Abstract
BackgroundInfectious disease (ID) is a dynamic field with new guidelines being adopted at a rapid rate. Clinical decision support tools (CDSTs) have proven beneficial in selecting treatment options to improve outcomes. However, there is a dearth of information on the abilities of CDSTs, such as drug information databases. This study evaluated online drug information databases when answering infectious disease-specific queries.MethodsEight subscription drug information databases: American Hospital Formulary Service Drug Information (AHFS), Clinical Pharmacology (CP), Epocrates Online Premium (EOP), Facts & Comparisons 4.0 Online (FC), Lexi-Comp (LC), Lexi-Comp with AHFS (LC-AHFS), Micromedex (MM), and PEPID PDC (PPDC) and six freely accessible: DailyMed (DM), DIOne (DIO), Epocrates Online Free (EOF), Internet Drug Index (IDI), Johns Hopkins ABX Guide (JHAG), and Medscape Drug Reference (MDR) were evaluated for their scope (presence of an answer) and completeness (on a 3-point scale) in answering 147 infectious disease-specific questions. Questions were divided among five classifications: antibacterial, antiviral, antifungal, antiparasitic, and vaccination/immunization. Classifications were further divided into categories (e.g., dosage, administration, emerging resistance, synergy, and spectrum of activity). Databases were ranked based on scope and completeness scores. ANOVA and Chi-square were used to determine differences between individual databases and between subscription and free databases.ResultsScope scores revealed three discrete tiers of database performance: Tier 1 (82-77%), Tier 2 (73-65%) and Tier 3 (56-41%) which were significantly different from each other (p < 0.05). The top tier performers: MM (82%), MDR (81%), LC-AHFS (81%), AHFS (78%), and CP (77%) answered significantly more questions compared to other databases (p < 0.05). Top databases for completeness were: MM (97%), DM (96%), IDI (95%), and MDR (95%). Subscription databases performed better than free databases in all categories (p = 0.03). Databases suffered from 37 erroneous answers for an overall error rate of 1.8%.ConclusionDrug information databases used in ID practice as CDSTs can be valuable resources. MM, MDR, LC-AHFS, AHFS, and CP were shown to be superior in their scope and completeness of information, and MM, AHFS, and MDR provided no erroneous answers. There is room for improvement in all evaluated databases.
Highlights
Infectious disease (ID) is a dynamic field with new guidelines being adopted at a rapid rate
While several previous studies have been conducted to determine the abilities of online databases to satisfy the general drug information needs of healthcare providers [20,21,22,23], this study helps to elucidate the differences in selected online drug databases and compares the effectiveness of each Clinical decision support tools (CDSTs)'s ability to perform for an ID specialty setting
This study aimed to evaluate the ability of online drug information databases to provide clinical decision support when answering infectious disease-specific queries
Summary
Infectious disease (ID) is a dynamic field with new guidelines being adopted at a rapid rate. Access to clinical decision support tools (CDSTs) has proven beneficial in selecting appropriate treatment options that result in improved therapeutic outcomes [16]. The use of such aids as personal digital assistants (PDAs), computerized physician order entry (CPOE), electronic health records (EHRs), and electronic databases has shown positive influence on patient morbidity and mortality, cost management and formulary compliance, and prevention of medication errors and related fatalities [3,7,8,9,10,11,12,13]. This study aimed to evaluate the ability of online drug information databases to provide clinical decision support when answering infectious disease-specific queries
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