摘要：Objective: The purpose of this study was to evaluate the efficacy of a decentralized intranet access in each medical department as opposed to centralized unique MEDLINE access in the medical library. Design: A two-phase questionnaire to evaluate MEDLINE use was given to junior and senior physicians at Rouen University Hospital (RUH). Phase I (August–October 1996) corresponded to a time period when centralized access was the only means of access available and phase II (August–October 1997) to a time period following the introduction of decentralized intranet access. Results: A total of 168 physicians filled out at least one phase of the questionnaire, among whom 123 (73%) filled out both phases. Use of MEDLINE significantly increased in 1997 (average of 10.2 ± 1.1 searches in three months) versus 1996 (average of 4.9 ± 0.7 searches in three months, P < 0.0001). The aim of searches changed, becoming significantly more care oriented in phase II ( P < 0.0001). The number of searches performed by the physicians alone increased ( P < 0.0001) and searches performed by the librarian decreased ( P < 0.0001) in phase II. The method of searches also changed, as searches by author ( P < 0.0001), by journal ( P = 0.0042), and by free word ( P = 0.0027) increased in phase II. Knowledge of the following concepts of MEDLINE significantly increased: explosion ( P < 0.0001), scope note ( P < 0.0001), Abridged Index Medicus (AIM) journals ( P < 0.0001), Medical Subject Headings (MeSH) qualifier ( P < 0.0001), and focus ( P < 0.0001). Conclusion: A decentralized intranet access to MEDLINE increased the number of searches and knowledge of this bibliographic database. MEDLINE intranet access modified the purpose and the methods of searching.
