Perhaps the results of a study we just published may help. Here, we looked at the efficiency of computerized versus manual literature search techniques which are likely to be used by a field doctor.1 The results are quite surprising!
Does this sound like you?
"I remember reading a clinical article that really had some good ideas about ------- but I just can't seem to remember the name of it or where I saw it."
Or how about this: "I am getting ready to make a presentation to -------- and I wish I knew where to get some specific articles about the advantages of chiropractic." Perhaps this is familiar: "I was contacted by -------- and I wish I knew how to get some clinical articles on chiropractic and ----- ."
Don't give up!
Chiropractic literature, like the x-ray and the adjusting table, can be seen as clinical tools that provide field doctors with improved expertise or enable them to expand their scope of patient management. As tools, the literature enables the doctor to extend their clinical information base and can improve the delivery of the health care they provide. Now more than ever accessing the chiropractic literature is easy and sometimes just a few keystrokes on the computer is all it takes.
However this was not always the case. In 1988, Curl and Antovich urged the chiropractic profession towards seeking innovations needed to assist the doctor in finding articles relevant to chiropractic and offered a pilot computer program (CLASP) dedicated to chiropractic literature.2,3 At about the same time, Dr. Rupert iterated the need to modernize the accessibility of chiropractic literature and presented the first fully operational computerized bibliographic index for chiropractic and related biomedical literature (CHIROLARS).4
A testimonial by a dedicated searcher of the chiropractic literature (Wagnon, 1990) supports the notion that the field doctor can quickly and effectively retrieve pertinent citations. He asserts that his experience with the CHIROLARS database has been valuable:
"Now it is possible to access all the chiropractic literature with a few keystrokes. In a matter of minutes I can print off a bibliography of all the chiropractic literature relating to a particular subject. We run almost no risk of missing the important paper that might change the whole approach to a problem."5
Really, where is the best place to look for a chiropractic article? The results of our study show that no single database is always capable of retrieving all the relevant or important citations. However in light of the fact that it appears as though no single database is ever capable of that esteemed goal, the question remains, "Is there a database for chiropractic literature where one is most likely to retrieve relevant or important citations?" The results of this study indicate that the answer appears to be "yes."
The CHIROLARS database exceeds four other databases we studied in its ability to provide the best cross-section of relevant literature. This is important to the field doctor especially when there is limited time to conduct a search. Rarely will a field doctor have the luxury of having enough time to search five or more databases (e.g., 21 hours in our case study just to obtain citations!). It is much more likely that the doctor will desire to allocate the time spent to a database where the citation yield is high and where the citations represent a large cross-section of the literature. CHIROLARS' consistently high retrieval values suggest that the field doctor will be well served in this manner.
We also studied the relative time taken to retrieve citations from each database. Our results iterate previous reports that searches of the manual databases are labor-intensive as compared to computerized databases. For example, it takes about 40 times longer to retrieve a citation manually than from CHIROLARS. The implications of these results are sufficiently obvious to the demands of the busy field doctor.
Summary
Just as the doctor's time is carefully utilized in patient care, so it should be when attempting to locate literature that can be put to practical, productive and profitable use. The results of this study show that a field doctor's search using the CHIROLARS database is likely to be the faster and more complete than a search of the manual databases or a nonchiropractic computerized database. In other words, it is now easier to search the literature for relevant chiropractic information since the arrival of computerized access to chiropractic literature.
As a final comment, the reader may be reminded that personally conducting a literature search is but one way to retrieve clinical information. Field doctors may subscribe to a journal review service or employ the services of a librarian, information specialist, or information gathering companies in lieu of spending time conducting their own search.
References
- Curl DD, Shapiro CS: Literature searching by a field doctor: a comparison of manual versus computerized methods. J Chiro Tech. Feb, 1993; 5(1):15-22.
- Curl DD, Antovich TJ: Paper presentation, California Chiropractic Association Annual Meeting (San Diego). Title: Introducing the CLASP project: a computerized index system for chiropractic literature. June, 1988.
- Curl DD, Antovich TJ: Addressing the issue of cataloging and making chiropractic literature accessible: Part I: Defining the problem. J Manipulative Physiol Ther 1990 Jun; 13(5):262-6.
- Rupert RL: Chirolars: a modern tool for chiropractic education. J Chiro Ed Mar 1990; 3(4):22-24.
- Wagnon RJ: Chirolars from a users point of view. [letter] J Chiro Ed Mar 1990; 3(4):25-27.
- Curl DD, Antovich TJ: Addressing the issue of cataloging and making accessible chiropractic literature: Part II. Pilot software development program. J Manipulative Physiol Ther 1990 Jul-Aug; 13(6):309-15.
With each article I encourage you to write the questions you may have, commentaries on patient care, or thoughts to share with your colleagues, to me:
Darryl Curl, DDS, DC
2330 Golden West Lane
Norco, California 91760
Please enclose your return, self-addressed, stamped envelope.