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Clinical Librarianship: A Systematic Review. Alison Winning & Catherine Beverley Information Resources Section, ScHARR Evidence Based Librarianship Conference 3 rd September 2001. Overview. Background Aims of our review Methods Results to date Conclusions. - PowerPoint PPT Presentation
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Clinical Librarianship: A Systematic Review
Alison Winning & Catherine BeverleyInformation Resources Section, ScHARR
Evidence Based Librarianship Conference3rd September 2001
Overview• Background
• Aims of our review
• Methods
• Results to date
• Conclusions
What is clinical librarianship?
• The provision of quality-filtered case-specific information directly to health professionals in acute settings to support clinical decision making (based on Veenstra & Gluck, 1992)
Fact or fiction?• Is there evidence for clinical
librarian (CL) programmes?• Can CLs have an impact on
clinicians’ information skills?• Can an effect on clinical outcomes
and interventions be measured?• Do clinicians value this service?• Are they cost-effective?
Cimpl’s (1985) review• Historical review 1971–1983• Reasons to evaluate:
– determine the quality of the service– measure cost– measure educational benefit to clinicians
• Benefits of clinical librarianship– enhancement of patient care– greater awareness of library resources
Aims of our review• To build upon Cimpl’s review
• To determine whether a CL service:
– Improves patient care
– Has an impact on clinicians’ use of the literature in practice
Methods• Application of NICE/CRD framework
to health information topic
• Inclusion and exclusion criteria • Search strategy• Quality assessment• Data extraction
Inclusion & exclusion criteria
• Types of study• Types of participants• Types of intervention• Types of outcomes
– General, relating to service use– Patient care– Clinicians’ use of the literature in practice– Cost
Inclusion & exclusion criteria (2)
• Excluded studies:– Health science librarians providing a
general hospital library service– Outreach librarians involved in
education of remote HCPs– Initiatives outside the acute setting– Initiatives aimed at patients– Non-English language papers– Pre-1983 studies
Search strategy• Multiple methods:
– Major information science, health & social science electronic bibliographic databases
– Internet searches– Citation searches– Reference lists checked– Key journals handsearched
Quality assessment• CRISTAL checklist for user studies
employed for evaluative studies
– Checklist comprises three components (based on CASP):
• Validity• Reliability• Applicability
Data extraction• Pre-determined data extraction form:
– General information (e.g. bibliographic details)
– Participant characteristics– Details about the intervention– Methods– Results for each outcome– Additional notes
Results … to date• Quantity of research:
– 215 references retrieved– 166 references ordered– 12 studies met our inclusion criteria
for evaluative studies– A further 29 studies met our inclusion
criteria for descriptive studies
Results … to date (2)• Quality of research:
– Poor reporting
– Bias– Reliability & validity of approach– Representative sample group?– Failure to acknowledge limitations
General outcomes
• Description of programmes
• Service usage
Patient care• Improved patient care?• Impact on factors:
– Advice given to patients– Choice of treatment– Choice of tests
• Prevention of events– Additional tests/procedures
HCPs’ use of the literature
• Ability of clinicians to find literature themselves
• Utilisation of the literature by clinicians
Costs
• No cost benefit analysis
• Limited applicability
Conclusions• Implications for practice and
research:– Evaluate CL programmes in practice
• Longer follow-up periods to assess impact on patient care
• Identification of use of the literature
• Future research:– High quality studies with large,
representative samples• Examination of clinical outcomes• Assessment of cost-effectiveness
Summary• Limited evidence for effectiveness
of CL• Outcomes can be measured• Clinicians appear to value service,
but this is not adequately explored in the literature
• No information regarding cost-effectiveness