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Interventions Encouraging the Use of Systematic Reviews in Clinical Decision-Making: A Systematic Review

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Abstract

Background

Systematic reviews have the potential to inform clinical decisions, yet little is known about the impact of interventions on increasing the use of systematic reviews in clinical decision-making.

Purpose

To systematically review the evidence on the impact of interventions for seeking, appraising, and applying evidence from systematic reviews in decision-making by clinicians.

Data Sources

Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and LISA were searched from the earliest date available until July 2009.

Study Selection and Data Extraction

Two independent reviewers selected studies for inclusion if the intervention intended to increase seeking, appraising, or applying evidence from systematic reviews by a clinician. Information about the study population, features of each intervention, methods used to measure the use of systematic reviews and those used to measure professional performance or health care outcomes, existence and use of statistical tests, study outcomes, and comparative data were extracted.

Data Synthesis

A total of 8,104 titles and abstracts were reviewed, leading to retrieval of 189 full-text articles for assessment; five of these studies met all inclusion criteria. All five studies reported on professional performance behavior; none reported on patient health outcomes. One study reported positive outcomes in improving preventive care. Three studies focused on obstetrical care, with two reporting no impact on professional practice change, and one study reporting increases in the use of prophylactic oxytocin and episiotomy. One study found no improvement in the sealant rate of newly erupted molars among dentists in Scotland.

Limitations

The small number of studies available for examination indicates the difficulty in summarizing and identifying key aspects in successful strategies that encourage clinicians to use systematic reviews in decision-making. Other concerns lay in selective reporting and lack of blinding during data collection.

Conclusions

The limited empirical data render the strength of evidence weak for the effectiveness and types of interventions that encourage clinicians to use systematic reviews in clinical decision making.

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Acknowledgements

We are grateful to David Newton for his technical assistance.

Funders

Canadian Institutes of Health Research, and each author’s institution. The funding source had no role in the study design, collection, analysis, and interpretation of results, in the writing of the report, or in the decision to submit the paper for publication.

Prior presentations

May 19, 2010, Cochrane Canada 8th Annual Symposium

Conflict of interest

None disclosed.

Ethical approval

Not required

Author information

Authors and Affiliations

  1. Office of Continuing Education and Professional Development, Faculty of Medicine, University of Toronto, Toronto, Canada

    Laure Perrier MEd, MLIS

  2. Li Ka Shing Knowledge Institute of St. Michael’s Hospital, 30 Bond Street, Toronto, M5B 1W8, Canada

    Laure Perrier MEd, MLIS

  3. Faculty of Medicine, University of Calgary, Calgary, Canada

    Kelly Mrklas MSc

  4. Department of Public Health, University of Oxford, Oxford, United Kingdom

    Sasha Shepperd MSc, DPhil

  5. School of Nursing, McMaster University, Hamilton, Canada

    Maureen Dobbins PhD

  6. Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Canada

    K. Ann McKibbon PhD

  7. Faculty of Medicine, University of Toronto, Toronto, Canada

    Sharon E. Straus MSc, MD, FRCP(C)

  8. Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, Toronto, Canada

    Sharon E. Straus MSc, MD, FRCP(C)

Authors
  1. Laure Perrier MEd, MLIS
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  2. Kelly Mrklas MSc
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  3. Sasha Shepperd MSc, DPhil
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  4. Maureen Dobbins PhD
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  5. K. Ann McKibbon PhD
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  6. Sharon E. Straus MSc, MD, FRCP(C)
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Corresponding author

Correspondence to Laure Perrier MEd, MLIS.

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Perrier, L., Mrklas, K., Shepperd, S. et al. Interventions Encouraging the Use of Systematic Reviews in Clinical Decision-Making: A Systematic Review. J GEN INTERN MED 26, 419–426 (2011). https://doi.org/10.1007/s11606-010-1506-7

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  • DOI: https://doi.org/10.1007/s11606-010-1506-7

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