Sidelines 18 (2)

Centre for Reviews and Dissemination

University of York

Web: http://www.york.ac.uk/inst/crd

Zarin D A, Ide N C, Tse T, Harlan W R, West J C, Lindberg D A. Issues in the registration of clinical trials. JAMA. 2007;297(19):2112-2120.

The registration of clinical trials is receiving increased attention, in the interests of enhancing decision making based on the best available evidence. Up to 37% of clinical trials presented as abstracts do not result in a full journal article and even those that do may suffer from reporting restrictions or selection. Registration of clinical trials on web-based free access databases is increasing, but comprehensive registration and a single access point to the many trial registers available has not yet been achieved. This timely overview describes the issues in clinical trial registration, the efforts of the ClinicalTrials.gov resource to capture trials data and to improve its quality and completeness, and the factors that make searching on drug names problematic in trials registers. The authors discuss the planned WHO search portal to trials registries. The next challenge is to improve not only information on ongoing trials, but access to the results of completed trials. Progress towards this is being achieved by measures such as links from trials registers to related final publications and assessment reports such as those of Drugs@FDA. However, the authors note that providing access to data that has not been subject to independent scientific assessment or peer review, and has not been placed in the context of other relevant research, also poses problems.

Chew M, Villanueva E V, Van der Weyden MB. Life and times of the impact factor: retrospective analysis of trends for seven medical journals (1994-2005) and their editor’s views. Journal of the Royal Society of Medicine 2007;100:142-150.

This paper investigates journal impact factors. It analyses trends and seeks out the views of journal editors on factors that influence their journals’ impact factor.

The authors selected seven journals – Annals of Internal Medicine, BMJ, JAMA, Lancet, New England Journal of Medicine, Medical Journal of Australia and the Canadian Medical Association Journal. Trends in impact factor were ascertained by a retrospective analysis of impact factor data from ISI Web of Knowledge Journal Citation Reports.

Analysis revealed that overall impact factors rose over the period. Although the New England Journal of Medicine had the highest impact factor from 1994-2005, the Canadian Medical Association Journal and JAMA had the greatest rises in impact factor, 500% and 260% respectively.

The reasons for the rise in impact factor suggested by the nine editors interviewed included some deliberate editorial practices such as publishing fewer articles. Other suggested reasons were the active recruitment of high impact articles, improving services to authors, enhancing the journal’s media profile to draw first class authors and the careful selection of articles. Only one editor suggested that the provision of free full text access to articles online increased the impact factor of his journal.

This paper raises concerns about the ways in which editorial practice can manipulate a journal’s impact factor. The authors give their support to finding alternative and complementary measures for journal impact / quality.

Hartmann C W, Sciamanna C N, Blanch D C, Mui S, Lawless H, Manocchia M, Rosen R K, Pietropaoli A. A website to improve asthma care by suggesting patient questions for physicians: qualitative analysis of user experiences. Journal of Medical Internet Research. 2007;9(1):e3

http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17478412

This study assessed the use and impact of an interactive asthma website on patients’ interaction with their doctors. A website was produced using asthma guidelines to create evidence-based decision rules for asthma care. Patients completed an online survey of 10-20 questions. Their responses were measured against the guidelines programmed into the website and tailored feedback was produced, suggesting questions the patients should discuss with their doctors. Patients’ impressions of the website and its effect on communication with their doctors and the resulting quality of care were assessed by semi-structured interviews before and after the visit to the doctor. Doctors were also surveyed about their impressions of the website.

Thirty seven patients who responded to adverts and met the inclusion criteria were introduced to the website and surveyed. Twenty six doctors volunteered to complete the online survey. The patient sample was overwhelmingly female (91.9%), white (89.2%) and adult (78.4% aged over 35). 56% of patients felt that the website had influenced the outcome of their visit to the doctor. Patients also reported feeling more self-confidence during the visit, that they talked more and had more confidence in the care they were receiving. Patients reported feeling more involved in their care and some treatment changes were initiated. No patients mentioned having a negative interaction with their doctor as a result of using the website. A large majority of the doctors who completed the online assessment rated the website positively.

The study does have generalisability issues stemming from the samples and the topic and the fact that only one interaction was assessed. The question of impact on patient outcomes remains to be addressed. However, the authors suggest this is a promising experiment in evidence-based interactive information communication which merits further development.

Urquhart C, Turner J, Durbin J, Ryan J. Changes in information behavior in clinical teams after introduction of a clinical librarian service. Journal of the Medical Library Association. 2007:95;14-22.

This paper reports on an 18 month evaluation of a clinical librarian project in North Wales, UK. The project assessed the changes in clinical teams’ information seeking behaviour, willingness to delegate searches to a clinical librarian and the effectiveness of information skills training. The methods used included a reflective diary kept by the clinical librarian, and a series of questionnaires and interviews of the clinical teams.

The results are generally positive. After the introduction of a clinical librarian service the respondents were more willing to undertake searches, more willing to delegate searches and, after attending training sessions, perceived an improvement in their search skills. It was noted that it may be difficult to generalize the results to other settings as the roles of clinical librarians differ widely between institutions.

Meier A, Lyons EJ, Frydman G, Forlenza M, Rimer BK. How cancer survivors provide support on cancer-related internet mailing lists. Journal of Medical Internet Research. 2007;9:54-75.

Self-help groups are a well established feature of the healthcare landscape. With the advent of the internet the increasing use of email support lists to serve this audience is not surprising.

This paper gives some background information about these lists (with particular emphasis on their development in the USA) and then describes the results of a content analysis of a sample of email messages from 10 cancer mailing lists over 5 months. They find that the most common topics related to information about treatments and how to communicate with health professionals. Information requests were more common than requests for emotional support and more offers of support than requests for support were posted.  The authors conclude that users can, and do, find the support they need from these communication channels and that they benefit from the resulting empowering roles. This is a fairly detailed report of a content analysis of a very difficult area to evaluate.

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This page was last updated on: 24 October 2007