You will be presented with a collection of medical randomized controlled trial (RCT) reports addressing a shared clinical question -- for instance, the efficacy of a medical intervention on a disease or condition. Given the titles and abstracts of these reports, your task is to generate the conclusion of the systematic review article synthesizing the key findings. Your conclusion should be a few sentences long. In your response, include only the conclusion and no other text. The RCT reports are below.



Title 1:
A mixed-methods analysis of a library-based hand-held intervention with rural clinicians.
Abstract 1:
BACKGROUND The East Tennessee State University Quillen College of Medicine Library has participated for several years in projects to provide rural clinicians with health information re sources . OBJECTIVES To determine whether a strategy of h and -held devices with a best- evidence point-of-care disease tool and a drug data base paired with access to a medical library for full-text articles and training to use the tools would be an affordable way to meet the information needs of rural underserved clinicians . METHODS This study is a mixed- methods methodology . The first project was evaluated using a r and omised controlled trial ( RCT ) methodology . The second was evaluated qualitatively using interviews and focus groups . RESULTS The quantitative findings discovered that clinicians equipped with a h and -held device with evidence -based software more frequently found answers to clinical questions , found answers more quickly , were more satisfied with information they found and use expensive re sources such as continuing medical education , online data bases and textbooks less than the group that did not have access to online technology . Qualitative results supported the quantitative findings . CONCLUSION Librarians can implement a three-pronged strategy of the secondary literature via a h and -held , the primary literature via Loansome Doc and quality training to meet basic information needs of rural clinicians


Title 2:
Teaching evidence-based medicine literature searching skills to medical students during the clinical years: a randomized controlled trial.
Abstract 2:
OBJECTIVES Constructing an answerable question and effectively search ing the medical literature are key steps in practicing evidence -based medicine ( EBM ) . This study aim ed to identify the effectiveness of delivering a single workshop in EBM literature search ing skills to medical students entering their first clinical years of study . METHODS A r and omized controlled trial was conducted with third-year undergraduate medical students . Participants were r and omized to participate in a formal workshop in EBM literature search ing skills , with EBM literature search ing skills and perceived competency in EBM measured at one-week post-intervention via the Fresno tool and Clinical Effectiveness and Evidence -Based Practice Question naire . RESULTS A total of 121 participants were enrolled in the study , with 97 followed-up post-intervention . There was no statistical mean difference in EBM literature search ing skills between the 2 groups ( mean difference = 0.007 ( P = 0.99 ) ) . Students attending the EBM workshop were significantly more confident in their ability to construct clinical questions and had greater perceived awareness of information re sources . CONCLUSIONS A single EBM workshop did not result in statistically significant changes in literature search ing skills . Teaching and reinforcing EBM literature search ing skills during both pre clinical and clinical years may result in increased student confidence , which may facilitate student use of EBM skills as future clinicians


Title 3:
Real-time EBM: From Bed Board to Keyboard and Back
Abstract 3:
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


Title 4:
A personalized approach to deliver health care information to diabetic patients in community care clinics.
Abstract 4:
OBJECTIVE The study 's purpose was to test the generalizability of an individualized information prescription model , which has been previously vali date d for educating patients about hypertension in emergency department and community health center setting s. Study investigators assessed the effects of educational material s targeted to health literacy levels and learning styles on patients ' diabetes knowledge  in a community clinic setting . METHODS From May to August 2012 , 160 patients were recruited and r and omized into intervention ( n = 81 ) and control ( n = 79 ) groups . Inclusion criteria included 18 years or older , English or Spanish speaker , and a type 2 diabetes diagnosis . Measures included modified versions of the Diabetes Knowledge Test and Subjective Numeracy Scale , along with brief health literacy and learning style assessment s. Study team members contacted both groups after 2 and 6 weeks to reassess diabetes knowledge . RESULTS The control group showed no significant change in diabetes knowledge at both follow-ups . In contrast , the mean number of diabetes knowledge questions answered correctly by the intervention group increased significantly after 2 weeks ( Δ = 2.66 , P = 0.000 ) , which persisted at 6 weeks ( Δ = 2.46 , P = 0.00 ) . CONCLUSIONS This study showed that patients ' knowledge about diabetes increased significantly after exposure to educational material s targeted to their health literacy levels and learning style preferences and that the model is transferrable among health conditions


Title 5:
Student peer assessment in evidence-based medicine (EBM) searching skills training: an experiment.
Abstract 5:
BACKGROUND  Student peer assessment ( SPA )  has been used intermittently in medical education for more than four decades , particularly in connection with skills training . SPA generally has not been rigorously tested , so medical educators have limited evidence about SPA effectiveness . METHODS EXPERIMENTAL DESIGN Seventy-one first-year medical students were stratified by previous test scores into problem-based learning tutorial groups , and then these assigned groups were r and omized further into intervention and control groups . All students received evidence -based medicine ( EBM ) training . Only the intervention group members received SPA training , practice with assessment rubrics , and then application of anonymous SPA to assignments su bmi tted by other members of the intervention group . RESULTS Students in the intervention group had higher mean scores on the formative test with a potential maximum score of 49 points than did students in the control group , 45.7 and 43.5 , respectively ( P = 0.06 ) . CONCLUSIONS SPA training and the application of these skills by the intervention group result ed in higher scores on formative tests compared to those in the control group , a difference approaching statistical significance . The extra effort expended by librarians , other personnel , and medical students must be factored into the decision to use SPA in any specific educational context . IMPLICATION S SPA has not been rigorously tested , particularly in medical education . Future , similarly rigorous studies could further vali date use of SPA so that librarians can optimally make use of limited contact time for information skills training in medical school curricula


Title 6:
Awareness, use and opinions of methodological search filters used for the retrieval of evidence-based medical literature-a questionnaire survey.
Abstract 6:
The aim of this study was to determine the level of awareness of method ological search filters among health and academic librarians in the UK and Irel and , their use of filters and views on the perceived benefits , limitations and ways to increase usage of search filters . A r and om proportional sample of health and academic librarians were surveyed by telephone and fax . Overall , 88 % ( 196/224 ) completed the telephone survey to establish awareness and use of filters . Eighty-four per cent ( 51/61 ) completed a fax survey focusing in more depth on usability issues surrounding filters . Results indicate a high level of awareness of method ological filters , but low level of usage . Furthermore , a high level of awareness did not necessarily correlate with a high level of knowledge or underst and ing . Examination of responses revealed limitations and recommendations beyond those reported in the literature and highlights the relationship between underst and ing and effective use of filters . Improved dissemination and publication of filters is required to better inform librarians on the concept of filters and how to use them effectively
Conclusion : By categorizing different aspects of training programs , this study aim ed at providing a basis for design ing a framework to identify the tasks of educational librarians in health sciences