FHSJulius Weinberg
Infection 2000
The information you have is not the information you want
The information you want is not the information you need
The information you need is not known
The information that’s known can’t be found in time
Information management problems in the NHS
Overload/Unfocussed
Contradictory
eBNF
Books
Editorial bias: Editors are more likely to publish positive studies
Methodological bias: Flawed randomisation produce positive biases
Abstracting bias: Abstracts emphasise positive results
Framing bias: Relative risk data produce a positive bias
slow to incorporate evidence
The NHS spend: c: £6 million a year on journals.
Thousands of journals, Average library contains a few hundred.
about ten important journals in each specialty, unlikely the average DGH has all ten.
Traditionally a major source of knowledge but are unreliable and biased:
Support opinions of authors. Unclear how decisions made to include/ exclude
Tend towards a positive and optimistic view of the effectiveness of interventions.
Journal articles
BMJ 1998;317:862-863
Public Concern
ACP Journal Club
Model widely copied and there now exists:
Evidence-Based Medicine, combined with the ACP Journal Club and published as Best Evidence;
Evidence-Based Mental Health; Cardiovascular Medicine; Healthcare; Oncology.
developed explicit methods for scanning;
selected journal articles based on strict and explicit quality criteria;
selected a sub-set of these articles on the basis of their clinical relevance;
prepared structured abstracts of the selected articles;
invited a clinician to comment on the structured abstract;
prepared a single sentence "declarative title" which summarised the finding of the research study in a single sentence that can usually be read in under fifteen seconds.
These journals select c2% of the articles
Journals of secondary publication
                                                             
by March 2002
with knowledge and know-how to support health care related decisions.
Provide easy access to best, current knowledge and know-how
To improve health and healthcare, clinical practice and patient choice
available via NHSnet and the Internet.
Concept: three “floors”
Atrium, Help Desk General Information, Generic Tools, Links, Guides
every healthcare professional working in the NHS access to linked databases across which a single search engine will work.
Knowledge and Know-How Platform
Clinical Evidence
Evidence Based On Call CATs
The British National Formulary (with updating links to other DoH funded publications, e.g. Drugs and Therapeutics Bulletins)
 NHS Direct On-Line,
if there is no useful knowledge on the Knowledge and Know-How Platform:
Medline,
Creating links to specialty information systems
Contributing to support and training
Communicable disease, cancer, public health, primary care, heart disease, diabetes, informatics, paediatrics
Provide best available evidence in
Treatment
Prevention
Control
Investigation
NeLCD
Technical Specification
Live Pilot March 2001
Catalogue cards and Links
Bottom Line Information
Use PHLS Expert Groups
NeLCD