***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Physicians have difficulty keeping up with new evidence from medical research . METHODS We developed the McMaster Premium LiteratUre Service ( PLUS ) , an internet-based addition to an existing digital library , which delivered quality - and relevance -rated medical literature to physicians , matched to their clinical disciplines . We evaluated PLUS in a cluster-r and omized trial of 203 participating physicians in Northern Ontario , comparing a Full-Serve version ( that included alerts to new articles and a cumulative data base of alerts ) with a Self-Serve version ( that included a passive guide to evidence -based literature ) . Utilization of the service was the primary trial end-point . RESULTS Mean logins to the library rose by 0.77 logins/month/user ( 95 % CI 0.43 , 1.11 ) in the Full-Serve group compared with the Self-Serve group . The proportion of Full-Serve participants who utilized the service during each month of the study period showed a sustained increase during the intervention period , with a relative increase of 57 % ( 95 % CI 12 , 123 ) compared with the Self-Serve group . There were no differences in these proportions during the baseline period , and following the crossover of the Self-Serve group to Full-Serve , the Self-Serve group 's usage became indistinguishable from that of the Full-Serve group ( relative difference 4.4 ( 95 % CI -23.7 , 43.0 ) . Also during the intervention and crossover periods , measures of self-reported usefulness did not show a difference between the 2 groups . CONCLUSION A quality - and relevance -rated online literature service increased the utilization of evidence -based information from a digital library by practicing physicians Abstract OBJECTIVE : To determine if a simple educational intervention can increase  resident physician literature search activity .  DESIGN : R and omized controlled trial . SETTING : University hospital-based internal medicine training program . PATIENTS / PARTICIPANTS : Forty-eight medical residents rotating on the general internal medicine service . INTERVENTIONS : One-hour didactic session , the use of well-built clinical question cards , and practical sessions in clinical question building . MEASUREMENTS AND MAIN RESULTS : Objective data from the library information system that included the number of log-ons to MEDLINE , search ing volume , abstract s viewed , full-text articles viewed , and time spent search ing . Median search activity as measured per person per week ( control vs intervention ) : number of log-ons to MEDLINE ( 2.1 vs 4.4 , P<.001 ) ; total number of search sets ( 24.0 vs 74.2 , P<.001 ) ; abstract s viewed ( 5.8 vs 17.7 , P=.001 ) ; articles viewed ( 1.0 vs 2.6 , P=.005 ) ; and hours spent search ing ( 0.8 vs 2.4 , P<.001 ) . CONCLUSIONS : A simple educational intervention can markedly increase resident search ing activity PURPOSE The study assesses potential for improving residents ' evidence -based medicine search ing skills in MEDLINE through real-time librarian instruction . SUBJECTS Ten residents on a rotation in a neonatal intensive care unit participated . METHODOLOGY Residents were r and omized into an instruction and a non-instruction group .  Residents  generated questions from rounds and search ed MEDLINE for answers . Data were collected through observation , search strategy analysis , and surveys . Librarians observed search es and collected data on questions , search ing skills , search problems , and the test group 's instruction topics . Participants performed st and ardized search es before , after , and six-months after intervention and were scored using a search strategy analysis tool ( 1 representing highest score and 5 representing lowest score ) . Residents completed pre- and post-intervention surveys to measure opinions about MEDLINE and search satisfaction . RESULTS Post-intervention , the test group formulated better questions , used limits more effectively , and reported greater confidence in using MEDLINE . The control group expressed less satisfaction with retrieval and demonstrated more errors when limiting . The test and control groups had the following average search scores respectively : 3.0 and 3.5 ( pre-intervention ) , 3.3 and 3.4 ( post-intervention ) , and 2.0 and 3.8 ( six-month post-intervention ) . CONCLUSION Data suggest that measurable learning outcomes were achieved . Residents receiving instruction improved and retained search ing skills six-months after intervention BACKGROUND The " Just-in-time Information " ( JIT ) librarian consultation service was design ed to provide rapid information to answer primary care clinical questions during patient hours . This study evaluated whether information provided by librarians to answer clinical questions positively impacted time , decision-making , cost savings and satisfaction . METHODS AND FINDING A r and omized controlled trial ( RCT ) was conducted between October 2005 and April 2006 . A total of 1,889 questions were sent to the service by 88 participants . The object of the r and omization was a clinical question . Each participant had clinical questions r and omly allocated to both intervention ( librarian information ) and control ( no librarian information ) groups . Participants were trained to send clinical questions via a h and -held device . The impact of the information provided by the service ( or not provided by the service ) , additional re sources and time required for both groups was assessed using a survey sent 24 hours after a question was su bmi tted . The average time for JIT librarians to respond to all questions was 13.68 minutes/ question ( 95 % CI , 13.38 to 13.98 ) . The average time for participants to respond their control questions was 20.29 minutes/ question ( 95 % CI , 18.72 to 21.86 ) . Using an impact assessment scale rating cognitive impact , participants rated 62.9 % of information provided to intervention group questions as having a highly positive cognitive impact . They rated 14.8 % of their own answers to control question as having a highly positive cognitive impact , 44.9 % has having a negative cognitive impact , and 24.8 % with no cognitive impact at all . In an exit survey measuring satisfaction , 86 % ( 62/72 responses ) of participants scored the service as having a positive impact on care and 72 % ( 52/72 ) indicated that they would use the service frequently if it were continued . CONCLUSIONS In this study , providing timely information to clinical questions had a highly positive impact on decision-making and a high approval rating from participants . 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 . Such services may reduce costs through decreasing the need for referrals , further tests , and other courses of action . TRIAL REGISTRATION Controlled-Trials.com IS RCT N96823810 The effect of introducing user fees on the frequency and quality of MEDLINE search ing with GRATEFUL MED by physicians in clinical setting s was tested . After training and free use ( prior study ) , consenting participants were r and omly allocated to pay search ing costs ( pay group ) or continue without fees ( no pay group ) . Fifty-nine physicians participated . Among the prior study 's frequent search ers , the pay group search ed at less than one third of the rate of those assigned to no pay . For less frequent search ers in the prior study , only 48 % of those assigned to pay did any search es , compared with 85 % for the no pay group ( P = 0.006 ) , and for those who did search , their frequency was almost half . However , there was no significant difference in the quality of search es ; both groups demonstrated about equivalent recall ( P = 0.77 ) , but significantly lower precision ( P = 0.03 ) than for the librarian 's independent search es . Similarly , there was no difference in the proportion of search es affecting clinical decisions for the two groups . Thus , imposing user charges for online search ing in clinical setting s after a period of free use adversely affects search ing quantity , but not quality . MEDLINE providers should consider whether user fees will undermine its benefits OBJECTIVE To determine if a preceptor and individualized feedback improves the performance of physicians in search ing MEDLINE in clinical setting s. DESIGN R and omized controlled trial with 2 to 10 months follow-up . SETTING A 300-bed teaching hospital . PARTICIPANTS All 392 physicians and physicians-in-training from 6 major clinical departments were invited to participate if they made patient-care decisions during the study period ; 79.4 % agreed . INTERVENTIONS All participants were given 2 hours of basic training , then r and omized to a control group ( no further intervention ) or an intervention group in which each person chose a clinical preceptor experienced in MEDLINE search ing and received individualized feedback from a study librarian on each of their 1st 10 search es . MAIN OUTCOME MEASURES The number and proportion of relevant and irrelevant references retrieved for 1st , 4th , and 8th search es of participants were compared with independent librarian search es on the same topics . RESULTS Intervention group members did not search more often than controls ( 5.9 search es per month versus 4.7 , respectively ; P = 0.26 ) and there were no significant differences in the quality of search es . Rather , search performance for both groups improved , with the average number of relevant references retrieved per search increasing from 4.5 to 7.4 ( P < 0.01 ) . The librarian retrieved more relevant citations than participants for the 1st search ( P = 0.001 ) but not for the 4th ( P = 0.60 ) or 8th ( P = 0.76 ) search es . CONCLUSIONS A program of assigning preceptors and providing feedback on individual search es did not enhance the quantity or quality of search es . Soon after a basic introduction to search ing , however , clinicians in both groups improved their search performance A double-blind r and omised controlled trial was conducted on a group of Hong Kong hospital clinicians . The objective was to test if a three-hour educational workshop ( with supervised h and s-on practice ) is more effective ( than no training ) to improve clinical question formulation , information-seeking skills , knowledge , attitudes , and search outcomes . The design was a post-test-only control group ; recruitment by stratified r and omization ( by profession ) , blocked at 800 .  End-user training was more effective than no training in improving clinical question formulation , in raising awareness , knowledge , confidence and use of data bases , but had made no impact on preference for secondary data bases . It changed the attitude of clinicians to become more positive towards the use of electronic information services ( EIS ) . Participants had higher search performance and outcomes ( satisfaction with information obtained ( NNT = 3 ) , EIS satisfaction ( NNT = 3 ) and success in problem solving ( NNT = 4 ) ) . The workshop improved knowledge and skills in evidence -based search ing , but this effect gradually eroded with time . Search logs confirmed that follow-up is required if effects are to be sustained . Longer effects on search behaviours appear to be positive . A r and omised controlled trial is valuable in identifying cause- and -effect relations and to quantify the magnitude of the effects for management decision-making Background To practice Evidence -Based Medicine ( EBM ) , physicians must quickly retrieve evidence to inform medical decisions . Internal Medicine ( IM ) residents receive little formal education in electronic data base search ing , and have identified poor search ing skills as a barrier to practicing EBM . Objective To design and implement a data base search ing tutorial for IM residents on inpatient rotations and to evaluate its impact on residents ’ skill and comfort search ing MEDLINE and filtered EBM re sources . Design R and omized controlled trial . Residents r and omized to the search ing tutorial met for up to 6 1-hour small group sessions to search for answers to questions about current hospitalized patients . Participants Second- and 3rd-year IM residents . Measurements Residents in both groups completed an Objective Structured Search ing Evaluation ( OSSE ) , search ing for primary evidence to answer 5 clinical questions . OSSE outcomes were the number of successful search es , search times , and techniques utilized . Participants also completed self- assessment surveys measuring frequency and comfort using EBM data bases . Results During the OSSE , residents who participated in the intervention utilized more search ing techniques overall ( p < .01 ) and used PubMed ’s Clinical Queries more often ( p < .001 ) than control residents . Search ing “ success ” and time per completed search did not differ between groups . Compared with controls , intervention residents reported greater comfort using MEDLINE ( p < .05 ) and the Cochrane Library ( p < .05 ) on post-intervention surveys . The groups did not differ in comfort using ACP Journal Club , or in self-reported frequency of use of any data bases . Conclusions An inpatient EBM search ing tutorial improved search ing techniques of IM residents and result ed in increased comfort with MEDLINE and the Cochrane Library , but did not impact overall search ing success Over the past decade , on-line data bases have become increasingly popular among health care professionals . As a group , these ' end-users ' report utilizing data bases to keep abreast of medical progress , to conduct research and to address specific patient care issues . Throughout the literature , medical professionals ( ' content experts ' ) have proved to be less effective search ers than librarians ( ' search experts ' ) . The potential implication s of this discrepancy are worrysome . For any given clinical scenario , for example , published reports may reach contradictory conclusions . A poorly skilled search er may not retrieve enough articles to appreciate this fact . Optimizing search ing skills is therefore a worthwhile goal . As a first step , many medical schools introduce students to on-line data bases , most notably MEDLINE . Residency is an ideal time to continue this training . A recognized obstacle to provide residents with formal MEDLINE instruction is time constraint . We therefore conducted this study to ascertain the impact an individual 1-hour tutorial session would have on MEDLINE utilization among obstetrics and gynecology residents training at an academic medical centre . Outcome measures included MEDLINE search frequency , duration , recall , precision and search er satisfaction . Search recall measures the search er 's ability to retrieve articles deemed relevant to the question at h and . Search precision 
    Output:
    
CIRT is an information and communication technology commonly used in healthcare setting s. Interventions promoting CIRT adoption by healthcare professionals have shown some success in improving search ing skills and use of electronic data bases .