P06S02:
Urinary tract infection (first-line treatment)
Bottom line: Information on urinary tract
infection was used to maintain the management of a patient (3-day first-line
antibiotherapy). There were no information-related patient health outcomes.
Level 1 outcome (situational relevance): On June 10,
2008, P06 did a search at work, with a patient (during the encounter). They
retrieved three information hits about urinary tract infection. The reported
search objective was to address a clinical question. “[The patient was] a 24 year-old woman. […] She was having dysuria. She
had stomach ache and I was not sure if it was a urinary infection or a vaginal
infection. I did some urine tests and it came back with leucocytes and nitrites
and proteins. So I told myself “ok, this is a urinary infection.” And I wanted
to treat her. […] [My clinical question
was about the] first line treatment.” According to P06, the information
from e-Therapeutics+ was in agreement with and equally relevant to the
information from another paper-based resource (Guidelines handbook). “I compared with my ‘Anti-infective
guidelines’. […] The two sources gave me exactly the same information.”
Level 2 outcome (cognitive impact): Three hits were associated with a report of positive cognitive
impact (see table). Regarding confirmation and reassurance, P06 stated: “[The information confirmed
and I was reassured that] I was doing the right thing, that my first line
choices, that they were good choices and that, once again, I am not way off
track (regarding all hits).”
Retrieved
information hit(s):
1) e-Therapeutics+ (CIRT):
Therapeutics tab – urinary tract infection – Highlight (P06S02H01).
2) e-Therapeutics+ (CIRT):
Therapeutics tab – urinary tract infection – Table 2: Clinical syndromes of
UTI, infecting organisms, and criteria for microbiologic diagnosis (P06S02H02).
3) e-Therapeutics+ (CIRT):
Therapeutics tab – urinary tract infection – Table 3: Antimicrobials for the
treatment of urinary tract infection (P06S02H03).
Level 3 outcome
(information use): Information on urinary tract infection was
retrieved, and used to maintain (be more certain
about) the management of the patient (information used as presented in
e-Therapeutics+). “I gave
Sulfamethoxazole–Trimethoprim […] twice a day for three days, which is exactly
what was recommended here [in e-Therapeutics+] (regarding all hits).”
Level 4 outcome (patient health): Without this
information, P06’s management of the patient would have been the same. There
were no clear relationships between the use of information and expected patient
health outcomes.
Levels of outcome of information-seeking
|
Situational relevance |
Positive cognitive
impact |
Information use |
Patient health |
|
Address a clinical question |
Confirmed Reassured |
Be more certain |
No outcome |