The "Just-in-Time" (JIT) information librarian consultation service
Notice bibliographique
Résumé
Background: This thesis is based on the “Just-in-Time information” (JIT) librarian consultation service project. The project was designed to test if a library-related service could be used to address an information gap in primary healthcare by assisting clinicians in answering their questions. The project specifically tested whether or not a librarian consultation service could have a positive impact in two delivery methods for primary care practice in Ontario, Canada. Design: Randomized controlled trial (RCT) with additional qualitative and quantitative evaluation. The literature review section includes two systematic reviews. Methods: The primary method of this thesis is RCT of clinical questions posed by primary care professionals who participated in the JIT librarian consultation service. The thesis also discusses the project’s service delivery model and its implementation, which was developed to support the RCT. Other elements broader than the RCT, such as a librarian survey, have also been developed and included to explore factors contributing to the success or failure of the librarian consultation service. It evaluates potential positive impacts in terms of costs (saving time, workload issues), patient care decision-making, and improved access to information by using such a service. Results: The JIT service was implemented and run for one year prior to the RCT phase of the project with 88 individuals who participated in the RCT. The primary outcome was time to receive a response; whether time for JIT librarians to locate information to provide a response to a question, or a participant’s time to search for the information. Librarians provided their responses to clinical questions in less than fifteen minutes. This time was quicker than the response time of the participants. Of the responses provided to intervention questions, participants rated 63% as having a highly positive impact. Of the responses provided to control questions, participants rated 24.8% as having no impact, and 44.9% as having a negative impact on decision-making. Most participants rated their level of satisfaction with the service as having a positive impact (86%) on the care they provided to their patients and 83% assessed the service as providing relevant information to their questions in an appropriate time frame. Most participants would consider using a similar service, and most participants preferred this service to be delivered by a hand-held wireless device or web interface. Discussion and conclusions: This thesis demonstrates the development and implementation of a cost-effective and user-friendly librarian consultation service that provided primary care professionals with information to assist them in answering their questions arising from patient visits. Using a librarian to respond to clinical questions may allow primary care professionals to have more time in their day, thus potentially increasing patient access to care. Participation in this RCT decreased the use of consultations with other practice physicians, return patient visits, referrals, and other actions in the control group; reductions in these areas decrease costs. The application of the RCT design by combining librarianship with health services research is unusual. The use of the response to a clinical question as the unit of randomization and allocation is also innovative.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,017 | 0,046 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,005 | 0,004 |
| Communication savante | 0,005 | 0,004 |
| Science ouverte | 0,003 | 0,009 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,039 | 0,008 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».