Developing and Using a Rubric for Evaluating Evidence-Based Medicine Point-of-Care Tools *

Article excerpt

Objective: The research sought to establish a rubric for evaluating evidence-based medicine (EBM) point-of-care tools in a health sciences library.

Methods: The authors searched the literature for EBM tool evaluations and found that most previous reviews were designed to evaluate the ability of an EBM tool to answer a clinical question. The researchers' goal was to develop and complete rubrics for assessing these tools based on criteria for a general evaluation of tools (reviewing content, search options, quality control, and grading) and criteria for an evaluation of clinical summaries (searching tools for treatments of common diagnoses and evaluating summaries for quality control).

Results: Differences between EBM tools' options, content coverage, and usability were minimal. However, the products' methods for locating and grading evidence varied widely in transparency and process.

Conclusions: As EBM tools are constantly updating and evolving, evaluation of these tools needs to be conducted frequently. Standards for evaluating EBM tools need to be established, with one method being the use of objective rubrics. In addition, EBM tools need to provide more information about authorship, reviewers, methods for evidence collection, and grading system employed.

INTRODUCTION

Health care providers require quick retrieval of information to efficiently answer questions related to patient care [I]. Evidence-based medicine (EBM) tools, designed for use at the point of care (POC), meet these needs by providing high-quality and synthesized information at the patients' "bedside" [2]. To support clinical information needs, medical and hospital libraries may wish to subscribe to multiple POC tools, owing to the variety in topics covered, the options provided, and the audiences targeted by each tool. To avoid redundancy and to offer the best products for their users, libraries need to periodically reassess available EBM POC resources [2]. What criteria should librarians utilize to evaluate these POC tools? Because these resources are used to make clinical decisions, resources providing the best evidence relevant to patient care would be most desirable. Those who use these tools "need to know how much confidence they can place in the recommendations" [3]. One role of medical librarians is to evaluate the quality of EBM resources so that users can have confidence in the information upon which they base clinical decisions. This is a weighty responsibility, and librarians have an important challenge determining which EBM POC resources to make available to users.

BACKGROUND

The Texas A&M University Medical Sciences Library (MSL) is 1 of 5 libraries on the College Station campus of Texas A&M University. MSL houses 120,000 print titles and 1,600 serials, with a collection budget of more than $1.8 million. One of the library's user groups is the Texas A&M Health Science Center (TAMHSC), which includes the TAMHSC College of Medicine, College of Nursing, School of Graduate Studies, Rangel College of Pharmacy, and School of Rural Public Health. The director of the MSL charged a team of 3 Librarians in 2008 to evaluate and determine which EBM POC subscription-based tools the library should keep or purchase, in order to reduce overlap and to ensure that user needs were met. In 2008, MSL subscribed to 5 EBM POC tools: Stat!Ref's ACP PIER, DynaMed, Cochrane Library, Essential Evidence Plus, and MD Consult's First Consult. The librarians were asked to evaluate all subscription EBM POC resources. No directions were given as to how to perform this evaluation. To determine which tools to evaluate and to find best practices for evaluation, the librarians conducted a literature review.

LITERATURE REVIEW

The literature review included searching MEDLINE (PubMed), CINAHL (EBSCO), Library Information Science Technology Abstracts (LISTA) (EBSCO), and Google Scholar. Search terms included combinations of "evidence based medicine tools," "point of care tools," "bedside tools," "evaluation," and names of specific tools. …