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Grad, R.; Pluye, P.; Granikov, V.; Johnson-Lafleur, J.; Shulha, M.; Sridhar, S.B.; Moscovici, J.L.; Bartlett, G.; Vandal, A.C.; Marlow, B.; Kloda, L.: Physicians' assessment of the value of clinical information : Operationalization of a theoretical model (2011)
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- Abstract
- Inspired by the acquisition-cognition-application model (T. Saracevic & K.B. Kantor, 1997), we developed a tool called the Information Assessment Method to more clearly understand how physicians use clinical information. In primary healthcare, we conducted a naturalistic and longitudinal study of searches for clinical information. Forty-one family physicians received a handheld computer with the Information Assessment Method linked to one commercial electronic knowledge resource. Over an average of 320 days, 83% of 2,131 searches for clinical information were rated using the Information Assessment Method. Searches to address a clinical question, as well as the retrieval of relevant clinical information, were positively associated with the use of that information for a specific patient. Searches done out of curiosity were negatively associated with the use of clinical information. We found significant associations between specific types of cognitive impact and information use for a specific patient. For example, when the physician reported "My practice was changed and improved" as a result of this clinical information, the odds that information was used for a specific patient increased threefold. Our findings provide empirical data to support the applicability of the acquisition-cognition-application model, as operationalized through the Information Assessment Method, in primary healthcare. Capturing the use of research-based information in medicine opens the door to further study of the relationships between clinical information and health outcomes.
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Pluye, P.; Grad, R.; Repchinsky, C.; Jovaisas, B.; Johnson-Lafleur, J.; Carrier, M.-E.; Granikov, V.; Farrell, B.; Rodriguez, C.; Bartlett, G.; Loiselle, C.; Légaré, F.: Four levels of outcomes of information-seeking : a mixed methods study in primary health care (2013)
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- Abstract
- Primary health care practitioners routinely search for information within electronic knowledge resources. We proposed four levels of outcomes of information-seeking: situational relevance, cognitive impact, information use, and patient health outcomes. Our objective was to produce clinical vignettes for describing and testing these levels. We conducted a mixed methods study combining a quantitative longitudinal study and a qualitative multiple case study. Participants were 10 nurses, 10 medical residents, and 10 pharmacists. They had access to an online resource, and did 793 searches for treatment recommendations. Using the Information Assessment Method (IAM), participants rated their searches for each of the four levels. Rated searches were examined in interviews guided by log reports and a think-aloud protocol. Cases were defined as clearly described searches where clinical information was used for a specific patient. For each case, interviewees described the four levels of outcomes. Quantitative and qualitative data were merged into clinical vignettes. We produced 130 clinical vignettes. Specifically, 46 vignettes (35.4%) corresponded to clinical situations where information use was associated with one or more than one type of positive patient health outcome: increased patient knowledge (n = 28), avoidance of unnecessary or inappropriate intervention (n = 25), prevention of disease or health deterioration (n = 9), health improvement (n = 6), and increased patient satisfaction (n = 3). Results suggested information use was associated with perceived benefits for patients. This may encourage clinicians to search for information more often when they feel the need. Results supported the four proposed levels of outcomes, which can be transferable to other information-seeking contexts.
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Pluye, P.; El Sherif, R.; Granikov, V.; Hong, Q.N.; Vedel, I.; Barbosa Galvao, M.C.; Frati, F.E.Y.; Desroches, S.; Repchinsky, C.; Rihoux, B.; Légaré, F.; Burnand, B.; Bujold, M.; Grad, R.: Health outcomes of online consumer health information : a systematic mixed studies review with framework synthesis (2019)
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- Abstract
- The Internet has become the first source of consumer health information. Most theoretical and empirical studies are centered on information needs and seeking, rather than on information outcomes. This review's purpose is to explore and explain health outcomes of Online Consumer Health Information (OCHI) in primary care. A participatory systematic mixed studies review with a framework synthesis was undertaken. Starting from an initial conceptual framework, our specific objectives were to (a) identify types of OCHI outcomes in primary care, (b) identify factors associated with these outcomes, and (c) integrate these factors and outcomes into a comprehensive revised framework combining an information theory and a psychosocial theory of behavior. The results of 65 included studies were synthesized using a qualitative thematic data analysis. The themes derived from the literature underwent a harmonization process that produced a comprehensive typology of OCHI outcomes. The revised conceptual framework specifies four individual and one organizational level of OCHI outcomes, while including factors such as consumers' information needs and four interdependent contextual factors. It contributes to theoretical knowledge about OCHI health outcomes, and informs future research, information assessment methods, and tools to help consumers find and use health information.
