Iltifat Husain MD contributed to this piece
We live in an amazing time of medical research, with multi-center trials being conducted around the world on a myriad of topics. Coupled with this substantial growth in research is the number of publications released detailing the results. Often, clinicians are responsible to keep up on these new trials and reviews and their implications to practice.
Will a new study increase the utilization of a new treatment? Will a study revoke years of conscious effort to stick to so-called dogma? Will medical guidelines need to be rewritten?
Interestingly, the essence of the matter is that there is a veritable deluge of information overload. I have several times overheard colleagues and others mutter that even if they read several articles a night and stuck to their primary specialization, there would be no conceivable way to keep up with every journal or article published relevant to their practice.
Perhaps the best way I have seen this put was by Alan Fraser and Frank Dunstan in the British Medical Journal in 2010, with their article titled On the impossibility of being expert, wherein they highlight that there are more papers being published than ever before. Pubmed has over 20 million papers listed, there are over 25,000 journals, and it is consistently growing. On top of this, we have multiple open-access journals coming into being with their origins in India and China that are increasing the number of articles being published online.
Publishers are realizing that traditional print is coming to an end, and are moving their resources online, with many popular journals even making their own apps. There are RSS feeds, microblogs, and full on news stories that are spurn by articles published in top rated journals.
So what’s a clinician to do? Especially in a world where many question the actual accuracy of certain studies, with many of the results that cannot be replicated. How good are our studies that we base so much on?
Then there is the issue being raised with open-access journals with the much abuzz publication by John Bohannon in Science Magazine, with his article “Who’s afraid of peer review?” While the results and methods are debatable, it lends fuel to the fire of the veracity of some journals.
How then, can a clinician first keep up with the overload of research in their field, and find dependable information? I think there are several ways, as others have outlined such as Dr Vartabedian at 33 Charts in his post about new digital literacies. In the end, it may come down to the type of clinician and user that you are ultimately. Do you want things given to you, which is not unfair to ask of for busy professionals, or do you want to take it upon yourself to find the information?
With such evidence based practice tools out there such as Up-to-Date and Dynamed, some could argue that these sources should more than make up for any self-mediated work. However, look sometime at the dates of those articles and the update mechanism currently set up, who conducts the reviews and writes the articles and it may inspire some to pick up the legwork on their own.
With that being said, social networks also may inspire many to keep up on the latest studies, as patients and colleagues will point out new studies to look into. While subscribing to some of the curators of medical information on social media may be beneficial, there may be a great business opportunity here some companies are already exploring. These companies want to be the creators of ways to keep up with the medical information, fostering their own communities and letting others help curate and keep the conversation alive.
Such companies include Read by QxMD, Docphin, and Docwise. We have reviewed many of these apps, and their primary purpose currently is to help users get quick access to the literature. However, I feel the next step is the curation process, whereby these companies will work to achieve, and help identify what studies the user should read. In some ways they do this already by crowdsourcing much of the content that is frequently read.
Perhaps through a mixture of analytics and a thorough questionnaire, it could be possible to determine what recent research is worth reading and recommending to the user. Further this information could then be paired with actual book content or “traditional content” — that could be a game changer. Beyond that, some of these companies have partnered with other apps, such as Docwise with Omnio, in order to create a centralized app with both medical literature and medical news and journal updates.
Let’s take it further, what if these apps could narrow research down further? Bringing in some testaments of Evidence Based Medicine (EBM), perhaps an app could both curate and create content from studies and give it in concise packets, such in the POEM format that is highly prevalent in the American Family Practice Journal (see examples).
Ultimately, the killer information app will pull together features like these new journal app hybrids, that allow access to the full literature, give a user concise and pertinent blurbs, and can maintain a database similar to Dynamed or UptoDate, while fostering a level of integration with a social network for broad interdisciplinary communication.