Net improvement of correct answers to therapy questions after pubmed searches: Pre/post comparison

Background: clinicians search pubmed for answers to clinical questions although it is time consuming and not always successful. objective: to determine if pubmed used with its clinical queries feature to filter results based on study quality would improve search success (more correct answers to clinical questions related to therapy). methods: we invited 528 primary care physicians to participate,143 (27.1%) consented,and 111 (21.0% of the total and 77.6% of those who consented) completed the study. participants answered 14 yes/no therapy questions and were given 4 of these (2 originally answered correctly and 2 originally answered incorrectly) to search using either the pubmed main screen or pubmed clinical queries narrow therapy filter via a purpose-built system with identical search screens. participants also picked 3 of the first 20 retrieved citations that best addressed each question. they were then asked to re-answer the original 14 questions. results: we found no statistically significant differences in the rates of correct or incorrect answers using the pubmed main screen or pubmed clinical queries. the rate of correct answers increased from 50.0% to 61.4% (95% ci 55.0%-67.8%) for the pubmed main screen searches and from 50.0% to 59.1% (95% ci 52.6%-65.6%) for clinical queries searches. these net absolute increases of 11.4% and 9.1%,respectively,included previously correct answers changing to incorrect at a rate of 9.5% (95% ci 5.6%-13.4%) for pubmed main screen searches and 9.1% (95% ci 5.3%-12.9%) for clinical queries searches,combined with increases in the rate of being correct of 20.5% (95% ci 15.2%-25.8%) for pubmed main screen searches and 17.7% (95% ci 12.7%-22.7%) for clinical queries searches. conclusions: pubmed can assist clinicians answering clinical questions with an approximately 10% absolute rate of improvement in correct answers. this small increase includes more correct answers partially offset by a decrease in previously correct answers.