Hospital Libraries Have a Positive Impact on Clinical Decision Making and Patient Care
Bibliographic record
Abstract
A review of: Marshall, Joanne Gard. “The Impact of the Hospital Library on Clinical Decision Making: the Rochester Study.” Bulletin of the Medical Library Association 80.2 (1992): 169-78. Objective – To determine the impact of hospital library services on clinical decision making. Design – A descriptive survey. Setting – Fifteen hospitals in the Rochester area of New York, United States of America. Seven hospitals were in the city of Rochester, and eight were in surrounding rural communities. Subjects – Active physicians and residents affiliated with the Rochester hospitals. Methods – This study built upon the methodology used in an earlier study by D. N. King of the contribution of hospital libraries to clinical care in Chicago. Lists were compiled of all the active physicians and residents who were affiliated with the Rochester hospitals. In order to ensure that there was a reasonable number of participants from each hospital, and that librarians in hospitals with larger numbers of staff were not overburdened with requests, predetermined percentages were set for the sample: 10% of active physicians from hospitals with more than 25 medical staff members, 30% from hospitals with less staff, and 30% of residents and rural physicians. This resulted in a desirable sample size of 448. A systematic sample with a random start was then drawn from each hospital’s list, and physicians and residents were recruited until the sample size was achieved. Participants were asked to request information related to a clinical case from their hospital library, and to evaluate its impact on patient care, by responding to a two-page questionnaire. Main results – Based on usable questionnaires, there was an overall response rate of 46.4% (208 of 448). Eighty percent of the respondents stated that they probably (48%) or definitely (32.4%) handled a clinical situation differently due to the information received from the library. In terms of the specific aspects of care for which changes were made, 71.6% reported a change in advice given to the patient, 59.6% cited a change in treatment, 50.5% a change in diagnostic tests, 45.2% a change in drugs, and 38.5% a change in post-hospital care or treatment. Physicians credited the information provided by the library as contributing to their ability to avoid additional tests and procedures (49%), additional outpatient visits (26.4%), surgery (21.2%), patient mortality (19.2%), hospital admission (11.5%), and hospital-acquired infections (8.2%). In response to a question about the importance of several sources of information, the library received the highest rating amidst other sources including lab tests, diagnostic imaging, and discussions with colleagues. Conclusion – This study validates earlier research findings that physicians view the information provided by hospital libraries as having a significant impact on clinical decision making. Library supplied information influences changes to specific aspects of care as well as the avoidance of adverse events for patients. The significance of this influence is underscored by the finding that relative to other sources, information obtained from the hospital library was rated more highly.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.066 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.005 | 0.005 |
| Scholarly communication | 0.015 | 0.004 |
| Open science | 0.001 | 0.010 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.021 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".