Answering Clinical Questions

Select An Information Source

The first step in a search is to select the best information source. This usually means a decision to quickly use the most available source or take the time to search the most comprehensive one. Today you may need rapid access to a specific piece of information, such as the dose of a particular drug. Tomorrow you may need comprehensive information about the latest treatment options for a particular condition.

A perfect information source provides exactly the amount of information you need, when you need it, and with a minimum of time and effort. Since no source is perfect, you have to make compromises. Ask yourself these questions the next time you have to search for information. It helps to determine what information source to use.

The Bottom Line is "How will I use the information?" The answer will focus your thinking for the rest of the questions.

Quickness

How soon do I need the information? Do you need the information immediately, or can you wait to do a more thorough search?

How quickly can I find the information? How rapidly can you access the source and then the information within the source? What is your time worth per hour? It may be more cost-effective to have someone else do the search for you.

How quickly can I read the information? This will affect your later decision about conciseness or comprehensiveness. It also depends on how well the information is written and organized.

Quantity

Do I want comprehensive information? Are you looking for a thorough review of a topic, such as a textbook chapter or a thorough search of the current literature? Comprehensive information will address more aspects of the topic,but will you have time to read it?

Do I want concise information? Are you looking for concise information such as the dosage of a specific drug, or perhaps an overview such as a review article about a particular disease? Concise information is easier to read, but may not discuss all relevant issues. This is always a trade-off with comprehensiveness.

Quality

Will the information be up-to-date? For instance, it is useless to look for information on Helicobacter Pylori as a cause for peptic ulcer in a textbook that was published ten years ago.

Will the information be evidence-based? Is the information likely to be based on solid research evidence? Unfortunately there are many important questions that have never been researched.

Will the information represent expert consensus? Even though a journal article may have gone through a peer-review process, it may often discuss only one side of controversial issues. It may also differ from the opinion of local experts.

Will the information be useable in my practice? For instance, journal articles often discuss treatment methods that were successful in specialized clinics. They may not work as well in physician's offices or in smaller centres.

Cost

What will the information cost? What will it cost to obtain the information? Remember to count value of your own time and effort.

Exercises

The next time a question arises in your clinical practice, take a moment to ask yourself these questions before you begin to search for information.

Estimate the cost per hour of your personal time, based on your local medical fee schedule.

Measure how long it takes to look up a drug dosage in the Compendium of Pharmaceuticals and Specialties (CPS, Canada) or Physician's Desk Reference (PDR, USA).

Measure how long it takes to look up and read a chapter in your favorite Internal Medicine textbook.