Tuesday, November 8, 2011

Dynamed versus uptodate

I received the following announcement from our hospital librarian
We are conducting a trial of the online clinical resource Dynamed for the month of November.  We wanted to get some feedback on this product as an alternative to UpToDate, or possibly as an addition to our electronic resources before we negotiate with UpToDate.
So to check it out I did a quick tour of UpToDate and then the same tour on DynaMed. I recently diagnosed a patient with Goodpastures so I looked that up in both databases.

UpToDate has a great autocomplete system for search terms. Not sure if Goodpasture is one or two words? Don't worry, typing "Good" is good enough.
The number of topics on Goodpastures is remarkable.

I love how the topic outline slides opens on the right when you hover over a topic. When I selected Treatment of anti-GBM antibody (Goodpasture's) disease I was treated to 3500 words (excluding references, of which there were 32) written by an editor team that puts their name to the review. In this case the authors are all tops in glomerulonephritis:

The article is long, detailed and tells the reader exactly how to treat the patient. What drugs, alternative treatments, how to pheresis including replacement fluid, schedule, dose and duration. It is beautiful in its completeness.

I typed in Good, no autocomplete at all. I searched Good and good pastures is not on the first page of search results. 

I searched Goodp and got nothing.

Searched Goodpastures and...jackpot! They even have the roll-over see the outline trick from UpToDate. Nice

The actual article though, is terrible compared to UpToDate. They have a single entry on Goodpastures which is barebones outline of the condition.

The treatment section contains 159 words, and really gives you no idea how to treat this condition. In fact, about a third of the treatment section is dedicated to combination ACEi and ARB therapy, a window dressing issue in the treatment of this rapidly progressive and potentially fatal disease. I would give this reference a failing grade. You read all 159 words and have no idea what to do. You need to go to a second source.

Their is no author associated with the outline of Goodpastures. Dynamed's editorial team does not list any nephrologists. The editorial board does have a single nephrologist, which is exactly how many podiatrists they have on the board.

As my colleague, Dr Steigerwalt, said, it should be spelled DinoMed as in Dinosaur.
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