What information sources do Dutch medical specialists use in medical decision-making: a qualitative interview study.

OBJECTIVE: To explore what information sources medical specialists currently use to inform their medical decision-making. DESIGN: Qualitative, semistructured interviews. SETTING AND PARTICIPANTS: A total of 20 semistructured interviews were conducted with 10 surgeons and 10 internal medicine specialists who work in academic and/or regional hospitals in the Netherlands. RESULTS: Medical specialists reported that they primarily rely on their general knowledge and experience, rather than actively using information sources. The sources they use to update their knowledge can be categorised into 'scientific publications', 'guidelines or protocols', and 'presentations and meetings'. When medical specialists feel their general knowledge and experience are insufficient, they use three different approaches to find answers in response to clinical questions: consulting a colleague, actively searching the literature and asking someone else to search the literature. CONCLUSION: Medical specialists use information sources to update their general knowledge and to find answers to specific clinical questions when they feel their general knowledge and experience are insufficient. An important finding is that medical specialists prefer accessible information sources (eg, consulting colleagues) over existing evidence-based medicine tools.

[The role of clinical guidelines in daily practice]. / Medisch-specialistische richtlijnen op de werkvloer.

In a time of exponential growth of medical scientific knowledge medical specialists need all the help they can get in translating the vast amount of information to the best treatment for their patients. Evidence based guidelines in essence seem a useful tool in promoting this translation as they report an extensive evaluation of available evidence. In daily practice however, guidelines do not always find their way to the clinical encounter with patients. But how do the end users of clinical practice guidelines, the medical specialists, utilize these instruments and how can this potentially be improved?