Quote attributed to the Dean of Cornell MedicalCollege

ldquoHalf of what we will teach you iswrong The problem is we donrsquotknow which halfrdquo

Joseph Bernstein MD Evidence BasedMedicine J Am Acad Orthop Surg 20041280-88

About 10 years ago if general internists wanted to keepabreast of the primary clinical literature they would haveneeded to read 17 articles dailyToday with more than 1000 articles indexed daily by MEDLINEthat figure is likely double

CMAJ bull APRIL 28 2009 bull 180(9)

PURPOSE The aim of this study was to determine the information needs of primary care physicians in Spain and to describe theirinformation-seeking patternsMETHODS This observational study took place in primary care practices located in Madrid Spain Participants were a random stratifiedsample of 112 primary care physicians Physiciansrsquo consultations were video recorded for 4 hours Clinical questions arising during thepatient visit and the sources of information used within the consultation to answer questions were identified Physicians withunanswered questions were followed up by telephone 2 weeks later to determine whether their questions had since been answeredand the sources of information used Clinical questions were classified by topic and type of informationRESULTS A total of 3511 patient consultations (mean length 78 minutes) were recorded leading to 635 clinical questions (018questions per consultation) The most frequent questions were related to diagnosis (53) and treatment (26) The most frequentgeneric type of questions was ldquoWhat is the cause of symptom xrdquo (205) Physicians searched for answers to 228 of the questions(96 during consultations) The time taken and the success rate in finding an answer during a consultation and afterward wereminutes (100) and 32 minutes (75) respectivelyCONCLUSIONS Primary care physicians working in settings where consultations are of short duration have time to answer only 1 in 5of their questions Better methods are needed to provide answers to questions that arise in ofice practicein settings where average consultation time is less than 10 minutes

Pacienteproblema IntervencioacutenComparador Desenlace de la intervencioacuten

Mujeres

embarazadas

Administracioacuten de

ISRS vs placebo

Malformaciones

cardiacuteacas

iquestProducen los faacutermacos ISRS malformaciones congeacutenitas cuando son administrados a mujeres embarazadas

Estudios (estudios originales)

Siacutentesis (revisiones sistemaacuteticas)

Sinopsis (resuacutemenes basados en la evidencia)

Sumarios (textos basados en la

evidencia)

Sistemas (toma de

decisiones)

Tipo de

evidencia

Herramienta de

evaluacioacuten

Direccioacuten en InternetObservaciones

Guiacuteas de

praacutectica cliacutenica

Instrumento

AGREE II

httpwwwagreetrustorg (Sitio

original)

httpwwwguiasaludescontenidosdo

cumentosGuias_Practica_ClinicaSpanis

h-AGREE-IIpdf (Traduccioacuten al espantildeol)

Revisiones

sistemaacuteticas

PRISMA httpwwwprisma-statementorg

(Sitio original Traducido al espantildeol)

Ensayos cliacutenicos

aleatorizados

CONSORT httpwwwconsort-

statementorgconsort-statement (Sitio

original Traducido al espantildeol)

Estudios

observacionales

STROBE httpwwwstrobe-statementorg (Sitio

original Traducido al espantildeol)

About 10 years ago if general internists wanted to keepabreast of the primary clinical literature they would haveneeded to read 17 articles dailyToday with more than 1000 articles indexed daily by MEDLINEthat figure is likely double

CMAJ bull APRIL 28 2009 bull 180(9)

PURPOSE The aim of this study was to determine the information needs of primary care physicians in Spain and to describe theirinformation-seeking patternsMETHODS This observational study took place in primary care practices located in Madrid Spain Participants were a random stratifiedsample of 112 primary care physicians Physiciansrsquo consultations were video recorded for 4 hours Clinical questions arising during thepatient visit and the sources of information used within the consultation to answer questions were identified Physicians withunanswered questions were followed up by telephone 2 weeks later to determine whether their questions had since been answeredand the sources of information used Clinical questions were classified by topic and type of informationRESULTS A total of 3511 patient consultations (mean length 78 minutes) were recorded leading to 635 clinical questions (018questions per consultation) The most frequent questions were related to diagnosis (53) and treatment (26) The most frequentgeneric type of questions was ldquoWhat is the cause of symptom xrdquo (205) Physicians searched for answers to 228 of the questions(96 during consultations) The time taken and the success rate in finding an answer during a consultation and afterward wereminutes (100) and 32 minutes (75) respectivelyCONCLUSIONS Primary care physicians working in settings where consultations are of short duration have time to answer only 1 in 5of their questions Better methods are needed to provide answers to questions that arise in ofice practicein settings where average consultation time is less than 10 minutes

Pacienteproblema IntervencioacutenComparador Desenlace de la intervencioacuten

Mujeres

embarazadas

Administracioacuten de

ISRS vs placebo

Malformaciones

cardiacuteacas

iquestProducen los faacutermacos ISRS malformaciones congeacutenitas cuando son administrados a mujeres embarazadas

Estudios (estudios originales)

Siacutentesis (revisiones sistemaacuteticas)

Sinopsis (resuacutemenes basados en la evidencia)

Sumarios (textos basados en la

evidencia)

Sistemas (toma de

decisiones)

Tipo de

evidencia

Herramienta de

evaluacioacuten

Direccioacuten en InternetObservaciones

Guiacuteas de

praacutectica cliacutenica

Instrumento

AGREE II

httpwwwagreetrustorg (Sitio

original)

httpwwwguiasaludescontenidosdo

cumentosGuias_Practica_ClinicaSpanis

h-AGREE-IIpdf (Traduccioacuten al espantildeol)

Revisiones

sistemaacuteticas

PRISMA httpwwwprisma-statementorg

(Sitio original Traducido al espantildeol)

Ensayos cliacutenicos

aleatorizados

CONSORT httpwwwconsort-

statementorgconsort-statement (Sitio

original Traducido al espantildeol)

Estudios

observacionales

STROBE httpwwwstrobe-statementorg (Sitio

original Traducido al espantildeol)

PURPOSE The aim of this study was to determine the information needs of primary care physicians in Spain and to describe theirinformation-seeking patternsMETHODS This observational study took place in primary care practices located in Madrid Spain Participants were a random stratifiedsample of 112 primary care physicians Physiciansrsquo consultations were video recorded for 4 hours Clinical questions arising during thepatient visit and the sources of information used within the consultation to answer questions were identified Physicians withunanswered questions were followed up by telephone 2 weeks later to determine whether their questions had since been answeredand the sources of information used Clinical questions were classified by topic and type of informationRESULTS A total of 3511 patient consultations (mean length 78 minutes) were recorded leading to 635 clinical questions (018questions per consultation) The most frequent questions were related to diagnosis (53) and treatment (26) The most frequentgeneric type of questions was ldquoWhat is the cause of symptom xrdquo (205) Physicians searched for answers to 228 of the questions(96 during consultations) The time taken and the success rate in finding an answer during a consultation and afterward wereminutes (100) and 32 minutes (75) respectivelyCONCLUSIONS Primary care physicians working in settings where consultations are of short duration have time to answer only 1 in 5of their questions Better methods are needed to provide answers to questions that arise in ofice practicein settings where average consultation time is less than 10 minutes

Pacienteproblema IntervencioacutenComparador Desenlace de la intervencioacuten

Mujeres

embarazadas

Administracioacuten de

ISRS vs placebo

Malformaciones

cardiacuteacas

iquestProducen los faacutermacos ISRS malformaciones congeacutenitas cuando son administrados a mujeres embarazadas

Estudios (estudios originales)

Siacutentesis (revisiones sistemaacuteticas)

Sinopsis (resuacutemenes basados en la evidencia)

Sumarios (textos basados en la

evidencia)

Sistemas (toma de

decisiones)

Tipo de

evidencia

Herramienta de

evaluacioacuten

Direccioacuten en InternetObservaciones

Guiacuteas de

praacutectica cliacutenica

Instrumento

AGREE II

httpwwwagreetrustorg (Sitio

original)

httpwwwguiasaludescontenidosdo

cumentosGuias_Practica_ClinicaSpanis

h-AGREE-IIpdf (Traduccioacuten al espantildeol)

Revisiones

sistemaacuteticas

PRISMA httpwwwprisma-statementorg

(Sitio original Traducido al espantildeol)

Ensayos cliacutenicos

aleatorizados

CONSORT httpwwwconsort-

statementorgconsort-statement (Sitio

original Traducido al espantildeol)

Estudios

observacionales

STROBE httpwwwstrobe-statementorg (Sitio

original Traducido al espantildeol)

Pacienteproblema IntervencioacutenComparador Desenlace de la intervencioacuten

Mujeres

embarazadas

Administracioacuten de

ISRS vs placebo

Malformaciones

cardiacuteacas

iquestProducen los faacutermacos ISRS malformaciones congeacutenitas cuando son administrados a mujeres embarazadas

Estudios (estudios originales)

Siacutentesis (revisiones sistemaacuteticas)

Sinopsis (resuacutemenes basados en la evidencia)

Sumarios (textos basados en la

evidencia)

Sistemas (toma de

decisiones)

Tipo de

evidencia

Herramienta de

evaluacioacuten

Direccioacuten en InternetObservaciones

Guiacuteas de

praacutectica cliacutenica

Instrumento

AGREE II

httpwwwagreetrustorg (Sitio

original)

httpwwwguiasaludescontenidosdo

cumentosGuias_Practica_ClinicaSpanis

h-AGREE-IIpdf (Traduccioacuten al espantildeol)

Revisiones

sistemaacuteticas

PRISMA httpwwwprisma-statementorg

(Sitio original Traducido al espantildeol)

Ensayos cliacutenicos

aleatorizados

CONSORT httpwwwconsort-

statementorgconsort-statement (Sitio

original Traducido al espantildeol)

Estudios

observacionales

STROBE httpwwwstrobe-statementorg (Sitio

original Traducido al espantildeol)

Estudios (estudios originales)

Siacutentesis (revisiones sistemaacuteticas)

Sinopsis (resuacutemenes basados en la evidencia)

Sumarios (textos basados en la

evidencia)

Sistemas (toma de

decisiones)

Tipo de

evidencia

Herramienta de

evaluacioacuten

Direccioacuten en InternetObservaciones

Guiacuteas de

praacutectica cliacutenica

Instrumento

AGREE II

httpwwwagreetrustorg (Sitio

original)

httpwwwguiasaludescontenidosdo

cumentosGuias_Practica_ClinicaSpanis

h-AGREE-IIpdf (Traduccioacuten al espantildeol)

Revisiones

sistemaacuteticas

PRISMA httpwwwprisma-statementorg

(Sitio original Traducido al espantildeol)

Ensayos cliacutenicos

aleatorizados

CONSORT httpwwwconsort-

statementorgconsort-statement (Sitio

original Traducido al espantildeol)

Estudios

observacionales

STROBE httpwwwstrobe-statementorg (Sitio

original Traducido al espantildeol)

Tipo de

evidencia

Herramienta de

evaluacioacuten

Direccioacuten en InternetObservaciones

Guiacuteas de

praacutectica cliacutenica

Instrumento

AGREE II

httpwwwagreetrustorg (Sitio

original)

httpwwwguiasaludescontenidosdo

cumentosGuias_Practica_ClinicaSpanis

h-AGREE-IIpdf (Traduccioacuten al espantildeol)

Revisiones

sistemaacuteticas

PRISMA httpwwwprisma-statementorg

(Sitio original Traducido al espantildeol)

Ensayos cliacutenicos

aleatorizados

CONSORT httpwwwconsort-

statementorgconsort-statement (Sitio

original Traducido al espantildeol)

Estudios

observacionales

STROBE httpwwwstrobe-statementorg (Sitio

original Traducido al espantildeol)

Estudios (estudios originales)

Siacutentesis (revisiones sistemaacuteticas)

Sinopsis (resuacutemenes basados en la

evidencia)

Sumarios (textos

basados en la evidencia)

Sistemas(toma de

decisiones)

Libros de texto basados en la evidencia

Fuente Direccioacuten en InternetObservaciones

Clinical

Evidence

httpclinicalevidencebmjcomcewebind

exjsp (Requiere suscripcioacuten)

Dynamed httpwwwebscohostcomdynamed

(Requiere suscripcioacuten)

Uptodate httpwwwuptodatecomindex (Requiere

suscripcioacuten)

Metabuscadores de guiacuteas de praacutectica cliacutenica

CMA Infobase httpwwwcmacaindexphpci_id5431

6la_id1htm (Acceso libre)

GuiacuteaSalud httpwwwguiasaludeshomeasp (En

espantildeol Acceso libre)

Guidelines

International

Network (GIN)

httpwwwg-i-

nnetindexcfmfuseaction=home (Acceso

libre)

National

Guideline

Clearinghouse

httpwwwguidelinegov (Acceso libre)

Guiacuteas de praacutectica cliacutenica

National

Instute for

Health and

Clinical

Excellence

(NICE)

httpwwwniceorguk (Acceso libre)

Scottish

Intercollegiate

Guidelines

Network

(SIGN)

httpwwwsignacuk (Acceso gratuito)

New Zealand

Guidelines

Group

httpwwwnzggorgnz (Acceso libre)

Temas valorados criacuteticamente

Fuente Direccioacuten en InternetObservaciones

ACP Journal Club httpwwwacpjcorg (Requiere suscripcioacuten)

Evidence Based

Medicine

httpebmbmjcom (Requiere suscripcioacuten)

Evidence Based On

Call (EBOC)

httpwwweboncallorg (Acceso libre)

Gestioacuten Cliacutenica y

Sanitaria

httpwwwiissesgcs (Acceso libre)

Farmacia de

Atencioacuten Primaria

httpwwwsefapes (Acceso libre)

Base de datos de preguntas cliacutenicas

ATRACT httpwwwattractwalesnhsuk (Acceso libre)

BestBETs httpwwwbestbetsorgindexphp (Acceso libre)

Medicines Q amp A httpwwwnelmnhsukenNeLM-

AreaEvidenceMedicines-Q--A (National electronic

Library for Medicines Acceso libre)

Preevid httpwwwmurciasaludespreevidphp (En espantildeol

Acceso libre)

Trip Database httpwwwtripdatabasecomsearchwizard (Acceso

libre)

Fuente DireccioacutenObservaciones

The Cochrane

Library

httpwwwthecochranelibrarycomview0indexht

ml (Acceso libre)

La Biblioteca

Cochrane Plus

httpwwwbibliotecacochranecom (En espantildeol

Acceso libre)

Centre for Reviews

and Dissemination

httpwwwcrdyorkacuk (Acceso libre)

PubMed Clinical

Queries

httpwwwncbinlmnihgovpubmedclinical (Acceso

libre) Filtros metodoloacutegicos para Medline

La Web 20

Podcasts y videoblogs

Elementos clave de la Web 20

Podcasts y videoblogs

Elementos clave de la Web 20

Imaacutegenes

Elementos clave de la Web 20

Wikis

Elementos clave de la Web 20Healthcare Social Media in Europe

Blogs (blogosfera sanitaria)

Elementos clave de la Web 20

Blogs (blogosfera sanitaria)

Elementos clave de la Web 20

Blogosfera docente

Redes sociales

Elementos clave de la Web 20

Redes sociales

Elementos clave de la Web 20

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