Answering Clinical Questions.

BACKGROUND. Physicians often have unanswered clinical questions. The purpose of this study was to determine how often the answers to these questions can be found in the medical literature. METHODS. We collected unanswered clinical questions from family physicians at the end of clinical half-days. The authors and medical librarians then used textbooks and MEDLINE to find answers to each question. We returned to the physicians one to five selected references for each question. Each physician rated these sources on how well they answered the questions and how they might influence the physician's practice. RESULTS. One hundred three questions were gathered. Physicians asked an average of 0.5 questions per half-day. We searched for answers to 86 questions, and the physicians returned ratings for 84. Forty-five (54%) of these questions were fully or nearly fully answered by the materials returned to the physicians. Of the questions for which answers were found, MEDLINE searches accounted for 71%; textbooks, 20%; and a combination, 9%. MEDLINE searches took an average of 27 minutes, whereas textbook searches averaged 6 minutes. CONCLUSIONS. The medical literature can provide answers to a majority of clinical questions; however, finding these answers is time-consuming and expensive. Physicians need more efficient ways to answer their clinical questions. [ABSTRACT FROM AUTHOR]