Rehabilitation Measures Database

From Rehabilitation Institute of Chicago:

http://www.rehabmeasures.org/default.aspx

This database has info on commonly used rehab measures.

Discussion on UpToDate

Answering Clinical Questions Improves Patient Safety and Saves Money

Speed of updating online evidence based point of care summaries: prospective cohort analysis

Type of Evidence Behind Point-of-Care Clinical Information Products: A Bibliometric Analysis

Giustini Wang Read UpToDate 2011

To Compare PubMed Clinical Queries and UpToDate in Teaching Information Mastery to Clinical Residents: A Crossover Randomized Controlled Trial

An opinion:

As librarians do we provide the “best evidence” or do we provide a summary of recent evidence? I would like to think the former, but I feel it is closer to the latter unless we are sending along summaries from a point-of-care resource. If we are doing the latter, we do save the clinician some time, but they still have to read the articles and decide if they are valid and then decide if they are important enough to change their practice. Point-of-care resources are supposed to make that simpler and its why I think clinicians take the recommendations from DynaMed and UTD at face-value.


So the issue with UTD then is that if a clinician takes it at face value and the evidence isn’t current is the recommendation valid, are changes to practice warranted and are the potential changes what a clinician should do in order to best serve his/her patient.

The question of translating new research into practice is interesting as well. One would think, and I have no idea if anyone has looked at this yet, that having a new, practice changing, recommendation appear on average in a product 2 months after publication is better than 12+ months. But even the BMJ article doesn’t really get at the heart of practice changing vs current so it’s hard to say.

I also think we are discounting the role marketing plays in users’ perceptions of the quality of the product. Like pharmaceutical companies UTD can provide us with shiny reprints showing how great they are when, as Patrick pointed out this morning, compared to nothing. Even some of the studies that have come up today compare UTD to citation databases and not to other point-of-care resources.


I don’t think that’s a fair comparison and I think there are a lot of questions that somehow need to be addressed in this type of research to truly determine what products provide the best, most current evidence in the most timely manner instead of what users “prefer” because it’s what is familiar or what they see ads for.

What I think the BMJ article is getting closer to is an actual comparison of different products in a meaningful way. One of the most important parts of all the research we see is that it is objective, and not based on “knee jerk” responses from clients who want the system to stay the same. I know I can go out and survey my clients to get a feeling for what they think would be best, but those surveys don’t really get at the heart of what I want to know when spending thousands of dollars on a resource which is will this product improve patient care?

Another opinion:

UTD is preferred by physicians (at least according to studies by
UTD, DynaMed has self-funded studies which say the same thing). But is
"preference" more important to the care of patients than correct and
current information?

The BMJ article (which I give kudos to BMJ for publishing since their
own product, Clinical Evidence ranked the lowest), looked at systematic
reviews published between 2009 and 2010 so it's pretty current.

Here's one of the big findings:

Dynamed has a median citation rate of around two months, EBM Guidelines
is around 10 months but quite close to the limit of our follow-up. The
citation rate of the other three point of care summaries (UpToDate,
eMedicine, Clinical Evidence) were so slow that they exceeded the
follow-up period and we could not compute the median.

So basically you can expect current evidence to appear in DynaMed at 2
months and it might not even appear in UTD at 1 year. I believe this is
because the process of including information in DynaMed is much
different than UTD.

In addition, while these resources are designed to be Point-of-Care I am
unsure how much further clinicians go when searching either DynaMed or
UTD (i.e. Do they really go to PubMed and then critically appraise what
they find? Do they even find the most current and clinically relevant
information if they do search there?).

If a clinician doesn't go beyond UTD and the information they find there
isn't current I don't think it matters how many searches/dollar are run
or how "useful" they preceive it to be.

I'd be interesting in the citation for the study you mention though. I
just pulled one that concludes UTD is quicker at finding answers than
Essential Evidence, First Consult and ACP PIER, but I can't see the
methods to see if they evaluated the "correctness" of the answers found.

A comparison of answer retrieval through four evidence-based textbooks
(ACP PIER, Essential Evidence Plus, First Consult, and UpToDate): A
randomized controlled trial.

Princeton goes open access to stop staff handing all copyright to journals – unless waiver granted

Prestigious US academic institution Princeton University will prevent researchers from giving the copyright of scholarly articles to journal publishers, except in certain cases where a waiver may be granted.

The new rule is part of an Open Access policy aimed at broadening the reach of their scholarly work and encouraging publishers to adjust standard contracts that commonly require exclusive copyright as a condition of publication.

Universities pay millions of dollars a year for academic journal subscriptions. People without subscriptions, which can cost up to $25,000 a year for some journals or hundreds of dollars for a single issue, are often prevented from reading taxpayer funded research. Individual articles are also commonly locked behind pay walls.

Researchers and peer reviewers are not paid for their work but academic publishers have said such a business model is required to maintain quality.

At a September 19 meeting, Princeton’s Faculty Advisory Committee on Policy adopted a new open access policy that gives the university the “nonexclusive right to make available copies of scholarly articles written by its faculty, unless a professor specifically requests a waiver for particular articles.”

“The University authorizes professors to post copies of their articles on their own web sites or on University web sites, or in other not-for-a-fee venues,” the policy said.

“The main effect of this new policy is to prevent them from giving away all their rights when they publish in a journal.”

Under the policy, academic staff will grant to The Trustees of Princeton University “a nonexclusive, irrevocable, worldwide license to exercise any and all copyrights in his or her scholarly articles published in any medium, whether now known or later invented, provided the articles are not sold by the University for a profit, and to authorise others to do the same.”

In cases where the journal refuses to publish their article without the academic handing all copyright to the publisher, the academic can seek a waiver from the open access policy from the University.

The policy authors acknowledged that this may make the rule toothless in practice but said open access policies can be used “to lean on the journals to adjust their standard contracts so that waivers are not required, or with a limited waiver that simply delays open access for a few months.”

Academics will also be encouraged to place their work in open access data stores such as Arxiv or campus-run data repositories.

Princeton University spokesman, Martin A. Mbugua, said the policy was not an outright ban on staff handing copyright to journal publishers.

“It is a new open access policy that gives our faculty an advantage, and the option of seeking a waiver,” he said.

A step forward

Having prestigious universities such as Princeton and Harvard fly the open access flag represented a step forward, said open access advocate Professor Simon Marginson from the University of Melbourne’s Centre for the Study of Higher Education.

“The achievement of free knowledge flows, and installation of open access publishing on the web as the primary form of publishing rather than oligopolistic journal publishing subject to price barriers, now depends on whether this movement spreads further among the peak research and scholarly institutions,” he said.

“Essentially, this approach – if it becomes general – normalises an open access regime and offers authors the option of opting out of that regime. This is a large improvement on the present position whereby copyright restrictions and price barriers are normal and authors have to attempt to opt in to open access publishing, or risk prosecution by posting their work in breach of copyright.”

“The only interests that lose out under the Princeton proposal are the big journal publishers. Everyone else gains.”

Professor Tom Cochrane, Deputy Vice-Chancellor Technology, Information and Learning Support at the Queensland University of Technology, who has also led an Open Access policy mandate at QUT welcomed Princeton’s new rule but warned that the waiver must not be used too regularly, lest the policy be undermined.

If all universities and research institutions globally had policies similar to Princeton’s, the ultimate owner of published academic work would be universities and their research communities collectively, Professor Cochrane said.

“They are the source of all the content that publishers absolutely require to run their business model,” he said.

Dr Danny Kingsley, an open access expert and Manager of Scholarly Communication and ePublishing at Australian National University said the move was a positive step and that the push for open access should come from the academic community.

In practice, however, the new policy requires staff have a good understanding of the copyright arrangements they currently have with journal publishers in their field.

They will need to ensure future publisher’s agreements accommodate the new position and if not, obtain a waiver from the University.

“This sounds easy but in reality might be a challenge for some academics. There is considerable evidence to show that academics often have very little understanding of the copyright situation of their published work,” she said.

“What will be most telling will be the publishers' response over the next year or so. If they start providing amended agreements to Princeton academics then the door will be open for other universities to follow this lead. I suspect however they will not, as generally the trend seems for publishers to make the open access path a complex and difficult one.”

Employee Collaboration, Customer Collaboration, Document Management, and Project Management

From SLA:

http://wiki.sla.org/display/SLAKM/2011/01/20/Employee+Collaboration%2C+Customer+Collaboration%2C+Document+Management%2C+and+Project+Management

By Ben Keefe.