Using Print and Online Content: The Information Seeking and Reading Habits of Physicians: A Case Study of Pediatricians

1
Using Print and Online Content The Information
Seeking and Reading Habits of Physicians A Case
Study of Pediatricians

• Michael Clarke
• Executive Editor, Pediatrics
• Online Information Education Conference 2005

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Development of Electronic Journals
WWW Search Engines HTML PubMed
Algorithmic Search XML CrossRef DOIs
SGML UNIX Electronic Databases
PC Windows Internet
Mainframe Computing
3
Development of Electronic Journals

Launching online journals and getting 100 of
journal content online and searchable
Incremental improvements for searching and
filtering vast amounts of information
2009
2003
2005
2004
2006
2007
2008
1st Phase of Electronic Journals

• Critical mass of legacy archives online
• Development of a truly integrated search of all
  scholarly literature (i.e. Google
  Scholar)

4
Methods Used to Analyze Readership
Reader Surveys

• Readers?

Usage Citation Analysis
Focus Groups/ User Studies
5
Methods Reader Survey

• Survey design and analysis conducted in
  collaboration with Professors Carol Tenopir
  Donald King
• 4,000 surveys sent out by snail mail Spring 2004
• 2 versions, each sent to 2,000 readers
• Surveys sent to AAP members
• 1 incentive
• Return postage paid
• 1 follow-up letter

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Methods Reader Survey

• Version 1 PEDIATRICS Journal Survey
• 685 returned questionnaires (34.25)
• Version 2 Critical Incident Survey
• 666 returned questionnaires 33.3

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Methods Questionnaires

• 2 brief questionnaires (sent to different sample
  groups of 1000 at different times)
• 34 31 response rates
• Conducted by Research USA
• Blinded data collection
• Sample of Table of Contents
• Purpose was to determine whether specific
  articles were read in print or online

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Methods Focus Groups

• 2 focus groups were held in May 2004
• Focus Group 1 Researchers
• PAS, May 2, 2004, San Francisco
• Focus Group 2 Clinicians
• AAP Practical Pediatrics Course, May 14, 2004,
  Sante Fe

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PEDIATRICS Vital Signs

• Published monthly
• Early Release articles published on 1st and
  15th of every month
• Impact factor 3.781 (1st in field)
• Total citations 25,691 (1st in field)
• Original science articles 700 annually
• 62,000 subscribers (English edition)

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Pediatrics Print and Online
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Journal Subscription Profile
Total Subscriptions 62,000
12
Demographics Practice Setting of Individual
Subscribers
Spring Reader Survey
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PEDIATRICS Electronic Pages

• Began in 1997 (first online-only section of a
  medical journal)
• Articles freely accessible (open access) from
  day of publication
• Same peer review process as printed articles
• Final, edited, redacted version only
• 30-40 percent of research articles published in
  e-pages

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Pediatrics Electronic
15
Electronic Pages
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Electronic Abstracts
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Why do you read PEDIATRICS? (print)

• 78.8 Keep current
• 36.7 Find specific information
• 20.2 Know what my colleagues are up to
• 12.0 Learn about other subspecialties

Spring Reader Survey
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What Sections of PEDIATRICS Do You Read
Regularly?

• Abstracts 71
• Policy Statements 56
• TOC on Cover 39
• Articles 32
• Commentaries 29
• TOC Inside Journal 18
• Green Pages 18

Spring Reader Survey
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What Sections of PEDIATRICS Do You Read
Regularly?

• Abstracts 71
• Policy Statements 56
• TOC on Cover 39
• Articles 32
• Commentaries 29
• TOC Inside Journal 18
• Green Pages 18

The abstracts in the Green Pages are difficult
to read. The green paper makes it harder to read
and the abstracts are formatted poorly. I often
read on the exercise bike, and I just give up
when I get to the green section. Focus Group
Participant
The abstracts in the Green Pages are difficult
to read. The green paper makes it harder to read
and the abstracts are formatted poorly. I often
read on the exercise bike, and I just give up
when I get to the green section. Focus Group
Participant
Spring Reader Survey
20
What Sections of PEDIATRICS Do You Read
Regularly?

• Abstracts 71
• Policy Statements 56
• TOC on Cover 39
• Articles 32
• Commentaries 29
• TOC Inside Journal 18
• Green Pages 18

I get the journal in the mail. I look at the
cover, circle the articles I am interested in,
and then set it aside for when I have time to
come back to it. Focus Group Participant
Spring Reader Survey
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Indicate your agreement with the following
statements (print)

• (Strongly agree 5/Strongly disagree 1)
• It is easy for me to read 4.08
• It is easy for me to use 4.07
• I like it because it is portable 4.06
• It is convenient for me 3.88
• It is easy for me to find things 2.95
• Using it is time consuming 2.88

Spring Reader Survey
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Indicate your agreement with the following
statements (electronic)

• (Strongly agree 5/Strongly disagree 1)
• Can search comprehensively 3.42
• Online features are valuable 3.29
• It is easy for me to find things 3.16
• The navigation makes sense 3.14
• It is convenient for me 3.08
• The interface is cumbersome 2.94
• Using it is time consuming 2.94

Spring Reader Survey
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Which features of the electronic edition do you
use?

• Advanced searching 14.2
• Links to Medline 12.1
• Most-Read Articles 8.9
• Topic Collections 5.4
• E-mail Alerts 4.7
• E-Letters 4.7
• Free Reference Links 4.5

Spring Reader Survey
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What electronic features would you be likely to
use if added?

• CME 56
• Download Figures to PowerPoint 56
• Publish Ahead of Print 41
• Full-text Search on PDA 32
• Citation Reporting by Article 27
• Usage Reporting by Article 15

Spring Reader Survey
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What format do you prefer to receive PEDIATRICS
in?

• 59.3 Print only
• 8.2 Electronic only
• 33.6 Both print electronic
• 92 Wish to continue to receive print

Spring Reader Survey
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And YetPEDIATRICS electronic usage
projected based on year-to-date statistics
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Indicate your agreement with the following
statements (e-only articles)

• (Strongly agree 5/Strongly disagree 1)
• e-articles are reviewed
• as strictly as print 3.21
• e-articles are as useful as print 2.84
• e-articles are second class 2.71

Spring Reader Survey
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e-Articles vs Articles, 1999 2005
projected based on year-to-date statistics
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Most-Read Articles, July 2004
Reported via Survey Reported via Usage Statistics
1. Hyperbilirubinemia Kernicterus 1. Hyperbilirubinemia in the Newborn
2. Assessment of Sleep Apnea 2. Neonatal Hyperbilirubinemia (e)
3. Violent Television Viewing 3. Nocturnal Cough Sleep Quality (e)
4. Gastrointestinal Disorders 4. Hymenal Measurements
5. Hyperbilirubinemia in the Newborn 5. Multivitamin Supplementation
6. SIDS Definitional Approach 6. Imperforate Hymen (e)
7. Trial of Multivitamins 7. Predicting Obesity (e)
8. Neonatal infections 8. Attention-Deficit Disorder (e)
9. Food Allergy and Asthma 9. Reduced Unnecessary Antibiotic
10. Habitual Snoring in Children 10. Use of Practice Guidelines (e)
July Questionnaire
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Most-Read Articles, July 2004
Reported via Survey Read in Print Read Online
1. Hyperbilirubinemia Kernicterus 46.2 1.3
2. Assessment of Sleep Apnea 44.6 1.3
3. Violent Television Viewing 44.6 0.6
4. Gastrointestinal Disorders 43.0 0.6
5. Hyperbilirubinemia in the Newborn 42.4 0.6
6. SIDS Definitional Approach 41.1 0.3
7. Trial of Multivitamins 37.9 .06
8. Neonatal infections 36.0 1.3
9. Food Allergy and Asthma 35.6 1.0
10. Habitual Snoring in Children 35.6 1.0
July Questionnaire
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Top e-Articles, July 2004
Reported via Survey Read Abstract in Print Read Article Online
1. Azithromycin for Petussis 20.4 3.2
2. Once-a-Day Aminoglycosides 9.2 2.5
3. Beordetella Pertussis Infections and 16.6 2.2
4. Conscious Sedation of Children with 14.6 2.2
5. Neonatal Hyperbilirubinemia 18.2 1.9
6. Vaccine Safety Concerns 16.2 1.9
7. Levels After Otitis Media 12.4 1.9
8. Children with ADHD 18.5 1.6
9. Atomoxetine in Childhood ADHD 16.9 1.6
10. Predictors of Asthma Care Quality 9.2 1.6
July Questionnaire
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Comparisons PEDIATRICS Readers to Other
Scientists

• King and Tenopir have surveyed 25,000
  respondents since 1977
• Medical, physical, and social scientists in all
  settings
• Data from 2001-2004 reported today

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Number of Articles Reader per Year Article Read

• Univ. medical
• Univ Scientists
• All Scientists
• Soc Sci/Psych
• Engineers
• Pediatricians

• 322 articles/year
• 216 articles/year
• 130 articles/year
• 191 articles/year
• 111 articles/year
• 180 articles/year

Spring Reader Survey Compared with Data from King
Tenopir
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Form of Reading
Pediatricians
16
84
Medical Faculty
Astronomers
20
25
75
80
Spring Reader Survey Compared with Data from King
Tenopir
35
Form of Final Reading PEDIATRICS Readers
7.5
92.6
Spring Reader Survey Compared with Data from King
Tenopir
36
Sources of Readings
Pediatricians
21.4
12
16
72
Medical Faculty
Astronomers
University Faculty
16
21
22
44
49
36
36
62
16
Spring Reader Survey Compared with Data from King
Tenopir
37
Age of Last Article Read
17
Scientists
Astronomers
Pediatricians
13
2
10
17
23
21
64
81
69
Spring Reader Survey Compared with Data from King
Tenopir
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Principal Purpose of Reading
Reasons Pediatricians Univ. Medical
Current Awareness 50.0 22.1
Treatment 18.2 -
Diagnosis 10.7 -
Teaching 5.3 16.9
Research 5.1 36.4
Consulting 3.4 3.9
Other 5.8 9.0
Writing 1.6 11.7
Spring Reader Survey Compared with Data from King
Tenopir
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Location when reading
Location Percentage
Home 50.5
Office 36.8
Hospital/Clinic 6.2
In transit 3.1
Other 2.5
Library 1.1
Spring Reader Survey Compared with Data from King
Tenopir
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Conclusions e-articles

• E-articles are read more online because that is
  the only place they can be found
• Perception of e-articles as second-class articles
  has diminished, but still lingers
• I sometimes wonder, why wasnt this one
  printed?

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Conclusions e-articles

• Due to rising tide of manuscripts and costs of
  print/postage, e-only articles are necessary
• 50 in 2005 and as high as 80 in near future
• Necessity of reader education on benefits of and
  reasons for e-only articles

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ConclusionsPEDIATRICS Readers

• Pediatrics has a bifurcated readership
• AAP members who receive print read primarily
  print
• Non-members who read the online edition largely
  via institutional subscriptions
• Those who receive print, go online for specific
  reasons searching, looking up a specific
  article, reading e-articles, etc.

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ConclusionsPEDIATRICS Readers

• Those members who do use the online edition seem
  to like it, but it is still not as convenient for
  most as print due to
• Portability
• Paper is easier to read
• It shows up in their mailbox
• Members indicate they may use electronic journals
  more in the future, particular for online-only
  features such as CME, obtaining figures for
  PowerPoint lectures, publish ahead of print, etc

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Thoughts for Libraries Serving Physicians

• Physicians may not be entirely comfortable yet
  with electronic journals (they are migrating
  slower than other scientists)
• The role of the librarian is critical in
  educating physicians in using electronic journals
• Tutorials
• Instructional material
• Web sites designed with physicians in mind