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Obstacles to answering doctors' questions about patient care with evidence: qualitative study. | LitMetric
Objective : To describe the obstacles encountered when attempting to answer doctors' questions with evidence.Design : Qualitative study.Setting : General practices in Iowa.Participants : 9 academic generalist doctors, 14 family doctors, and 2 medical librarians.Main Outcome Measure : A taxonomy of obstacles encountered while searching for evidence based answers to doctors' questions.Results : 59 obstacles were encountered and organised according to the five steps in asking and answering questions: recognise a gap in knowledge, formulate a question, search for relevant information, formulate an answer, and use the answer to direct patient care. Six obstacles were considered particularly salient by the investigators and practising doctors: the excessive time required to find information; difficulty modifying the original question, which was often vague and open to interpretation; difficulty selecting an optimal strategy to search for information; failure of a seemingly appropriate resource to cover the topic; uncertainty about how to know when all the relevant evidence has been found so that the search can stop; and inadequate synthesis of multiple bits of evidence into a clinically useful statement.Conclusions : Many obstacles are encountered when asking and answering questions about how to care for patients. Addressing these obstacles could lead to better patient care by improving clinically oriented information resources.
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