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Autumn 2016


imaging; clinical medicine

series of brain scan images

Does a young woman’s recurring flank pain warrant a CT scan or is she better off undergoing an ultrasound?

To help clinicians choose the most appropriate imaging test for a patient, HMS is launching the Library of Evidence, a publicly accessible digital repository of medical evidence. Initially focused on imaging, the long-term goal of the database is to include laboratory testing and other medical procedures that require evidence-based support tools.

“The overarching goals are to improve patient care and curb wasteful imaging by optimizing clinicians’ ability to choose the most appropriate imaging,” says David Osterbur, director of Public and Access Services at the Francis A. Countway Library of Medicine and co-executive director of the Library of Evidence.

Adds Ramin Khorasani, an HMS professor of radiology at Brigham and Women’s Hospital and chair of the new library’s governing council, “The library is an important step toward organizing what is known to help advance the goal of evidence-based practice in a concrete way.”

The Library of Evidence database contains clinical information compiled from the review and scoring of scientific evidence, published research, and professional organizations’ imaging guidelines.

Free and accessible to clinicians worldwide, the library can be embedded into various clinical information systems used by individual practices and hospitals. If a physician is ordering a CT scan for a patient with back pain, for example, the system might indicate an ultrasound instead and provide evidence-based recommendations as support for the analysis.

In an era of rushed appointments, physicians may have become overly reliant on imaging. The Library of Evidence is designed to curb this practice by providing clinicians with readily accessible medical evidence for each clinical scenario.

The most important benefit of evidence-based decision making, the HMS team says, is improving quality of care.

The launch of the library may be particularly timely for clinicians caring for Medicare and Medicaid patients. Federal legislation requiring clinicians to consult “appropriate-use” criteria using certified decision-support systems is slated to go into effect in 2018.

Information for physicians is available at the Library of Evidence website.  

Image: iStock

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