How to keep up with the medical literature: IV. Using the literature to solve clinical problems.

Ideally, searches for published articles to solve clinical problems should lead to the best evidence on a given topic quickly and at reasonable expense. This goal can be achieved with modern information skills, sources, and services. In this article, we describe and compare various means, from textbooks to computers, that provide access to information of potential value in addressing clinical problems as they arise. Using the problem of understanding and controlling the risk for the acquired immunodeficiency syndrome among personnel of a community hospital, we examined the following sources for their utility in locating journal literature: general and specialty medical texts, personal reprint collections, expert clinicians, recent journal issues, library textbook collections, the Index Medicus "Bibliography of Reviews" and subject index, and MEDLINE computer searching. For this problem, Index Medicus and MEDLINE were the best sources of up-to-date articles, but MEDLINE was three times as fast.