MD Consult - Find The Answer

By Marjorie Lazoff, M.D.

Medical Editor, Information Development

                First Consult

(Originally posted on the First Consult home page)

Throughout most of the 20th century, medical knowledge as contained in authoritative textbooks has certainly grown and evolved, but relatively slowly and only after a fully vetted expert-driven editorial and peer review process. The end result was the print publication of a new edition of a textbook, at best once every few years.

Each month, First Consult highlights a timely disease or condition, including a current summary and a link to the topic within First Consult, which is freely available.  This month’s theme is influenza.

Visit the First Consult home page to take the Order Set Quiz on Influenza.

By Margaret Trexler Hessen, M.D.

First Consult Medical Editor, New Content

(Originally posted on the First Consult home page)

A 77-year-old man with a history of hypertension, diabetes, and ischemic cardiomyopathy complains of increasing exertional dyspnea, orthopnea, and pedal edema. The symptoms began several days after abandoning his dietary restrictions in order to enjoy Thanksgiving to the fullest. Physical examination reveals a well-nourished man in moderate respiratory distress and pulse oximetry of 92%, blood pressure of 170/85 mmHg, pulse 84 bpm with occasional irregular beats, respirations 22/min, and temperature of 97°F. The patient has prominent jugular venous distension, fine moist rales throughout both lung fields, an S3 gallop, and +3 pitting pedal edema. The complete blood count is within normal limits and serum chemistries are remarkable only for glucose of 282 mg/dL, blood urea nitrogen of 40 mg/dL, and creatinine of 1.7 mg/dL. A chest radiograph reveals a large heart, diffuse vascular congestion, and blunting of the costophrenic angles. An electrocardiogram shows normal sinus rhythm with occasional premature atrial contractions, an old anterior myocardial infarction, and low voltage throughout.

Click here to read the rest of the case presentation on First Consult’s home page, access for free First Consult’s Influenza topic, and test your clinical knowledge via the free First Consult Order Set Quiz. READ MORE >>

Evidence-based medicine, or EBM, is the application to clinical decision making of the best available evidence gained from the scientific method.  Medical research across the globe is relentless – constantly churning out new scientific findings on the effectiveness of certain medical treatments, procedures and diagnoses.  So EBM is continually changing with the research.

The physician editorial team at First Consult is constantly reviewing the latest in medical literature to ensure that each First Consult topic includes the most relevant evidence-based medicine presented with a practice-oriented approach.

As part of their rigorous editorial process, the team recently launched a feature on the First Consult home page called EBM Watch.  Dr. Belinda Ireland, First Consult’s Evidence Editor, provides an assessment of the latest in evidence-based medical research on particular topics.  You can find the EBM Watch in the middle column on the First Consult home page, directly below the Newly Updated Topics.

Currently, the EBM Watch addresses the use of heparin prophylaxis to decrease the incidence and mortality of venous thromboemboli (VTE).  The Annals of Internal Medicine recently published an evidence-based clinical practice guideline from the American College of Physicians about VTE prophylaxis in medical patients based on on a systematic review that appears in the same Annals issue.

What are the findings of this high quality systematic review?  Visit the First Consult home page to find out.

I encourage you to regularly visit the First Consult home page for the latest EBM Watch, as well as other features including original essays, case presentations and polls.

   By Jonathan M. Teich, MD, PhD

   Chief Medical Informatics Officer, Elsevier Health Sciences

(Originally posted on the First Consult home page)

In The English Practice essay, Dr Harry Brown reflected on the impressive efforts in England to provide electronic health records (EHRs) that computerize and connect nearly all primary care physician practices. Indeed, the UK has among the highest rate of office-based EHR adoption in the world, joining a few other standout countries such as Denmark and The Netherlands.

The United States, of course, is still far from achieving such universal EHR prevalence, although EHR adoption has been slowly rising for a decade, and more rapidly so in the past year or two.

To read the rest of Dr. Teich’s essay on the adoption of EHRs in the U.S., please visit the First Consult home page. READ MORE >>

Did you know that 30% of physicians own an iPad and another 28% plan to purchase an iPad this year?  Physician adoption of the iPad is strong according to Manhattan Research.

We recently sat down with a group of physicians and asked them to show us how they use their iPads and MD Consult with First Consult to quickly find clinical answers.  View a video of their responses here.