McMaster PLUS: A Cluster Randomized Clinical Trial of an Intervention to Accelerate Clinical Use of Evidence-based Information from Digital Libraries
- R Brian Haynes,
- Jennifer Holland,
- Chris Cotoi,
- R James McKinlay,
- Nancy L Wilczynski,
- Leslie A Walters,
- Dawn Jedras,
- Rick Parrish,
- K Ann McKibbon,
- Amit Garg,
- Stephen D Walter
- Affiliations of the authors: Health Information Research Unit (RBH, JH, CC, RJM, NLW, LAW, DJ, RP, AM), Department of Clinical Epidemiology and Biostatistics (RBH, JH, CC, RJM, NLW, LAW, DJ, RP, KAM, AG, SDW), Department of Medicine (RBH) Faculty of Health Sciences, McMaster University, Hamilton, Ontario, L8N 3Z5 Canada; Division of Nephrology, University of Western Ontario, London, Ontario N6A 4G5 Canada (AG)
- Correspondence and reprints: R. Brian Haynes, McMaster University, Epidemiology and Biostatistics, McMaster Health Sciences Centre, 1200 Main St West, Rm 2C10b, Hamilton, Ontario, Canada L8N 3Z5. e-mail: <bhaynes{at}mcmaster.ca>
- Received 23 May 2006
- Accepted 8 August 2006
Abstract
Background Physicians have difficulty keeping up with new evidence from medical research.
Methods We developed the McMaster Premium LiteratUre Service (PLUS), an internet-based addition to an existing digital library, which delivered quality- and relevance-rated medical literature to physicians, matched to their clinical disciplines. We evaluated PLUS in a cluster-randomized trial of 203 participating physicians in Northern Ontario, comparing a Full-Serve version (that included alerts to new articles and a cumulative database of alerts) with a Self-Serve version (that included a passive guide to evidence-based literature). Utilization of the service was the primary trial end-point.
Results Mean logins to the library rose by 0.77 logins/month/user (95% CI 0.43, 1.11) in the Full-Serve group compared with the Self-Serve group. The proportion of Full-Serve participants who utilized the service during each month of the study period showed a sustained increase during the intervention period, with a relative increase of 57% (95% CI 12, 123) compared with the Self-Serve group. There were no differences in these proportions during the baseline period, and following the crossover of the Self-Serve group to Full-Serve, the Self-Serve group’s usage became indistinguishable from that of the Full-Serve group (relative difference 4.4 (95% CI −23.7, 43.0). Also during the intervention and crossover periods, measures of self-reported usefulness did not show a difference between the 2 groups.
Conclusion A quality- and relevance-rated online literature service increased the utilization of evidence-based information from a digital library by practicing physicians.
Footnotes
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The McMaster PLUS system was developed with support from a grant from the Ontario Ministry of Health and Long-term Care and the PLUS trial was supported by funds from the Canadian Institutes of Health Research.
The opinions stated here are solely those of the authors.
Trial registration International eHealth Study Registry (IESR) IESN2005RH00013.
