Surfing the Net For Medical Advice

In a presentation delivered during the Pri-Med NY 2010 meeting, Frank J. Domino, MD, discussed the characteristics that denote best medical evidence and highlighted the resources available to the physician at bedside or with EMRs, to solve questions in real time.

Domino is an Associate Professor at the Department of Family Medicine & Community Health at the University of Massachusetts Medical School.

During the presentation, entitled, “Solving Questions on the Fly: Using Best Evidence,” Domino said the top source of nonbiased information for physicians comes from systematic reviews, followed by evidence based review, randomized clinical trial, cohort study prospective, case control study retrospective, and finally textbook-like content.

He highlighted a number of websites and programs that physicians could easily use to discuss medical topics with their patients. For example, Domino suggested that for questions about when and if to screen a patient based on disease or age the www.ahrq.gov site should be used.

For medical learners or students, he recommended sending them to sites such as emedicine.com, epocrates.com, or 5mcc.com, but also mentioned that caution needs to be taken when searching these private medical sites to learn about diagnosis. Many for-profit sites may have their own biases.

For the best systematic reviews, Domino said health professionals should turn to the Cochrane Databse of SR, or pubmed.gov.

Answers for uncommon, complicated questions can be searched for on Uptodate.com.