Finding the right information at the right time. Part 2: MEDLINE, medical journals, and websites.

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I

In this ar ticle, we present MEDLINE and systematic reviews, electronic medical journals, medical information websites, and some search engines. The websites we pre- sent have not been researched systematically, nor have they been evaluated by means of validated grids, but they have been examined closely for their relevance, validity, and especially their usefulness for daily practice.

MEDLINE and systematic reviews

Clinicians do not need to do bibliographic searches on MED- LINE every week, but it is good to know that free access to the MEDLINE databank is available through PubMed (Table 1). Canadian Medical Association members can also do free searches in various databases using OSLER/OVID.

Because MEDLINE searches require time and expertise in research methodology, clinicians often prefer to use selective databases that provide critical reviews of the literature. The most reliable of these is the Cochrane Library, an interna- tional collaborative group that provides systematic reviews on a variety of therapeutic and preventive treatments. Its reviews are high quality and address many focused clinical questions. Only the abstracts are free of charge. Also includ- ed is a register of more than 250 000 controlled trials.

England’s University of York, a partner in the Cochrane Library, provides an active watch and, in some cases, presents a critical appraisal of systematic reviews in the literature. It also maintains an international register of evaluative reports on health technologies (including those published in Canada).

Medical journals

The full versions of prominent medical journals are now of fered on the Inter net, and some are free of charge (Table 1). Archives can be accessed and specific articles located using a search tool. Users can also ask to receive tables of contents periodically. Some journals are available only in electronic form, such as Medscape General Medicine. On the

“Free Medical Journal” website, you can locate journals free

of charge on the Internet, by speciality. Amedeo and Jade are innovative websites that actively monitor certain jour- nals on different topics, providing recent information on a range of subjects.

Critical appraisal of the literature

Websites that provide critical appraisal of the literature are useful for physicians who want to keep up-to-date (Table 1). Among such sites, the American College of Physicians Journal Club is the most elaborate and credible in its methodology (the “Best Evidence” CD-ROM contains more than 1200 critical appraisals of articles since 1991).

Other journal clubs with even greater relevance to family medicine include “Info POEMS,” “Critique et pratique,” and the College of Family Physicians of Canada’s “Critical appraisal.” Bandolier provides critical appraisals of certain systematic reviews of general interest.

Medical information websites and directories Table 1 shows websites that are good places to start look- ing for medical information on the Internet (eg, medical news, weekly journal abstracts, new developments, access to medical information from many sources, and continuing medical education). Have a look at the “MD Consult,”

“WebMD Canada,” and “Doctor’s Guide” websites and choose your point of entry into the medical Internet.

Many “director y” websites provide general medical information and links to reputable medical associations, government agencies, universities, and hospitals.

Search engines

Sometimes, despite the range of the resources presented, a search of the electronic medical literature fails to answer a particular clinical question. Using search engines might help, but the accuracy and validity of the information pro- vided can var y. “Medical World Search” and “MedNets”

allow users to conduct targeted searches of preselected bio- medical websites. Other tools, such as Google (Alta Vista, Excite…) or Copernic, which use several search engines simultaneously, conduct wider searches (Table 1).

Finding the right information at the right time

Part 2: MEDLINE, medical journals, and websites

Yvan Leduc, MD, CCFPMichel Cauchon, MD

Resources

Ressources

Resources

Ressources

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Ressources

Conclusion

Electronic resources are an increasingly important source of cur- rent medical information for family doctors. Compared with tra- ditional libraries, they offer up-to-date information that is easily accessible and often available either free or at little cost. We sug- gest you explore these websites and use those most relevant to your practice. The electronic age has brought an overabundance

of information, but physicians now have many excellent tools at their disposal for finding the answers they need quickly.

We invite you to send your comments by e-mail to yvan.leduc@mfa.ulaval.caor michel.cauchon@mfa.ulaval.ca.

Drs Leduc and Cauchon practise in the family medicine unit of the Hôpital Enfant-Jésus in Quebec city, Que.

RESOURCE INTERNET ADDRESS COUNTRY FRENCH ENGLISH COST

OSLER/OVID http://www.cma.ca/osler/index.htm Canada No Yes Yes

MEDLINE by Pub Medhttp://www.ncbi.nlm.nih.gov/PubMed/ United States No Yes No

Cochrane Library http://www.updateusa.com/clibpw/clib.htm International No Yes Yes Abstracts of Cochrane reviews http://www.update-software.com/cochrane/cochrane-

frame.html

International No Yes No

York Systematic Reviews http://www.york.ac.uk/inst/crd/srinfo.htm United Kingdom

No Yes No

MEDICAL JOURNALS

Canadian Medical Association Journal http://www.cma.ca/cmaj-f/index.asp Canada Yes Yes No

British Medical Journal http://www.bmj.com/ United

Kingdom

No Yes No

Annals of Internal Medicine http://www.acponline.org/journals/annals/annaltoc.htm United States No Yes No

JAMA http://jama.ama-assn.org/ United States No Yes No

Lancet http://www.thelancet.com/ United

Kingdom

No Yes Yes

Free Medical Journals http://www.freemedicaljournals.com/ United States No Yes No Medscape General Medicine http://www.medscape.com/Medscape/GeneralMedicine/

journal/public/mgm.journal.html

United States No Yes No

Amedeo http://www.amedeo.com United States No Yes No

Jade http://www.biodigital.org/jade/ United States No Yes No

JOURNAL CLUBS

Critique et pratique http://www.crsfa.ulaval.ca/umf/ Canada Yes No No

CFPC Critical Appraisal http://www.cfpc.ca/CFP/cfpcritindex.htm Canada No Yes No Info POEMS; Journal of Family Practice http://www.infopoems.com/POEMs/jcindex.htm United States No Yes No ACP Journal Club http://www.acponline.org./journals/acpjc/jcmenu.htm United States No Yes Yes Best Evidence (CD-ROM version) http://www.acponline.org/catalog/electronic/best_evi-

dence.htm

United States No Yes Yes

Bandolier http://www.jr2.ox.ac.uk/Bandolier/index.html United Kingdom

No Yes No

MEDLINE AND SYSTEMATIC REVIEWS

Table 1.Helpful websites

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Resources

Ressources

MD Consult http://www.mdconsult.com/ United

States

No Yes Yes

WebMD Canada http://www.webmd.ca/ Canada No Yes No

Medscape http://www.medscape.com United

States

No Yes No

Doctor’s Guide http://www.docguide.com Canada No Yes No

Canadian Medical Association http://www.cma.ca/fra-index.htm Canada Yes Yes No

Health Canada http://www.hc-sc.gc.ca/francais/ Canada Yes Yes No

CFPC Canadian Library of Family Medicine http://www.uwo.ca/fammed/clfm/findex.html Canada Yes Yes No Laval University’s Department of Family Medicine http://www.ulaval.ca/mfa/umf.htm Canada Yes No No Critical review of evidence-based medicine,

clinically oriented websites

http://www.medecine.quebec.qc.ca Canada Yes Yes No

SEARCH ENGINES

Copernic http://www.copernic.com Canada Yes Yes No

Medical World Search http://www.mwsearch.com/ United

States

No Yes No

MedNets http://www.internets.com/smedlink.htm United

States

No Yes No

Google http://www.google.com United

States

Yes Yes No

DIRECTORY WEBSITES

MEDICAL INFORMATION WEBSITES