Systematic review and meta-analysis of information source usage: do medical specialists use the best evidence for clinical decision-making?

objectivesTo examine which information sources medical specialists use to answer clinical questions in daily practice and to describe the relative frequency of use for each source.

designSystematic review with narrative synthesis and meta-analysis. DATA SOURCES: Academic Search Premier, APA PsycINFO, CINAHL, Emcare, Cochrane Library, Web of Science, Embase and PubMed were searched for relevant studies published from 2000 to 1 June 2025. ELIGIBILITY CRITERIA: We included peer-reviewed English-language studies reporting on the frequency of information source usage by medical specialists when addressing clinical questions. Studies reporting usage on a continuous (0-100%) scale were eligible for meta-analysis. DATA EXTRACTION AND SYNTHESIS: Two reviewers independently screened studies. Data were extracted by one reviewer and checked by a second. Study quality was assessed using the Quality Assessment tool with Diverse Studies tool. A narrative synthesis was conducted for studies that were not eligible for quantitative pooling to summarise patterns in information-seeking behaviour and reported barriers. A random-effects meta-analysis was performed for studies reporting continuous usage percentages and assessing at least four information sources. Sensitivity analyses were conducted using a leave-one-out approach. Potential publication bias was explored descriptively using funnel plots.

results25 studies were included, of which 6 (with 8641 participants) were eligible for meta-analysis. The narrative synthesis of non-pooled studies showed a consistent reliance on standalone information sources and identified barriers to the use of aggregated sources. In the meta-analysis, digital databases such as PubMed were the most frequently used information source (74%, 95% CI 63% to 85%), followed by textbooks (71%, 95% CI 57% to 85%) and consultation with colleagues (43%, 95% CI 15% to 71%). Systematically aggregated sources, including clinical practice guidelines (38%, 95% CI 27% to 49%) and point-of-care websites (49%, 95% CI 17% to 81%), were used less frequently. Sensitivity analyses indicated that pooled estimates were generally robust, although results should be interpreted cautiously given methodological variability across studies.

conclusionsMedical specialists predominantly rely on standalone information sources when addressing clinical questions, while systematically aggregated and interpreted sources such as clinical practice guidelines and point-of-care tools are used less frequently. These findings highlight the need to better understand and address barriers to the use of aggregated information sources in clinical practice. PROSPERO REGISTRATION NUMBER: CRD42022267431.