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The Clinical Informationist: Does the Model Work

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00226291
Recruitment Status : Completed
First Posted : September 26, 2005
Last Update Posted : May 28, 2014
Information provided by (Responsible Party):
Nunzia Giuse, Vanderbilt University

Brief Summary:
This study is investigating the effects of an established clinical informationist program (evidence-based practice support service in which information professionals with significant clinical knowledge bases and advanced information seeking and appraisal skills) on clinical decision making at selected critical care units at Vanderbilt University Medical Center

Condition or disease Intervention/treatment Phase
Critical Illness Other: Synthesized evidence report Not Applicable

Detailed Description:

Background To evaluate the role of the Clinical Informatics Consult Service(CICS), an informationist service at the Eskind Biomedical Library (EBL) at Vanderbilt University Medical Center (VUMC, in clinical decision-making, the EBL has been awarded a 3-year grant from the National Library of Medicine (5 R01 LM07849-02). The CICS is a well-established program that facilitates evidence-based practice by delivering targeted information in answer to complex, patient-specific questions. The CICS places librarians with specialized training in medical subject areas and in information retrieval ("clinical informationists") on clinical teams in intensive care settings. Acting as expert consultants, they analyze the biomedical literature to identify, filter, and present the best examples of each clinical viewpoint expressed about key problems.

Evaluation Project Working in cooperation with the Center for Evaluation and Program Improvement (CEPI) at Peabody College of Vanderbilt, the investigators will evaluate formally the role of CICS in clinical decision-making and evidence-seeking behavior. While past studies have evaluated clinical medical librarians' roles, few if any studies have examined the effectiveness and utility of the new clinical informationist approach in sites where informationists are well-established.

The project will also create reusable evaluation tools transferable across environments. Through a combination of observation and interviews, investigators will examine librarian involvement in three existing Vanderbilt CICS intensive care units. The project will collect detailed information about the ways in which clinicians incorporate CICS-provided information into their workflows. Next, investigators will conduct a randomized trial to evaluate the effect of CICS on decision-making. Investigators will compare clinicians' intended course of care vs. actual care when CICS results are provided and when clinicians seek information themselves.

Finally, "virtual cases" developed from actual patient CICS-related scenarios in each clinical unit will be incorporated into training tools that can be used to export elements of the CICS model to other locations. Demonstration of the utility of the clinical informationist approach can foster widespread adoption nationally, and increase the degree to which clinical practice becomes evidence-based.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 299 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Official Title: The Clinical Informationist: Does the Model Work
Study Start Date : August 2004
Actual Primary Completion Date : February 2006
Actual Study Completion Date : May 2007

Arm Intervention/treatment
Experimental: Synthesized evidence report
Each consultation response included a documented bibliographic search strategy with corresponding references, a targeted list of full-text articles, and a written synthesis and critique of the relevant research materials.
Other: Synthesized evidence report
Each consultation response included a documented bibliographic search strategy with corresponding references, a targeted list of full-text articles, and a written synthesis and critique of the relevant research materials.
Other Names:
  • Literature summary
  • Evidence report

No Intervention: No evidence report

Primary Outcome Measures :
  1. Immediate and potential future clinical decisions [ Time Frame: 3 days post-consult ]

Secondary Outcome Measures :
  1. Clinical action index [ Time Frame: 3 days post-consult ]
  2. Number of research articles read [ Time Frame: 3 days post-consult ]
  3. Satisfaction [ Time Frame: 3 days post-consult ]
  4. Colleague consults [ Time Frame: 3 days post-consult ]
  5. Time spent searching the literature [ Time Frame: 3 days post-consult ]

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

Evidence-based questions requested by clinician on current service as an attending, resident, fellow, or nurse practitioner on one of the units included in the study

Exclusion Criteria:

All others

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00226291

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United States, Tennessee
Vanderbilt University Medical Center
Nashville, Tennessee, United States, 37232
Sponsors and Collaborators
Vanderbilt University
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Principal Investigator: Nunzia B Giuse, MD, MLS Vanderbilt University Medical Center
Additional Information:
Publications of Results:
Mulvaney S, Bickman L, Lambert W, Sathe N, Jerome R, Guise NB. Barriers to and facilitators of evidence based practices in physicians. Society for Behavioral Medicine 28th Annual Meeting. Washington, DC. March 2007. (Poster)

Other Publications:
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Responsible Party: Nunzia Giuse, Assistant Vice Chancellor for Knowledge Management; Director, Eskind Biomedical Library; Professor, Department of Biomedical Informatics, Vanderbilt University Identifier: NCT00226291    
Other Study ID Numbers: 040624
5R01LM007849 ( U.S. NIH Grant/Contract )
First Posted: September 26, 2005    Key Record Dates
Last Update Posted: May 28, 2014
Last Verified: May 2014
Keywords provided by Nunzia Giuse, Vanderbilt University:
evidence based medicine
clinical medical librarian
Additional relevant MeSH terms:
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Critical Illness
Disease Attributes
Pathologic Processes