What influences the clinical relevance of information in the daily POEM?

Abstract

<h3>Context:</h3> In a popular continuing medical education program, Canadian physicians use the Information Assessment Method (IAM) to rate the daily POEM (Patient-Oriented Evidence that Matters). From the physician perspective, most POEMs are perceived as highly relevant to their clinical practice, but some are not. Information scientists have described dimensions of relevance that can serve as a starting point for understanding this variation. Knowing the reasons for this variation in the relevance of POEM information to clinical practice could improve the future selection of studies that become POEMs. <h3>Objective:</h3> To recommend how to improve the relevance of research studies selected for inclusion in the daily POEMs program. <h3>Study Design:</h3> Longitudinal. <h3>Dataset:</h3> Ratings of clinical relevance from the perspective of the reader for all POEMs delivered to Canadian physicians from 2015-2019. Ratings of clinical relevance were calculated from the answers provided by physicians to one question in the validated IAM questionnaire. <h3>Outcome Measures and Methods:</h3> Starting with Wilson’s three dimensions of situational relevance, we first defined a theme for each dimension that could explain the low clinical relevance of a POEM. Two readers then independently considered whether each POEM within the lowest decile of our measure of clinical relevance could be assigned to at least one theme using deductive content analysis. When there were differences in opinion, adjudication first involved discussion between these two readers to see whether agreement could be reached. If disagreement persisted, a third reader adjudicated the discrepancy. Elements of the PICO framework were used to understand why a given POEM was assigned to a theme of low clinical relevance. <h3>Results:</h3> From 1,556 POEMs, 155 of 156 POEMs in the lowest decile of relevance could be assigned to one of our three themes: 1. Specialty, 2. Geography, and 3. Newsworthiness. Of these POEMs, 147 (94%) were of low relevance because of specialty, 11 (7%) because of geography and 9 (6%) because of newsworthiness. <h3>Conclusions:</h3> POEMs of low clinical relevance are primarily due to the information being outside the sphere of practice of most physicians in Family Medicine.