Systematic reviews and original articles differ in relevance, novelty, and use in an evidence-based service for physicians: PLUS project

OBJECTIVES: To describe the ratings from physicians, and use by physicians, of high quality, clinically pertinent original articles and systematic reviews from over 110 clinical journals and the Cochrane Database of Systematic Reviews (CDSRs). STUDY DESIGN AND SETTING: Prospective observational study. Data were collected via an online clinical rating system of relevance and newsworthiness for quality-filtered clinical articles and via an online delivery service for practicing physicians, during the course of the McMaster Premium LiteratUre Service Trial. Clinical ratings of articles in the MORE system by over 1,900 physicians were compared and the usage rates over 13 months of these articles by physicians, who were not raters, were examined. RESULTS: Systematic reviews were rated significantly higher than original articles for relevance (P<0.001), but significantly lower for newsworthiness (P<0.001). Reviews published in the CDSR had significantly lower ratings for both relevance (P<0.001) and newsworthiness (P<0.001) than reviews published in other journals. Participants accessed reviews more often than original articles (P<0.001), and accessed reviews from journals more often than from CDSR (P<0.001). CONCLUSION: Physician ratings and the use of high-quality original articles and systematic reviews differed, generally favoring systematic reviews over original articles. Reviews published in journals were rated higher and accessed more often than Cochrane reviews.