Libraries and EBM – What’s the Impact?

According to the seminal BMJ editorial on the subject, “Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients,” while “The practice of evidence based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research.” [1]

With a basic definition like this, it sounds like the clinical librarian’s role should be central, yet, since the rise of EBM in the mid-nineties, it’s been difficult to track down examples of the impact of information professionals’ searches on clinical practice [2].

Undaunted, Zena Woodley, Library Resources Manager at the Warner Library, Broomfield Hospital in Chelsmford, put out a call to librarians on LIS-MEDICAL for examples of “direct experience that the articles you have supplied have made a (critical) difference to a real-live patient?” [3]

The results of her enquiry, along with her commentary and conclusions, can be seen in an article on fumsi [4] – everything from water coolers in Highland schools through to guideline changes in blood discard volumes in a major London hospital.

However, small and large triumphs aside, Woodley is probably right to highlight these two everyday responses:

‘I’ve been asked to carry out searches to find evidence on many occasions. I don’t always get told that this is why the information is required, but on occasion am told that my searches have contributed to changes in practice.’

…

‘I have a couple of consultants, one in particular, who only come to the library when they want some information to help them solve a patient’s problem … Sometimes we find the answers he needs and sometimes we don’t, but he is a regular customer.’ [5]

It’s only anecdotal evidence (which my former law library colleagues will tell you is no evidence at all), but it does seem to encapsulate the commonplace experience of health information professionals with regard to their user group …

Refs

[1] David L. Sackett et al. Evidence based medicine: what it is and what it isn’t. British Medical Journal 1996; 312: 71-72.

[2] This was the theme of Health Information and Libraries Journal December 2007; 24(s1).

[3] Zena Woodley. [Message to LIS-MEDICAL], 5 August 2008.

[4-5] Zena Woodley. Making a difference to patient care: using Evidence Based Medicine. fumsi, September 2008.