Main Organiser

Julius Centre University of Malaya

Co-organiser

Department of Social and Preventive Medicine, Faculty of Medicine, University of Malay

Supported by

University of Malaya

THE RATE OF CHANGE IN PRACTICE- GUIDING MEDICAL KNOWLEDGE

Author

Alper BS, Ehrlich A, Giles N.

Institution

EBSCO Publishing

Abstract

Objectives: To measure the rate of change in management overviews derived from the best evidence.

Methods: Two hundred DynaMed topics will have evaluated overview sections (integrating the best evidence and guidance) will be analyzed for changes over 1-2 years. We will classify each change as resulting from new evidence or guidance, user feedback, or quality improvement.

Results: As of March 13, 2012 management overviews of 27 topics have been evaluated for change over 0.84 to 1.78 years. Twenty-one overviews (78%) changed based on new evidence and twenty-one (78%) changed based on new guidelines. Twenty-five overviews (93%) changed based on new evidence or new guidelines. Among 1,468 lines in these overviews, 398 (27%) were modified and 195 (13%) were deleted; 310 new lines (21%) were added. Of the 903 changes, 460 (51%) were due to new evidence or guidelines. The annualized rate of change of overview content due to new evidence or guidelines was 22.4%.

Conclusion: More than 20% of practice guiding medical knowledge changes within one year. Textbooks are inadequate in an era of evidence based medicine and instant electronic access. Evidence based clinical references, guidelines, medical education and medical informatics systems should be adapted to keep pace.