DynaMed Plus

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Contents

Last Update

  • Updated.jpg 6 March 2017

Introduction

See also ClinicalKey by Elsevier | Google scholar | Point-of-care tools in medicine | UpToDate | Web 2.0

  • DynaMed via UBC Library
  • DynaMed Plus™ (Dynamic Medical Information System) is a quick and easy-to-use medical reference system designed for use at the point of care:
  • DynaMed Plus is physician-focused DynaMed (meant to compete with UpToDate) and includes expert opinion for 800 topics; overviews and graded recommendations with links to levels of evidence and guidelines
  • Daily updates of original research; earn CME credits for CFPC and RCPSC
  • The old DynaMed is now a subset of DynaMed Plus
  • Over 4000 images and graphics (1000+ from the American College of Physicians (ACP); used in teaching and "point of care"
  • Mobile optimized; mobile app (see review) can be used with no Internet connection
  • Google-like search interface; custom taxonomy
  • Content from McMaster, ACP and Micromedex (but not full Drugdex, which has to be purchased separately)
  • Easy access to updates by specialty, ‘practice-changing’ updates flagged, can set alerts.

Building on the old system, DynaMed Plus contains clinically organized summaries of thousands of topics and is updated several times a day from a review of the research literature. It provides current, unbiased, evidence-based information to enable physicians to make decisions at point of care. DynaMed Plus is useful in clinical, educational and research settings. Its content is written by physicians who synthesize the evidence and provide objective analysis.

History of DynaMed

The American physician Brian S. Alper, MD, MSPH, FAAFP created DynaMed for physicians (especially in hospital settings) to assist them in their clinical decision-making activities. DynaMed now provides evidence-based summaries for ~3200 topics which are a synthesis of the best available evidence. Dynamed is also updated daily while monitoring 500+ medical journals and databases. All published medical evidence is reviewed by DynaMed from cover-to-cover and evaluated for its clinical relevance and scientific validity. Any new evidence is then integrated into the existing content and conclusions are supported or changed as needed upon rigorous syntheses of the evidence. Through a process of systematic surveillance of the medical literature, the best available evidence determines the content of DynaMED. A 2005 study published in Annals of Family Medicine revealed that primary care clinicians answered more clinical questions by using DynaMED than other tools. Despite being the clear winner in head-to-head comparisons with other POC tools (see Banzi et al, 2011), some clinicians still seem to prefer UpToDate.

Selection criteria

DynaMed Plus employs the following approach to the analysis and processing of literature review, appraisal and summary integration:

DynaMed - Selection Criteria
1. Systematic identification of evidence
2. Systematic selection of the best available evidence from that identified
3. Systematic evaluation of the selected evidence (critical appraisal)
4. Accurate summarization of the evidence and its quality
5. Making conclusions dependent on the evidence
6. Synthesizing multiple bits of evidence for overall conclusions
7. Changing conclusions as new evidence is discovered

Literature surveillance

DynaMed Plus monitors over 100 journals each day. An additional 400 medical journals are monitored through journal review services along with systematic reviews, guidelines, and drug information sources. Each publication is reviewed cover-to-cover, and each article evaluated for clinical relevance and scientific validity. DM's mission is "to provide the most useful information at the point of care for health care professionals". Librarian and user input is continually sought. A DynaMed Librarian Advisory Council assists in product development, and the site has feedback links within each disease summary. A user reports that emailing Dynamed about content that she wanted to see, resulted in the content being added within the same day. Although one paper states that "peer-reviewed summaries form the core of DM", another cautions that only 10% of summaries are peer reviewed. Each disease summary is formatted as an outline, with sections and subcategories. Users may open (expand) sections or subcategories. In this way, users can quickly locate specific information or more comprehensive overviews, as required. Information is selected based on validity, relevance, convenience and affordability.

Video

Usefulness

DynaMed Plus conforms to principles of the Health on the Net (HON) code. As such, it is recognized by the American Academy of Family Physicians as a resource that "...may be of assistance to family physicians in answering clinical questions with a high quality of evidence". In developing countries, DynaMED access is provided to health providers at a discount; free access can be obtained by becoming a contributor or reviewer of the content in DynaMED. The project is funded by the National Science Foundation, a Small Business Initiative Research Grant, and modest subscription fees through EBSCO. No advertisement money is accepted in the creation of EBSCO. Similar in approach to First Consult, DynaMED is targeted to primary care providers and family practice physicians. In addition, nurses and pharmacists use DynaMED. On the other hand, UpToDate is also a type of point-of-care tool aimed at internal medicine physicians and selected subspecialties. DynaMED is designed for quick consultation at point of care. Primary care providers including physicians, residents, physicians' assistants, and nurse practitioners are its target users.

References

Type of evidence used to support content Source: Ketchum, 2009
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