Hyperlink-Embedded Journal Articles Improve Statistical Knowledge and Reader Satisfaction

ABSTRACT Background To practice evidence-based medicine, physicians should have a solid understanding of fundamental epidemiological and biostatistical concepts. Research suggests that only a minority of physicians have such an understanding of biostatistics. Objective To collect pilot data on a novel biostatistical educational tool, a hyperlink-embedded journal article, which is aimed at improving knowledge in biostatistics. Methods Forty-four physicians-in-training participated in this pilot study. Participants completed a pretest consisting of 5 questions about biostatistical terms that would be encountered in the article. They were randomized to either an unmodified journal article or to the same article with hyperlinked biostatistical terms. All participants then completed a posttest that was identical to the pretest. Results Having access to hyperlinked information had a positive association with the number of improved test answers (P = .05). Use of hyperlinks varied, and were seemingly dependent on user comfort with terms; well-understood definitions (“average”) were clicked on a few times (5.5% of participants), whereas more obscure method terms (“Lexis diagram”) were clicked on by 94% of participants. While only 42% of participants stated they would have looked up definitions of the biostatistical terms if they had not been provided in the hyperlinked article, 94% of participants identified the hyperlink tool as something they would use if readily available to them when reading journal articles. Conclusions Results of this pilot study of a novel educational intervention suggest that embedded hyperlinks within journal articles may be a useful tool to teach biostatistical terms to physicians.