SRFP122: What influences the clinical relevance of information in the daily POEM? (Pearls)

Sarah Waicus, BSc, MBChB; Jasmin Ali, BSc, MDCM Candidate; Roland Grad, MD, CCFP, FCFP; Nishaant Bhambra, BSc, MDCM(c)

Abstract

Context: In a popular continuing medical education program, Canadian physicians use the Information Assessment Method (IAM) to rate the daily POEM (Patient-Oriented Evidence that Matters). From the physician perspective, most POEMs are perceived as highly relevant to their clinical practice, but some are not. Information scientists have described dimensions of relevance that can serve as a starting point for understanding this variation. Knowing the reasons for this variation in the relevance of POEM information to clinical practice could improve the future selection of studies that become POEMs. Objective: To recommend how to improve the relevance of research studies selected for inclusion in the daily POEMs program. Study Design: Longitudinal. Dataset: Ratings of clinical relevance from the perspective of the reader for all POEMs delivered to Canadian physicians from 2015-2019. Ratings of clinical relevance were calculated from the answers provided by physicians to one question in the validated IAM questionnaire. Outcome Measures and Methods: Starting with Wilson's three dimensions of situational relevance, we first defined a theme for each dimension that could explain the low clinical relevance of a POEM. Two readers then independently considered whether each POEM within the lowest decile of our measure of clinical relevance could be assigned to at least one theme using deductive content analysis. When there were differences in opinion, adjudication first involved discussion between these two readers to see whether agreement could be reached. If disagreement persisted, a third reader adjudicated the discrepancy. Elements of the PICO framework were used to understand why a given POEM was assigned to a theme of low clinical relevance. Results: From 1,556 POEMs, 155 of 156 POEMs in the lowest decile of relevance could be assigned to one of our three themes: 1. Specialty, 2. Geography, and 3. Newsworthiness. Of these POEMs, 147 (94%) were of low relevance because of specialty, 11 (7%) because of geography and 9 (6%) because of newsworthiness. Conclusions: POEMs of low clinical relevance are primarily due to the information being outside the sphere of practice of most physicians in Family Medicine.
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Jack Westfall
jwestfall@aafp.org 11/21/2021

Terrific poster and presentation. Thanks for your work. thanks for sharing at NAPCRG

Gillian Bartlett
gillian.bartlett@health.missouri.edu 11/21/2021

Great presentation and happy to see ongoing work with the IAM - very interesting results.

William R. Phillips
wphllps@uw.edu 11/22/2021

Thanks for a great poster on an interesting topic of relevance to every reader of poems. The finding that most low value poems are due to judging it outside of one's specialty should be useful to inform the selection and creation of future poems. The criteria of "will not change my practice" is of interest, as I think one value of CME is to reaffirm the practicing clinician that what they are you doing is still up-to-date. This is hard feedback to get in practice. Thanks for sharing your work here at NAPCRG. - Bill Phillips

Diane Harper
harperdi@med.umich.edu 11/22/2021

Thank you for sharing your work with NAPCRG!

Pierre Pluye
11/22/2021

Great poster and very useful for selecting topics (pico)! There may be some potential insights for analyzing expected benefits of POEMS (e.g., is CRII an intermediate outcome or a confounding variable?).

Diane Harper
harperdi@med.umich.edu 11/22/2021

Thank you for sharing your work with NAPCRG!

Andy Pasternak
avpiv711@sbcglobal.net 11/27/2021

Love the poster and the data! Great work

Louise Acheson
11/30/2021

I echo Bill Phillips' comment--maybe not everything needs to change practice to be relevant. I think the mouse infestation example may be one where we undervalue and are disappointed in the results of a negative trial. Thank you for your work and for presenting it a t NAPCGRG.

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