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Medical Specialties & Graduate Medicine

What are Point of Care Tools?

  • Syntheses of current evidence for diagnosis, tests and interventions (e.g. treatments, drugs)
  • Designed for rapid consultation at the point of patient care
  • Evidence-based and frequently updated, with links to relevant literature
  • May include drug information, ICD coding, information for patients, and provision for links to electronic health records

Point of Care Tools

Product Reviews and Comparisons

Charbonneau, D. H., & James, L. N. (2018). DynaMed Plus®: an evidence-based clinical reference resourceMedical Reference Services Quarterly, 37(2), 168-176.

  • Table 1. Comparison of DynaMed Plus and UpToDate

Feature

DynaMed Plus

UpToDate

     Update Frequency

Daily

Daily

     Number of Clinical Topics

2,500+

10,500+

     Peer-Reviewed Content and
     Evidence Appraisal

3 Tiered System of Evidence Rating

2 Levels of Grading

(Level 1=likely reliable; Level 2=mid-level evidence; Level 3=lacking evidence)

(Grade 1=Strong; Grade 2=Weak)

     Journals Monitored

529+

440+

     Section for Guidelines in Topics

Yes

No

(“Guidelines and Resources” Section in each topic summary)

(Guidelines may be cited in “References;” but not consistently collected and presented)

     Graphics/Images

Yes

Yes

     Mobile Version

Yes

Yes

     Off-Campus Access

Yes

Yes

     Clinical Calculators

Yes

Yes

     Patient Education Materials

Yes

Yes

     CME/CE Credit Available

Yes

Yes



 

Andrews, R., Mehta, N., Maypole, J., & Martin, S. A. (2017). Staying afloat in a sea of information: point-of-care resourcesCleveland Clinic Journal of Medicine, 84(3), 225-235.​

  • "Each of the resources [UpToDate, DynaMed, First Consult etc.] has strengths and weaknesses. For example, UpToDate offers the most topics, but its articles tend to be too long to be practical to read at the point of care."
     
  • "Physicians should familiarize themselves with these resources and use the ones that best suit their needs."
     


Johnson, E., Emani, V. K., & Ren, J. (2016). Breadth of coverage, ease of use, and quality of mobile point-of-care tool information summaries: an evaluationJMIR mHealth and uHealth, 4(4).

Kwag KH, González-Lorenzo M, Banzi R, Bonovas S, Moja L. (2016). Providing doctors with high-quality information: an updated evaluation of web-based point-of-care information summaries. J Med Internet Res.,18(1):e15.

  • Five products (ACP Smart Medicine, BMJ Best Practice, Dynamed, Essential Evidence Topics, and UpToDate) received the maximum score for editorial quality. Six (ACP Smart Medicine, BestBets, BMJ Best Practice, Dynamed, EBM Guidelines, and UpToDate) received the maximum score for evidence-based methodology.

  • The ranking of point-of-care information summaries based on their strength of volume, editorial quality, and evidence-based methodology is shown in Figure 3 (full data reported in Multimedia Appendices 4-6). Best Practice, Dynamed, and UpToDate scored in the highest quartile across all three dimensions.

 

Campbell JM, Umapathysivam K, Xue Y, Lockwood C. (2015). Evidence-based practice point-of-care resources: a quantitative evaluation of quality, rigor, and content. Worldviews Evidence-Based Nursing, 12(6):313–27. 

  • Table 2. Content Presentation
 

Type of output

Formal ontology

Flexibility of summary

 Reference 

Formal grade of recommendation

 CME 

Education other material

Patient handout

Clinical tools

BMJ Best Practice

Key point summaries

Yes

Yes

Yes, specific

No

Yes

Yes

Yes

Yes

DynaMed

Key point summaries

Yes

Yes

Yes, specific

Yes

Yes

Yes

Yes

Yes

UpToDate

Book chapter like summaries

Yes

Yes

Yes, specific

Yes

Yes

No

Yes

Yes

 

  • Table 3. Editorial Quality

 

Authorship stated

Peer review

Frequency of updates

Conflict of interest

Commercial support

Total

UpToDate

3

3

1

3

3

13

BMJ Best Practice

3

3

1

3

3

13

DynaMed

1

1

1

1

0

4

  • Table 4. Evidence‐Based Methodology
 

Literature search/surveillance

Method of critical appraisal

Type of evidence

Grading of evidence

Expert opinion given

 Total  

UpToDate

3

1

3

3

3

13

BMJ Best Practice

3

3

3

1

1

11

DynaMed

3

3

3

1

0

10

 

 

Why Bracken Library does not subscribe to UpToDate

Bracken Library is frequently asked to provide access to UpToDate (UTD).  We have investigated the possibility of subscribing several times over a number of years and have concluded that we are unable to purchase this resource.  There are a number of reasons for this decision.

UTD’s pricing model is primarily geared to individual subscriptions.  Institutional subscriptions for UTD are extremely expensive, particularly when remote (off-campus) access is included.  Simply put, the cost for UTD is not within the budget for Bracken Library.  Remote access to our information resources is essential for health sciences students and residents on placement throughout Southeastern Ontario and beyond.  In our commitment to equitable and full access to information resources, our policy is to not purchase an electronic resource that is limited to on-campus users only.

Some Canadian medical schools and/or their libraries do have subscriptions to UTD. See the box below for the results of a scan prepared by the University of Alberta of academic health science libraries in Canada. In some cases the schools have purchased on-campus usage only.  The source of funding varies. A number of other medical schools and libraries across Canada do not subscribe to UTD.

Bracken librarians, with input from our users, have evaluated other point-of-care tools and have chosen several that we recommend.  These excellent, evidence-based point-of-care clinical tools include:

Each of these resources can be accessed remotely and some have mobile apps that will allow you to access them on your tablet or smartphone.  

Clinical Search Engines

Trip Database

TRIP was created in 1997 to bring together all the evidence-based healthcare resources available on the Internet. Tutorial.