Clinical decision support tools: analysis of online drug information databases

Kevin A Clauson¹ , Wallace A Marsh² , Hyla H Polen³ , Matthew J Seamon⁴ and Blanca I Ortiz⁵

¹Nova Southeastern University, College of Pharmacy – West Palm Beach, Palm Beach Gardens, FL 33410, 3970 RCA Boulevard, Suite 7006A, USA

²Shenandoah University, Bernard J. Dunn School of Pharmacy, Winchester, VA, USA

³Health Care District of Palm Beach County, Delray Beach, FL, USA

⁴Nova Southeastern University, College of Pharmacy, Davie, FL, USA

⁵Nova Southeastern University, College of Pharmacy – Ponce, Ponce, Puerto Rico, USA

author email corresponding author email

BMC Medical Informatics and Decision Making 2007, 7:7doi:10.1186/1472-6947-7-7


Published:	8 March 2007

Abstract

Background

Online drug information databases are used to assist in enhancing clinical decision support. However, the choice of which online database to consult, purchase or subscribe to is likely made based on subjective elements such as history of use, familiarity, or availability during professional training. The purpose of this study was to evaluate clinical decision support tools for drug information by systematically comparing the most commonly used online drug information databases.

Methods

Five commercially available and two freely available online drug information databases were evaluated according to scope (presence or absence of answer), completeness (the comprehensiveness of the answers), and ease of use. Additionally, a composite score integrating all three criteria was utilized. Fifteen weighted categories comprised of 158 questions were used to conduct the analysis. Descriptive statistics and Chi-square were used to summarize the evaluation components and make comparisons between databases. Scheffe's multiple comparison procedure was used to determine statistically different scope and completeness scores. The composite score was subjected to sensitivity analysis to investigate the effect of the choice of percentages for scope and completeness.

Results

The rankings for the databases from highest to lowest, based on composite scores were Clinical Pharmacology, Micromedex, Lexi-Comp Online, Facts & Comparisons 4.0, Epocrates Online Premium, RxList.com, and Epocrates Online Free. Differences in scope produced three statistical groupings with Group 1 (best) performers being: Clinical Pharmacology, Micromedex, Facts & Comparisons 4.0, Lexi-Comp Online, Group 2: Epocrates Premium and RxList.com and Group 3: Epocrates Free (p < 0.05). Completeness scores were similarly stratified. Collapsing the databases into two groups by access (subscription or free), showed the subscription databases performed better than the free databases in the measured criteria (p < 0.001).

Conclusion

Online drug information databases, which belong to clinical decision support, vary in their ability to answer questions across a range of categories.