Utility of the electronic
information resource UpToDate for clinical decision-making at bedside rounds.
Phua J, See KC, Khalizah
HJ, Low SP, Lim TK.
Singapore Med J. 2012
Feb;53(2):116-20.
Introduction:
Clinical questions often arise at daily hospital bedside rounds. Yet, little
information exists on how the search for answers may be facilitated. The aim of
this prospective study was, therefore, to evaluate the overall utility,
including the feasibility and usefulness of incorporating searches of UpToDate,
a popular online information resource, into rounds.
Methods:
Doctors searched UpToDate for any unresolved clinical questions during rounds
for patients in general medicine and respiratory wards, and in the medical
intensive care unit of a tertiary teaching hospital. The nature of the questions
and the results of the searches were recorded. Searches were deemed feasible if
they were completed during the rounds and useful if they provided a satisfactory
answer.
Results:
A total of 157 UpToDate searches were performed during the study period.
Questions were raised by all ranks of clinicians from junior doctors to
consultants. The searches were feasible and performed immediately during rounds
44% of the time. Each search took a median of three minutes (first quartile: two
minutes, third quartile: five minutes). UpToDate provided a useful and
satisfactory answer 75% of the time, a partial answer 17% of the time and no
answer 9% of the time. It led to a change in investigations, diagnosis or
management 37% of the time, confirmed what was originally known or planned 38%
of the time and had no effect 25% of the time.
Conclusion:
Incorporating UpToDate searches into daily bedside rounds was feasible and
useful in clinical decision-making.
Correspondence:
Division of Respiratory and Critical Care Medicine, Department of Medicine,
National University Hospital, National University Health System Tower Block,
Level 10, 1E Kent Ridge Road, Singapore 119228.
tow_keang_lim@nuhs.edu.sg.
Dr Hjh Khalizah, Division of Respiratory Medicine, Department of Medicine, RIPAS
Hospital, Bandar Seri Begawan BA 1710, Brunei Darussalam.
