 Type of evidence used to support content - Ketchum, 2009 To browse other articles on a range of HSL topics, see the wiki index.
Introduction
See also DynaMed (EBSCO) | First Consult | Point of care decision-making tools - Overview
UpToDate (see UpToDate mobile) is a popular evidence-based clinical tool available via computer or mobile device. UpToDate is designed to provide concise, practical answers when clinicians need them. It was launched in 1992 by Drs. B. Rose and J. Rush. More than 8,500 topics are available on UpToDate and more than 4,800 physicians serve as authors, editors and peer reviewers. UpToDate has an extensive peer review process to ensure that information and recommendations are current, accurate and reliable. While considered an electronic textbook, UpToDate is also described as a "practical clinical reference tool designed to provide quick access to synthesized medical information in an easy-to-use format." UpToDate is comprised of topics written by experts who summarize current research and make recommendations for treatments based on best available evidence. To write entries, over 440 medical journals are searched regularly along with the biomedical databases and hand-searching of the literature. UpToDate content is updated whenever important new information is published.
The chief controversy about UpToDate seems to be its cost; another is that its search strategies and appraisal guidelines are not sufficiently explicit or evidence-based. Apart from this, physicians recommend it more than any other clinical decision support tool. This tends to put health librarians in a difficult position as they often agitate for them to buy subscriptions and networked licenses.
UpToDate's usefulness
UpToDate helps physicians to:
- access the most current information within different specialties
- recognize clinical manifestations of disorders
- describe options for diagnosis, management and therapy (e.g., efficacy, doses and interactions of drugs)
- identify optimal screening and prevention strategies
Value
UpToDate is produced in cooperation with major medical societies and more than 4,400 physician authors. Its goal is to address clinical issues with synthesized topics, using relevant evidence from medical journals and other sources of information. Authors synthesize and summarize the medical literature and provide specific recommendations for patient care. All content is peer-reviewed and updated regularly. The unique value of UpToDate is its concise, practical answers for use at the point of care. In addition, its search features are clear and straightforward. UpToDate covers 16 specialties, including primary care internal medicine and all of the internal medicine subspecialties (at a level that meets the needs of the subspecialist), ob/gyn, neurology, emergency medicine and pediatrics. Dermatology, psychiatry and surgery are currently in development.
UpToDate is recommended by the American Academy of Family Physicians and is an official educational program of or offered in cooperation with the American College of Obstetricians and Gynecologists, American College of Rheumatology, American Gastroenterological Association, American Thoracic Society, Society of General Internal Medicine and The Endocrine Society. It offers CME credits/CE contact hours for physicians, physician assistants, nurses and nurse practitioners.
References
- Banzi R, Liberati A, Moschetti I, Tagliabue L. A review of online evidence-based practice point-of-care information summary providers. J Med Internet Res. 2010;12(3):1-16.
- Blackman D, Cifu A, Levinson W. Can an electronic database help busy physicians answer clinical questions? J Gen Intern Med. 2002;17(S1):220.
- Campbell R, Ash J. An evaluation of five bedside information products using a user-centered, task-oriented approach. J Med Libr Assoc. 2006;94(4):435–41.
- Ely JW, Osheroff JA, Chambliss ML, Ebell MH, Rosenbaum ME. Answering physicians' clinical questions: obstacles and potential solutions. JAMIA. 2005;12(2):217–24.
- Farrell A. An evaluation of the five most used evidence based bedside information tools in Canadian health libraries. Evid Based Libr Inf Pract. 2008;3(2):3–17.
- Fenton SH, Badgett RG. A comparison of primary care information content in UpToDate and the National Guideline Clearinghouse. J Med Libr Assoc. 2007;95(3):255-9.
- Fox GN, Moawad NS. UpToDate: a comprehensive clinical database. J Fam Pract. 2003;52(9): 706-710.
- Garrison JA. UpToDate. J Med Libr Assoc. 2003;91(1):97.
- Glasziou PP, Irwig LM. An evidence based approach to individualising treatment. BMJ. 1995(311):1356-1359.
- Goodyear-Smith F, Kerse N, Warren J, Arroll B. Evaluation of e-textbooks. DynaMed, MD Consult and UpToDate. Aust Fam Physician. 2008;37(10):878-82.
- Green ML, Ciampi MA, Ellis PJ. Residents' medical information needs in clinic: are they being met? Am J Med. 2000;109(3):218-23.
- Grimshaw JM, Russell IT. Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations. Lancet. 1993;342:1317-1322.
- Hoogendam A. Answers to questions posed during daily patient care are more likely to be answered by UpToDate than PubMed. J Med Internet Res. 2008;10(4):e29.
- Ketchum A, Saleh A. The evidence behind point of care products. Pittsburgh: Health Sciences Library System, University of Pittsburgh; 2009.
- Krumholz HM, Radford MJ. Aspirin for secondary prevention after acute myocardial infarction in the elderly: prescribed use and outcomes. Ann Intern Med. 1996;124:292-298.
- Lai CJ. Multiprogram evaluation of reading habits of primary care internal medicine residents on ambulatory rotations. J Gen Intern Med. 2006;21(5):486–9.
- Leff B, Harper GM. The reading habits of medicine clerks at one medical school: frequency, usefulness, and difficulties. Acad Med. 2006;81(5):489–94.
- Liddle J, Williamson M. Method for evaluating research and guideline evidence. Sydney: NSW, 1996.
- McDonald FS, Zeger SL. Factors associated with medical knowledge acquisition during internal medicine residency. J Gen Intern Med. 2007 Apr 28.
- Patel MR, Schardt CM. Randomized trial for answers to clinical questions: evaluating a pre-appraised versus a MEDLINE search protocol. J Med Libr Assoc. 2006;94(4):382-7.
- Peterson MW, Rowat J. Medical students' use of information resources: is the digital age dawning? Acad Med. 2004;79(1):89-95.
- Phua J, Lim TK. How residents and interns utilise and perceive the personal digital assistant and UpToDate. BMC Med Educ. 2008;8:39.
- Scott I, Heyworth R. The use of evidence-based medicine in the practice of consultant physicians. Aust N Z J Med. 2000;30:319-326.
- Schilling LM, Steiner JF, Lundahl K. Residents' patient-specific clinical questions: opportunities for evidence-based learning. Acad Med. 2005;80(1):51-6.
- Smith R. What clinical information do doctors need? BMJ 313:1062-1068.
- Trumble J. A systematic evaluation of evidence based medicine tools for point-of-care. Texas Health Science Libraries Consortium. SCC/MLA Meeting, 2006.
- UMDNJ Physician's Core Toolkit
- Vine R, Shaughnessy R, Thuna M. EBM Tool-Picking Made Easy. Medical Library Association Meeting; 2008.
- Weinfeld JM, Finkelstein K. How to Answer Your Clinical Questions More Efficiently
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