Here’s what it looks like in use:

(Above: embedded video)

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http://eai.nlm.nih.gov/

The Emergency Access Initiative (EAI) is a partnership of the National Library of Medicine, the National Network of Libraries of Medicine, and the Professional/Scholarly Publishing Division of the Association of American Publishers. EAI provides free access to full text articles from major biomedicine titles to healthcare professionals, librarians, and the public in the United States affected by disasters.

Of course, I won’t be using this because I’m not doing anything related to the disaster in Haiti- but the NLM deserves all kinds of attention and praise for doing this, as do contributing publishers:

American Academy of Pediatrics, American Association for the Advancement of Science, American College of Physicians, American Society of Health-Systems Pharmacists, ASM Press, B.C. Decker, BMJ, Elsevier, FA Davis, Mary Ann Liebert, Massachusetts Medical Society, McGraw-Hill, Merck Publishing, Oxford University Press, People’s Medical Publishing House, Springer, University of Chicago Press, Wiley, and Wolters Kluwer.

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After 30 minutes of my patiently letting her finish pitching me with sales information I did not want (We’re already interested in the product! Why would I ask for a trial and quote otherwise?!), I asked for the third time if we could get a quote.

Vendor: Well, I’d really like for you to have the trial for a week before I tell you that.

[Uncomfortable pause]

Me: I can understand why, from a sales perspective, you’d want that. However, if my internal client evaluates the trial for a week, likes it, and THEN finds out it is impossibly beyond her budget, she will have wasted a week of her valuable time…so I need to have that information up front.

Vendor: Well, how much money do you have budgeted for this type of resource?

[Uncomfortable pause as I wrestle with my disbelief that the question was asked]

Me: (Slowly and calmly) Lets assume for a moment that I have that information. The quote you give me should be based on what you feel the product’s market demand merits. If I have that kind of information, let us assume that there is no way on earth I’d share it with you. The quote you give us will not be based on how much money is available.

Vendor: Well, we don’t want to devalue our data either.

Me: That’s why you set prices based on market demand, not on how much money the prospective client has, especially in this economy. Right now, you’re devaluing a prospective client- and I suspect that’s even worse for your bottom line than devaluing your data.

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Fortunately, my internal client finds this behavior as despicable as I do.

(Again, I’d love to hear your guesses about who the vendor/product is. If you guess correctly in the comments, I’ll email you and tell you so.)

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Full text (PDF)

Abstract

Objective – This project sought to identify the five most used evidence based bedside information tools used in Canadian health libraries, to examine librarians’ attitudes towards these tools, and to test the comprehensiveness of the tools.

Methods – The author developed a definition of evidence based bedside information tools and a list of resources that fit this definition. Participants were respondents to a survey distributed via the CANMEDLIB electronic mail list. The survey sought to identify information from library staff regarding the most frequently used evidence based bedside information tools. Clinical questions were used to measure the comprehensiveness of each resource and the levels of evidence they provided to each question.

Results – Survey respondents reported that the five most used evidence based bedside information tools in their libraries were UpToDate, BMJ Clinical Evidence, First Consult, Bandolier and ACP Pier. Librarians were generally satisfied with the ease of use, efficiency and informative nature of these resources. The resource assessment determined that not all of these tools are comprehensive in terms of their ability to answer clinical questions or with regard to the inclusion of levels of evidence. UpToDate was able to provide information for the greatest number of clinical questions, but it provided a level of evidence only seven percent of the time. ACP Pier was able to provide information on only 50% of the clinical questions, but it provided levels of evidence for all of these.

Conclusion – UpToDate and BMJ Clinical Evidence were both rated as easy to use and informative. However, neither product generally includes levels of evidence, so it would be prudent for the practitioner to critically appraise information from these sources before using it in a patient care setting. ACP Pier eliminates the critical appraisal stage, thus reducing the time it takes to go from forming a clinical question to implementing the answer, but survey respondents did not rate it as high in terms of usability. There remains a need for user-friendly, comprehensive resources that provide evidence summaries relying on levels of evidence to support their conclusions.

Full text (PDF)

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You can also check out what other medical libraries are doing by searching the Medical Library CSE for ovidsp.

You could even seek out specific instructional materials by searching for Ovidsp (handout OR instructions OR “how to” OR training)

For what the biblioblogosphere has had to say about OvidSP, see this LibWorm search.

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(Above: Embedded video. If you are reading this in your feed aggregator, you may need to visit the site to view the video)

The Visible Body features a 360 degree, whole-body, 3D model that allows unparalleled investigation and study of human anatomy and physiology. Available on the Web, the Visible Body runs in Internet Explorer on any PC* connected to the Internet. A free, fully interactive release is scheduled for mid-November 2007.

With the Visible Body, users can:

• View highly detailed models of all body systems.
• Search for and locate anatomical structures by name.
• Click on anatomical structures to reveal names.
• Rotate and explore anatomy in a virtual space.
• Peel away layers to view relative placement of the components of all body systems.
• See placement of specific organs relative to other anatomical structures.
• View anatomical structures with or without surrounding anatomy.
• Investigate anatomy virtually, without the costly cadaver lab.

*System Requirements: Windows XP/2000/Vista, Internet Explorer 6.0 or above, Flash Player 8.0+.

I can imagine a lot of uses for such a tool…but if the free tool is everything the video claims, I can’t help but wonder why it is free. Is it just a very expensive (and cool) way to publicize what Argosy can do?

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I hadn't realized until now exactly how worried publishers might be about tools like AskDrWiki and Ganfyd. I always thought that AskDrWiki or Ganfyd, if developed and maintained well, might threaten to take business away from UpToDate, DynaMed, MDConsult or other similar products- but it would appear that Elsevier sees them as a bigger threat than I have. Why else start a brand-new medical wiki and seed it with content they own from John Noble’s “Textbook of Primary Care Medicine”? In doing this, Elsevier probably hopes to gather the users that would otherwise use Ganfyd or AskDrWiki (or Wikipedia). This way, they can sell advertising and promote their own offerings. Brilliant.

Still, I think it'll bomb. Sure, people will be happy to make use of the free content that Elsevier seeded it with, but I think that Physicians inclined to contribute to a wiki will prefer to contribute to AskDrWiki or Ganfyd.

WiserWiki's Terms and Conditions say:

All content in this Site, including site layout, design, images, programs, text and other information (collectively, the “Content”) is the property of Elsevier and its affiliated companies or licensors and is protected by copyright and other intellectual property laws. You may not copy, display, distribute, modify, publish, reproduce, store, transmit, create derivative works from, or sell or license all or any part of the Content, products or services obtained from this Site in any medium to anyone, except as otherwise expressly permitted under applicable law or as described in these Terms and Conditions or relevant license or subscriber agreement.

Really? Even the stuff that contributors write?

We do not claim ownership of any material that you provide to us (including feedback and suggestions) or post, upload, input or submit on or through this Site, including our blog pages, message boards, chat rooms and forums, for review by the general public or by the members of any public or private community (“Submission”) and we are not responsible for its content or accuracy.

Okay, I guess that's good…

…However, by posting, uploading, inputting, providing or submitting (“Posting”) your Submission you grant us, our affiliated companies and sublicensees permission to display, publish and otherwise use your Submission in any format in connection with the operation of our respective businesses (including, without limitation, the Site). No compensation will be paid with respect to the use of your Submission. We are under no obligation to display or otherwise use any Submission you may provide, and we may remove any Submission at any time in our sole discretion.

So…Elsevier provides the server and hosting…and physicians write the content…but Elsevier can leverage the content for profit? I think that if a physician is the sort of community-minded sharer who gives her/his time and expertise for free (hint: these are the sorts of physicians who contribute to Wikipedia or medical wikis), he/she will probably prefer to give it to a non-profit than to let Elsevier make money off of it.

 And what about this:

Q: Who holds the copyright to the information submitted on this site?
A: Contributors retain the copyright to information they contribute to WiserWiki. Please read our Terms & Conditions.

How do you simultaneously have authors retain copyright…and have documents editable by registered users? Perhaps Elsevier intends for contributors to only submit full, complete articles for consideration of inclusion…but wouldn't that defeat about half the purpose of making the site a wiki instead of a digital book?

(Added to the List of Medical Wikis)

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New York Times article:

“…Reed Elsevier, which publishes more than 400 medical and scientific journals, is trying an experiment that stands this model on its head. Over the weekend it introduced a Web portal, www.OncologySTAT.com, that gives doctors free access to the latest articles from 100 of its own pricey medical journals and that plans to sell advertisements against the content.

The new site asks oncologists to register their personal information. In exchange, it gives them immediate access to the latest cancer-related articles from Elsevier journals like The Lancet and Surgical Oncology. Prices for journals can run from hundreds to thousands of dollars a year.”

Read the rest here.

Visit OncologySTAT.com

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There’s been another big surge in online discussion of UpToDate recently.

• Linda Spadaccini asks via a post to MEDLIB-L if other libraries have considered requesting that their “…physicians or medical staff office pay for it…”
• Also via a post to MEDLIB-L, Chris Williams asks if others are enjoying the same clear documentation and friendly customer service that Chris is experiencing.
• Intueri points out UpToDate’s extraordinary pricing and makes some comparisons to DynaMed.
• Dr. RW asks: Are you UpToDate Dependent?
• Ves Dimov at Clinical Cases and Images continues on the theme of UpToDate dependence, reminding us to “…beware the man of a single book (homo unius libri)…”

Prediction: As time passes, UpToDate will have more and more well-designed, well-maintained, effectively-marketed, affordable competitors. The competition will bring subscription costs down to a more reasonable level.

To keep up with future commentary on UpToDate from the medical blogosphere, subscribe to this MedWorm feed.

For each purpose category (therapy, diagnosis, prognosis, reviews, clinical prediction guides, qualitative, causation (etiology), costs, economics), the following data are shown: the single term with the highest sensitivity while keeping specificity at ³ 50%; the single term with the highest specificity while keeping the sensitivity ³ 50%; the single term with the least (minimal) absolute difference between sensitivity and specificity; and then the same data for multiple terms (the single term strategy may be shown again if it performs at least as well as multiple terms). In the second column of the table the search strategies are shown in Ovid syntax followed by the PubMed translation. In the third column of the table: sens = sensitivity; spec = specificity; prec = precision; acc = accuracy. References for the methods and individual categories appear at the end of the document.