situation that triggered the question, and whether an answer was found.Results We analyzed 1305 patient-related questions sent to PubMed and/or UpToDate between October 1, 2005 and March 31, 2007 using our portal. A complete answer was found in 594/1125 (53%) questions sent to PubMed or UpToDate. A partial or full answer was obtained in 729/883 (83%) UpToDate searches and 152/242 (63%) PubMed searches (P < .001). UpToDate answered more questions than PubMed on all major medical topics, but a significant difference was detected only when the question was related to etiology (P < .001) or therapy (P = .002). Time to answer was 241 seconds (SD 24) for UpToDate and 291 seconds (SD 7) for PubMed.Conclusions Specialists and residents in internal medicine generally use less than 5 minutes to answer patient-related questions in daily care. More questions are answered using UpToDate than PubMed on all major medical topics.

A Survey from a Large Academic Medical Center

“…For example, UpToDate was the preferred source in each domain, often by a large margin. Other studies have corroborated this finding with UpToDate frequently being the source most often used to generate the correct answer to various clinical questions [6,14,26]. What is difficult to glean from these results, however, is whether respondents actually prefer synthesized information generally or whether or not they are most familiar with and have ready access to UpToDate and responded accordingly.…”

“…However, despite the growing popularity of online resources, many barriers remain that prevent clinicians from frequently and successfully answering clinical questions using online knowledge searches. These barriers include, but are not limited to, time limitations, uncertain knowledge accuracy, technology malfunction, and knowledge seeker forgetfulness of the questions needing answered [5][6][7][8][9][10].…”

Interactive Visual Displays for Interpreting the Results of Clinical Trials: Formative Evaluation With Case Vignettes (Preprint)

“…The average time for clinicians to look up clinical questions on PubMed ranges from 5 minutes to 60 minutes [7]. In addition, clinicians report high levels of dissatisfaction with their information seeking experience [8,9]. Ultimately, clinicians' challenges in consuming evidence from the primary literature may contribute to slowing the translation of scientific evidence [10].…”

Use of UpToDate and outcomes in US hospitals

“…4 UpToDate is one of the most widely used computerized clinical knowledge management systems in the nation. 1,2,5,6 Previous studies of UpToDate and similar systems demonstrated that these systems improve acquisition of knowledge, increase the number of answered clinical questions, and change management decisions. 7,8 However, whether these changes lead to real improvements in clinical outcomes is unknown.…”