To 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.

Systematic review with narrative synthesis and meta-analysis.

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.

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.

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.

25 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.

Medical 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.

CRD42022267431.

Atopic dermatitis (AD) is a chronic, relapsing, heterogeneous skin disease affecting 2%–7% of adults, with roughly 30% having moderate-to-severe disease. AD symptoms, like intense itching and skin pain, carry a substantial disease burden that negatively impacts patients’ quality of life (QoL) and psychosocial well-being. Lebrikizumab is a novel, high-affinity monoclonal antibody that selectively binds to and neutralises interleukin-13 with high potency. Three clinical trials with lebrikizumab (ADvocate 1 and 2; ADhere) demonstrated significant clinical benefit in patients with AD, while the 3-year long-term extension study of lebrikizumab (ADjoin) further demonstrated long-term efficacy and safety in patients with AD. The ADTrust study will evaluate patient well-being, their relationship with their skin, long-term effectiveness, and safety of lebrikizumab, treatment satisfaction, and long-term effect of lebrikizumab treatment on different aspects of patients’ lives, including itch, pain, sleep, fatigue, work impairment and overall QoL among adult patients with moderate-to-severe AD in a real-world setting.

This non-interventional, prospective, observational, real-world evidence study will involve approximately 150 sites across Europe and approximately 1200 adults with moderate-to-severe AD treated with lebrikizumab for 2 years. The primary endpoint is patient well-being assessed by the 5-item WHO Well-Being Index (WHO-5) questionnaire. Key secondary endpoints include clinical effectiveness (Eczema Area and Severity Index and Investigator’s Global Assessment Scale), disease symptomatology and control (Patient-Oriented Eczema Measure, 24-hour peak pruritus, skin pain, fatigue and sleep quality Numerical Rating Scale, and safety and tolerability. Other validated endpoints will evaluate physician-reported and patient-reported QoL and treatment satisfaction (Dermatology Life Quality Index, Treatment Satisfaction Questionnaire-9), patients’ work productivity and impairment (Work Productivity and Activity Impairment (WPAI)-AD) and disease control (AD Control Tool). Novel experimental endpoints will also be evaluated with the aim to assess patients’ relationship with their skin (SkinLove questionnaire), disease control (intensity and frequency of flares) and an Effectiveness Diary^+© (a brief monthly survey on a voluntary basis with the aim to assess the long-term impact of lebrikizumab on three fundamental aspects of the patients’ life: the well-being (WHO-5), the itch intensity (24 hours peak pruritus) and the frequency and intensity of flares). Statistical analyses will be descriptive and explorative and based on observed cases. Missing data imputation may be used to handle missing data for primary endpoints and secondary effectiveness endpoints.

This study will be conducted according to the protocol, which has ethics committee approval (Hamburg Ethic Committee in Germany: 2024-101358-BO-ff), and all applicable laws and regulatory requirements for each participating country. The results will be disseminated through scientific publications and congress presentations.

NCT06815380 (Pre-results).