Utilization of the PICO framework to improve searching PubMed for clinical questions
Utilization of the PICO framework to improve searching PubMed for clinical questions
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DOI：
10.1186/1472-6947-7-16
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发表时间：
2007-06-15
影响因子：
3.5
通讯作者：
Fontelo, Paul
中科院分区：
文献类型：
--
作者：
Schardt, Connie;Adams, Martha B.;Fontelo, Paul
背景资料：支持21世纪世纪的卫生保健和循证医学（EBM）的实践需要无处不在的临床信息和知识为基础的资源，以回答临床问题。许多问题得不到解答，但是，由于缺乏技能，制定问题，制定有效的搜索策略，并访问数据库，以确定最佳水平的evidence.Methods：这项随机试验的目的是作为一个试点研究，以衡量使用三种不同的接口检索结果的相关性PubMed搜索系统。其中两个检索界面使用了一个名为皮科的特定框架，该框架旨在关注临床问题并提示发表类型或所问问题的类型。第三个接口是标准的PubMed接口，可在网上随时获得。研究对象是从美国一家学术医疗中心的住院全科医学轮换的实习生和住院医生中招募的。31名受试者被随机分配到三个界面之一，给出3个临床问题，并要求在PubMed中搜索一组相关文章，为每个问题提供答案。成功的搜索结果是由一个精确度分数，它比较了在一个结果集检索到的相关或金标准的文章的数量，在该set.Results检索到的文章总数：使用皮科模板（协议A或协议B）的参与者有更高的精确度分数比谁使用协议C，标准的PubMed Web界面的参与者每个问题。（问题一：A = 35%，B = 28%，C = 20%;问题2：A = 5%，B = 6%，C = 4%;问题3：A = 1%，B = 0%，C = 0%）使用零下限计算每个问题精密度的95%置信区间。然而，95%的置信限重叠，表明groups.Conclusion之间没有统计学差异：由于每个手臂的搜索数量少，这项试点研究无法证明搜索协议之间的统计学显着差异。然而，存在更高精度的趋势，需要在更大规模的研究中进行调查，以确定皮科是否可以提高搜索结果的相关性。
Background: Supporting 21st century health care and the practice of evidence-based medicine (EBM) requires ubiquitous access to clinical information and to knowledge-based resources to answer clinical questions. Many questions go unanswered, however, due to lack of skills in formulating questions, crafting effective search strategies, and accessing databases to identify best levels of evidence.Methods: This randomized trial was designed as a pilot study to measure the relevancy of search results using three different interfaces for the PubMed search system. Two of the search interfaces utilized a specific framework called PICO, which was designed to focus clinical questions and to prompt for publication type or type of question asked. The third interface was the standard PubMed interface readily available on the Web. Study subjects were recruited from interns and residents on an inpatient general medicine rotation at an academic medical center in the US. Thirty-one subjects were randomized to one of the three interfaces, given 3 clinical questions, and asked to search PubMed for a set of relevant articles that would provide an answer for each question. The success of the search results was determined by a precision score, which compared the number of relevant or gold standard articles retrieved in a result set to the total number of articles retrieved in that set.Results: Participants using the PICO templates ( Protocol A or Protocol B) had higher precision scores for each question than the participants who used Protocol C, the standard PubMed Web interface. ( Question 1: A = 35%, B = 28%, C = 20%; Question 2: A = 5%, B = 6%, C = 4%; Question 3: A = 1%, B = 0%, C = 0%) 95% confidence intervals were calculated for the precision for each question using a lower boundary of zero. However, the 95% confidence limits were overlapping, suggesting no statistical difference between the groups.Conclusion: Due to the small number of searches for each arm, this pilot study could not demonstrate a statistically significant difference between the search protocols. However there was a trend towards higher precision that needs to be investigated in a larger study to determine if PICO can improve the relevancy of search results.