Evidence summary resources may influence clinical decision making: A case-based scenario evaluation of an evidence summary tool

J Crit Care. 2020 Feb;55:9-15. doi: 10.1016/j.jcrc.2019.10.001. Epub 2019 Oct 19.

Abstract

Purpose: Evidence summary resources are popular with clinicians but it is unknown whether they can influence clinical decision making. We evaluated whether an extremely condensed and explicit evidence summary tool could influence clinical decision making.

Materials and methods: An evidence summary tool was developed using a formal mapping exercise and graphic design principles. An invitation to participate was sent to subscribers of a critical care e-mail discussion list. Participants received a study package (evidence summary tool précising prone positioning in severe ARDS; case-based scenario describing a patient with severe ARDS plus evaluation questionnaire). Influence on clinical decisions was captured regarding six competing interventions, with Belief in benefit measured before and after reading the summary tool.

Results: Among 93 participants, 87% were male with a mean age of 49.6(SD9.3) years. Mean ICU experience was 20.0(SD9.9) years. The evidence summary tool significantly influenced clinical decision making: belief in benefit of prone positioning increased (P < .001), belief in benefit of higher PEEP decreased (P = .002) and belief in benefit in ECMO decreased (P = .07).

Conclusions: Using a before-after evaluation, we demonstrated an extremely condensed and explicit information format can influence clinical decision making. Evidence summary tools may be a useful adjunct to support closing evidence-practice gaps.

Keywords: Clinical decision making; Critical care medicine; Evidence summary tool; Evidence-practice gaps; Intensive care unit; Knowledge synthesis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Clinical Decision-Making*
  • Critical Care*
  • Evidence-Based Medicine
  • Female
  • Humans
  • Intensive Care Units
  • Male
  • Middle Aged
  • Respiratory Distress Syndrome / therapy*
  • Surveys and Questionnaires