Open AccessHow Current Are Leading Evidence-Based Medical Textbooks? An Analytic Survey of Four Online Textbooks
Author(s) -
Rebecca A. Jeffery,
Tamara Navarro,
Cynthia Lokker,
R. Brian Haynes,
Nancy L. Wilczynski,
George Farjou
Publication year - 2012
Publication title -
jmir. journal of medical internet research/journal of medical internet research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.446
H-Index - 142
eISSN - 1439-4456
pISSN - 1438-8871
DOI - 10.2196/jmir.2105
Subject(s) - inclusion (mineral) , consistency (knowledge bases) , evidence based medicine , medline , medical education , evidence based practice , family medicine , clinical practice , psychology , medicine , alternative medicine , computer science , artificial intelligence , social psychology , political science , pathology , law
Background The consistency of treatment recommendations of evidence-based medical textbooks with more recently published evidence has not been investigated to date. Inconsistencies could affect the quality of medical care. Objective To determine the frequency with which topics in leading online evidence-based medical textbooks report treatment recommendations consistent with more recently published research evidence. Methods Summarized treatment recommendations in 200 clinical topics (ie, disease states) covered in four evidence-based textbooks–UpToDate, Physicians’ Information Education Resource (PIER), DynaMed, and Best Practice–were compared with articles identified in an evidence rating service (McMaster Premium Literature Service, PLUS) since the date of the most recent topic updates in each textbook. Textbook treatment recommendations were compared with article results to determine if the articles provided different, new conclusions. From these findings, the proportion of topics which potentially require updating in each textbook was calculated. Results 478 clinical topics were assessed for inclusion to find 200 topics that were addressed by all four textbooks. The proportion of topics for which there was 1 or more recently published articles found in PLUS with evidence that differed from the textbooks’ treatment recommendations was 23% (95% CI 17-29%) for DynaMed, 52% (95% CI 45-59%) for UpToDate, 55% (95% CI 48-61%) for PIER, and 60% (95% CI 53-66%) for Best Practice ( χ 23 =65.3, P <.001). The time since the last update for each textbook averaged from 170 days (range 131-209) for DynaMed, to 488 days (range 423-554) for PIER ( P <.001 across all textbooks). Conclusions In online evidence-based textbooks, the proportion of topics with potentially outdated treatment recommendations varies substantially.