Traditional teaching on EBM held that doctors should do PubMed searches to find answers to clinical questions. Because PubMed is cumbersome and time consuming for unskilled users, recent trends favor filtered resources or, as the writer of the introductory editorial calls them, secondary literature:
Family physicians are busier than ever and have limited time to keep current with the literature. Reading lengthy and detailed original research studies is hardly the best use of that time. Practicing physicians, and even most academic physicians, do not have the training or time to critically appraise all of the articles needed to answer clinical questions or stay current.
I propose a different skill set that prioritizes making the practicing family physician an informed consumer of the secondary literature (e.g., evidence–based guidelines, systematic reviews, critical appraisals, validated decision–support tools).
I only partially agree. While secondary sources are indispensable, there are situations where there’s no substitute for the primary source. And while some secondary sources like UptoDate have the advantage of greater speed, PubMed can be used very efficiently with a little training and practice.
While this series is directed toward family physicians the information should be useful to general internists and hospitalists as well. If time constraints and lack of computer searching skills are barriers to the application of EBM this series should help. I’ll be commenting on various installments in future posts.