WebMD-owned site of original medical content authored by physiciansĭatabase of abstracts and citations maintained by the US National Library of Medicine Uptake of such resources has been extensive among health professionals in several high-income countries: among 16 122 health professionals surveyed across 181 hospitals in the USA and Canada about clinical resource usage in the past 6 months, 53% of attending physicians and 77% of residents had used UpToDate-one of the leading EBCRs 59% of physicians used online journals, 20% eMedicine and 24% Micromedex. In response to this, private and public entities in high-income countries created numerous online evidence-based clinical resources (EBCRs) over the past decade that distilled research into guidelines for therapeutic choices and care ( table 1). 2 In 2004, investigators in The Lancet asked, ‘Can we achieve health information for all by 2015?’ and, in 2006, the WHO identified access to information as a critical step towards improving population health. 1 Alarmingly, preventable medical errors, which result partly from lack of access to or understanding of the best available evidence, are common across the world: A 2012 study of over 15 000 medical records from 26 hospitals in Africa and the Middle East showed that 6.8% of all hospitalised patients experienced a medical error and one-third of them died as a result. In 2014, providers were faced with consuming new evidence from over 5000 clinical trials. Some assumed barriers to its expansion (poor internet connectivity, lack of training and infrastructure) might pose less of a burden than subscription fees.Īll health professionals face the daily challenge of incorporating a vast and rapidly evolving body of medical knowledge into their clinical practice. Our programme demonstrates that there are barriers to evidence-based clinical knowledge in resource-limited settings we can help remove. Search patterns reflected local epidemiology with ‘clinical manifestations of malaria’ as the top search in Africa, and ‘management of hepatitis B’ as the top search in Asia. During 2013–2014, users logged into UpToDate ∼150 000 times 61% of users logged in at least weekly users in Africa were responsible for 54% of the total usage. Since 2009, ∼2000 individual physicians and healthcare institutions from 116 countries have received free access to UpToDate through our programme. We evaluated the provision of UpToDate access to health workers by analysing their usage patterns. In 2009, the Global Health Delivery Project collaborated with UpToDate to provide free subscriptions to qualifying health workers in resource-limited settings. UpToDate, a leading evidence-based clinical resource is used extensively in the USA and other regions of the world and has been linked to lower mortality and length of stay in US hospitals. Access to evidence is instrumental in reducing diagnostic errors and generating better health outcomes. The rapidly changing landscape of medical knowledge and guidelines requires health professionals to have immediate access to current, reliable clinical resources.
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