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Advisor Reviews / The Charleston Advisor / January 2021
The mobile app is free to download however much of the content re- quires in-app purchases and/or an institutional subscription. BMJ also touts that the app is available offline however the user will want to be careful to ensure they are reviewing the most updated clinical practice guidelines and recommendations which does require connectivity to update. Critical Evaluation BMJ Best Practice has established different interfaces based on re- gionality. When entering the site there are platforms for USA/Canada, Portuguese, Chinese, and UK/Rest of the World. While this can be helpful for searching for specific guidelines and available drugs/treat- ments based on regional availability and policy, it can also potentially introduce some bias into providing the best available evidence. Cli- nicians may often benefit from the latest news and information from around the globe even if those options are not currently available in their region. This can be most easily evidenced on the news and stud- ies page. The UK/Rest of the World version of the platform has in- formation posted as of November 20, 2020, while the USA/Canada version has not had any updates since early March 2020. Additional- ly, there appears to be a comorbidity tool on the UK version that has not yet been released in the United States version as of the date of this publication. Conflict of interest disclosures are included on each of the overview topics and pages. The clinical experts who have reviewed the content and determined the best available evidence and current literature to support findings are listed on each page along with a disclosure of any potential financial conflicts of interest. This is a topic of discus- sion and growing concern surrounding other evidence-based point of care tools on the market; therefore, prominent disclosures set them apart from other competitor platforms. While there is a level of transparency regarding the evaluation of ev- idence, daily updates versus actual time to reflect changes in clinical overviews vary and can be a bit misleading. The main pages of the platform tout daily updates; however, if you look a bit further into the pages regarding the evaluation of evidence, it is there you will find a more detailed update schedule. Drug withdrawals or changes that may affect patient safety are made within 24 to 48 hours, evidence that changes practice will be reflected within one month while new evidence that confirms current practice guidelines will be made avail- able within three months. BMJ is a world-renowned medical publisher with several journals un- der their umbrella. It would be interesting to see if there is any cor- relation between the evidence graded as high quality and the pub- lisher. Perhaps an independent analysis of content and grading of the included evidence would be a good initiative for this and other point of care tools with similar potentially perceived conflicts of interest. Ultimately, the institutional priorities and clinical needs should be considered when selecting a point of care tool. As described in the Competitive Products section, there are other point of care tools on the market. Each of these, however, cover slightly different clinical specialties and their clinical topics undergo different editorial pro- cesses and peer review which can lead to differences in the content provided. Electronic medical record integration may be essential for some organizations which can ultimately influence the decision as well. Overall, it is important for librarians to obtain input from the
clinical user group during the selection process to identify the re- source that meets the organization’s needs and covers the relevant medical specialties. Competitive Products DynaMed is a point of care tool provided by EBSCO. DynaMed pro- vides evidence-based synopses and recommendations for clinical care in multiple specialty areas listed below. All content goes through a rigorous editorial process and updates are made to the content daily. Currently, over 100,000 evidence and guideline summaries are pre- sented within DynaMed from over 3,500 journals and guideline or- ganizations from across the globe. Additional features such as drug monographs, drug interaction reports, clinical calculators, and patient handouts are also available on this platform. DynaMed does provide integration with most electronic health record management systems currently being used in the United States. There is a mobile app ver- sion of this resource available to subscribed institutions. DynaMed Specialty Areas are shown in Table 2. UpToDate is a clinical point of care tool provided by Wolters Kluwer. UpToDate provides clinical summaries and diagnostic overviews in the medical specialty areas listed below. This platform provides prac- tice changing updates as a highlighted feature. The editorial process allows for a primary author and two peer-reviewers to ensure that the latest evidence is being incorporated into the clinical summary and treatment recommendations. In addition to the clinical topic summa- ries several additional features are also available such as drug mono- graphs, drug interaction information, clinical calculators, and patient education materials. UpToDate is equipped for integration into most electronic health records systems in the United States and there is a mobile app version available to subscribers. UpToDate Specialty Areas are shown in Table 3.
Table 2 DynaMed Specialty Areas
Obstetric Medicine Oncology Ophthalmology Oral Health Orthopedics and Sports Medicine Otolaryngology Palliative Care Pathology and Laboratory Medicine Pediatrics Physical Medicine and Rehabilitation Psychiatry Pulmonary Medicine
Allergy Anesthesiology and Pain Management Cardiology Critical Care Dermatology Emergency Medicine Endocrinology
Family Medicine Gastroenterology Geriatrics Gynecology Hematology Hospital Medicine Immunology Infectious Diseases Internal Medicine Nephrology Neurology Neurosurgery
Rheumatology Sleep Medicine
Surgery Urology
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