Information overload is a critical problem in most professions, but none more so than in medicine, where life and death decisions can hinge on access to current treatment and research data. These days, there's no way to keep up with the literature, even in one's medical specialty. There's a growing consensus that the future of clinical practice is in evidence-based medicine (EBM). And the major medical information vendors are clearly stepping up efforts to meet this need with appropriate content and tools. ProQuest Information and Learning announced it is now the exclusive global distributor of Evidence Matters to academic and hospital markets. Evidence Matters is an online subscription service that accesses and synthesizes relevant content and allows clinicians to compare therapies for their patients based on peer-reviewed medical research. The distribution agreement is a key move for ProQuest to compete in this hot market area. It helps to build ProQuest's family of health sciences information products and offers interesting synergistic possibilities with ProQuest's other digital products.
Evidence Matters uses proprietary software and editorial expertise to extract results from research trials for specific diseases that are published in key scientific journals. The results are standardized and aggregated into an online database. Evidence Matters uses a simple "ask-a-question" interface, and results are organized into summary graphs or tables. The Web-based service allows users to quickly make comparisons between therapies for effectiveness, safety, and cost based on the best evidence available.
Evidence Matters research comes from a range of sources including MEDLINE and CINAHL (Cumulative Index to Nursing and Allied Health), as well as the Cochrane Library and journals such as the New England Journal of Medicine, Journal of Clinical Oncology, Journal of the American Medical Association, British Medical Journal, and The Lancet.
Evidence Matters was founded in 2001 by Dr. Ofer Allan Avital. MedTech Partners, originally formed by the Canadian Medical Discovery Fund and MDS Capital, is one of Canada's leading seed investors and is the main investor in Evidence Matters. Harvard and McGill-associated teaching hospital libraries were early test centers as the company worked on its new service. When the cancer module was ready, Evidence Matters launched in mid-2005.
Suzanne BeDell, vice president of publishing for ProQuest Information and Learning, said that ProQuest first saw the system and met with Evidence Matters during the June 2005 SLA meeting in Toronto. The companies talked over the next few months and signed their distribution agreement in December 2005. She said the two main attractions for ProQuest were how Evidence Matters handled the structured metadata in an object-oriented database and the product's interface.
BeDell said the first thing on ProQuest's to-do list is to use open URL technology to provide links from Evidence Matters into the full text of articles in ProQuest's health and medical databases. Then, ProQuest plans to link referenced book content in Evidence Matters over to the texts available in the medical e-books on its MyiLibrary platform. (ProQuest announced an agreement in September 2005 with MyiLibrary to distribute more than 2,000 medical e-books.) I asked BeDell about any plans to extract articles from ProQuest databases to add to the Evidence Matters content. She said the company hadn't thought about it but admitted, "It could be a great opportunity."
Evidence Matters currently covers cancer, cardiology, and endocrinology and will grow to cover other medical disciplines. BeDell said that Evidence Matters expects to add 10 more within the next 6 to 12 months.
"This is the most time-friendly device for medical information I've ever seen," said George Michaels, assistant professor of Family Medicine at McGill University and assistant physician-in-chief at St. Mary's Hospital. "I cannot believe this will not become the new standard of care."
Evidence Matters is available as a stand-alone version accessible via a Web browser, with no installation required and no security concerns. It can also be integrated into an institution's electronic medical records as a custom project. ProQuest would not release pricing details but said that for medical schools it would be based on FTEs, number of affiliated physicians, and funding.
BeDell said that this is an attractive market for ProQuest—122 out of 125 U.S. medical schools teach EBM in a required course. EBM is clearly a key area for recent information product development, and most of the big medical content providers are either developing or acquiring a service.
But, just what is EBM? Here's a definition from the textbook of the same name, now in its second edition.
The conscientious, explicit, and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.
—Sackett, et. al., Evidence-Based Medicine: How to Practice and Teach EBM, 2nd edition, 2000, Churchill Livingston, London.
In July 2005, EBSCO Publishing acquired DynaMed (http://www.dynamicmedical.com), which was created by a physician for physicians and healthcare professionals as a point-of-care clinical reference tool to replace most routine textbook and article searches. It is also a tool for medical students and residency programs. DynaMed provides clinically organized summaries for more than 1,800 topics. A topically driven menu allows physicians, medical students, and other healthcare professionals to research synthesized information from publications, associations, and contributing clinicians. DynaMed is updated daily and monitors the content of more than 400 medical journals directly and indirectly by using 10 journal review services.
In October 2005, John Wiley acquired InfoPOEM, Inc., a provider of EBM content and search tools. Founded in the early 1990s, InfoPOEM, Inc. (http://www.infopoems.com) delivers daily e-mail summaries of medical evidence and provides a Web-based software tool called InfoRetriever. This tool enables access to EBM resources at the clinical point of care. The acronym POEM stands for "Patient-Oriented Evidence that Matters." POEMs are selected from more than 100 leading peer-reviewed medical journals.
Just a few weeks ago, Wolters Kluwer announced plans to acquire ProVation Medical, Inc., which offers products for the point-of-care market. Under the brand names of Medi-Span, Facts & Comparisons, and Clin-eguide, these tools provide information and evidence-based treatment plan options at the point of care. Now, Ovid (http://www.ovid.com), a Wolters Kluwer business, has just announced the launch of ClinicalResource@Ovid, a new point-of-care tool that draws on these sources. It integrates key information resources and provides Ovid customers with one-click access to all of their subscribed Ovid book, journal, and EBMR (Evidence-Based Medical Reviews from the American College of Physicians) resources.
Then there are other options—MD Consult (Elsevier), UpToDate, eMedicine, and more. Medical professionals—and their patients—should certainly welcome these recent products, though choosing among them could be a chore. Pricing is likely to be a key factor. For medical schools with subscriptions to ProQuest, Evidence Matters should prove an attractive addition when the linking to full text is available.