Clinical usefulness of library and information services in Japan: The detailed use and value of information in clinical settings

ObjectivesConsidering that there is a lack of evidence regarding the contribution of library and information services to evidence-based medicine in actual clinical practice in Japan, the purpose of the study is to explore the current status of use and value of library and information services in clinical settings to examine the usefulness of information in implementing evidence-based medicine (EBM) into practice.MethodsA Web-based survey was conducted at seven sites (hospitals with 300–1,200 beds) and interviews conducted at five sites to investigate information behavior among health professionals (physicians, residents, and nurses) in 2016, replicating the Value Study carried out in the United States in 2010 and 2011. Using a critical incident technique, respondents answered questions about their information topics, information resources used, search location, access points, and evaluation of the information.ResultsAnalysis from 598 valid responses (275 physicians, 55 residents, and 268 nurses) revealed the characteristics of information use and recognition of the value of information. Physicians and residents showed their information needs regarding clinical care using PubMed (80.4%, 65.5%), Ichushi-Web (61.8%, 63.6%), and UpToDate (40.4%, 65.5%). While physicians rely more on electronic journals (37.8%), residents use more hybrid resources including Japanese print books (38.2%) and online books (30.9% for Japanese, 32.7% for English) to confirm their knowledge. Nurses need more information close to patients and explore a wider variety of information resources such as Japanese print books (60.4%), Ichushi -Web (40.3%), Japanese online books (20.5%), and websites of academic organizations (19.0%). Although the overall recognition of the value of information was relatively modest, concrete changes in clinical practice were found in some areas. Environments with insufficient information and availability of electronic resources should be improved to increase the use of library and information services for implementing EBM.

研究背景与目的：鉴于目前日本临床实践中，尚无关于图书馆与信息服务对循证医学（evidence-based medicine, EBM）贡献的相关实证依据，本研究旨在探讨临床场景下图书馆与信息服务的使用现状及价值，以检验信息在推动循证医学落地实践中的效用。

研究方法：本研究于2016年针对7家床位规模300至1200张的医院开展网络问卷调查，并在另外5家医院进行访谈，以探究医疗从业者（医师、住院医师及护士）的信息行为，该研究复刻了2010至2011年在美国开展的「价值研究」（Value Study）。研究采用关键事件技术（critical incident technique），要求受访者回答其信息主题、使用的信息资源、检索场所、获取途径及信息评价相关问题。

研究结果：对598份有效问卷（其中医师275份、住院医师55份、护士268份）的分析揭示了信息使用特征及信息价值认知情况。医师与住院医师针对临床诊疗的信息需求主要通过PubMed（占比分别为80.4%、65.5%）、Ichushi-Web（61.8%、63.6%）及UpToDate（40.4%、65.5%）满足。其中医师更依赖电子期刊（37.8%），而住院医师则更多使用混合资源，包括日文印刷书籍（38.2%）及在线图书（日文版30.9%、英文版32.7%）以巩固专业知识。护士则更倾向于获取贴近临床场景的患者相关信息，并会使用更多样化的信息资源，如日文印刷书籍（60.4%）、Ichushi-Web（40.3%）、日文在线图书（20.5%）及学术机构官网（19.0%）。尽管整体对信息价值的认知程度相对温和，但部分领域已出现临床实践的具体变革。未来需完善信息供给不足及电子资源可及性欠佳的场景，以提升图书馆与信息服务在推动循证医学落地中的应用率。