Just like all online content, medical knowledge is expanding at an exponential pace. The traditional model of reading the print copy of a medical journal each month is a nice romantic tradition, but will leave your knowledge in the dust if you don’t utilize and adapt various new content curation technologies. Here are three important resources physicians should be using to stay current.
The NNT is one of the greatest resources for getting quick summaries to evidence-based medicine. For any major topic you can think of from statin therapy to Antibiotics for Cirrhotics with Upper GI bleeds, the NNT provides a great fast summary of the major papers and review articles on the topic. But unlike most medical review services, they summarize the usefulness of each intervention or diagnostic technique with one single figure: The number needed to treat. As explained on their site, the NNT “offers a measurement of the impact of a medicine or therapy by estimating the number of patients that need to be treated in order to have an impact on one person. The concept is statistical, but intuitive, for we know that not everyone is helped by a medicine or intervention — some benefit, some are harmed, and some are unaffected. The NNT tells us how many of each.”
For example, regarding the intervention of giving Statins for 5 years in patients with known heart disease, the number needed to treat to prevent one death is 83. In other words, if you give these drugs to 83 people with known heart disease, 82 of them will not benefit. For one of our most common pharmacologic preventative measures in medicine, giving a baby aspirin to prevent a first heart attack or stroke, it would take 1,662 people to take the drug for one cardiovascular event to be prevented. On the other hand, given immediately to someone having a heart attack, it only takes 42 patients to take aspirin for one to benefit.
These numbers are very sobering and challenge our ability as physicians to treat individual patients as opposed to preventing death on a population level. Nevertheless, this information is essential to know and a priceless tool for a layperson (or many physicians) who may not understand complicated statistics and relative risks.
Read by QxMD is an excellent app for keeping up with multiple different medical journals. Essentially a Google Reader for medical journals, Read lets you choose which journals you want to follow and access published literature hot off the press. If you work at a major university, you can even give your login information and get access to the full PDF of every article. A must have.
VisualDx is a great supplement to every physician who is rusty on their rashes, rare skin changes and interesting physical findings. After seeing a patient with a strange rash you have never seen before on their left leg, you can input the history and key characteristics and VisualDx will present a differential diagnosis of photos that you can scroll through to help narrow down your diagnosis. You can use their differential builder to quickly build a contextualized, patient-relevant differential diagnosis. Or try their diagnosis search to access disease images and concise clinical information
These three tools will keep you up to date and hone your diagnostic skills as a budding physician or experienced doctor.