eMedicine

eMedicine.com, Incorporated is an online clinical medical knowledge base founded in 1996 by two medical doctors, Scott Plantz and Jonathan Adler, and by Jeffrey Berezin, a computer engineer. The fundamental concept was to create a large repository of professional level medical content that could be both updated and accessed continuously to assist in clinical care and physician education. The eMedicine website consists of approximately 6,800 medical topic review articles, each of which is associated with one of 62 clinical subspecialty "textbooks". Pediatrics, for example, has 1,050 articles organized into 14 subspecialty "textbooks" (Pediatric endocrinology, genetics, cardiology, pulmonology, etc.); the emergency medicine volume has 630 articles and internal medicine is near 1,400. The knowledge base includes about 25,000 clinically relevant images. Each article is authored by board certified specialists in the subspecialty to which the article belongs and undergoes three levels of physician peer-review, plus review by a Doctor of Pharmacy. The article's authors are identified with their current faculty appointments. Each article is updated yearly, or more frequently as changes in practice occur, and the date is published on the article.[1] eMedicine.com was sold to WebMD in January, 2006 and is available as the Medscape Reference[2].

History

Dr. Plantz, Dr. Adler and Mr. Berezin evolved the concept for eMedicine.com in 1996 and deployed the initial site via Boston Medical Publishing, Inc., a corporation in which Plantz and Adler were principals. Over a period of 1.5 years the Group Publishing System was developed that allowed large numbers of contributors to collaborate simultaneously. That system was first used to create a knowledge base in Emergency Medicine with 600 contributing MDs creating over 630 chapters in just over a year. In 1997 eMedicine.com, Inc. was legally spun off from Boston Medical Publishing. Several key individuals made investments in the company, including Richard Lavely, MD, JD who led recruitment and execution for the Internal Medicine volume, Julie Bohlen who ran editorial operations for many years and became a board member, and others. In that year the decision was made to broaden the scope of eMedicine to effectively all specialties.

Several years were then spent creating the tables of contents, recruiting expert physicians and in the creation of the additional 6,170 medical articles. Operation were based out of a main office in Omaha, NE and the company was operated "virtually" with key staff in multiple sections of the US.

eMedicine.com became widely trafficked. In 2005, eMedicine entered into discussions for acquisition. The board of directors at the time of sale, consisting of Jonathan Adler, Jeffrey Berezin, Craig Burson, Lilian Shackelford Murray and Michael P. Tierney, unanimously recommended approval for sale of the company to WebMD. The sale was completed in January 2006 and the content is available via WebMD's Medscape site.

Content now includes allergy and immunology, cardiology, clinical procedures, critical care, dermatology, emergency medicine, endocrinology, gastroenterology. genomic medicine, hematology, infectious diseases, nephrology, neurology, obstetrics/gynecology, oncology, pathology, perioperative care, physical medicine and rehabilitation, psychiatry, pulmonology, radiology, rheumatology, and sports medicine. Surgical subspecialties include neurosurgery, ophthalmology, orthopedic surgery, (ENT) and facial plastic surgery, plastic surgery, thoracic surgery, transplantation, Trauma, urology, and vascular surgery.[1]

The site is free to use, requiring only registration. More than 10,000 physician contributors from several countries participated in the creation of the articles. Novel at the time, eMedicine content could also be accessed as an e-book, and could be downloaded into a palm top device.[3]

Usage among specialists

In 2012 Volsky et al.[4] evaluated the most frequently used internet information sources by the public, (1) identifying the three most frequently referenced Internet sources; (2) comparing the content accuracy of each of the three sources and (3) ascertaining user-friendliness of each site; and (4) informing practitioners and patients of the quality of available information. They found Wikipedia, eMedicine, and NLM/NIH MedlinePlus were the most referenced sources. For content accuracy, eMedicine scored highest (84%; p<0.05) over MedlinePlus (49%) and Wikipedia (46%). The highest incidence of errors and omissions per article was found in Wikipedia (0.98±0.19), twice more than eMedicine (0.42±0.19; p<0.05). Errors were similar between MedlinePlus and both eMedicine and Wikipedia. On ratings for user interface, which incorporated Flesch-Kinkaid Reading Level and Flesch Reading Ease, MedlinePlus was the most user-friendly (4.3±0.29). This was nearly twice that of eMedicine (2.4±0.26) and slightly greater than Wikipedia (3.7±0.3). All differences were significant (p<0.05). There were 7 topics for which articles were not available on MedlinePlus. They concluded "Knowledge of the quality of available information on the Internet improves pediatric otolaryngologists' ability to counsel parents. The top web search results for pediatric otolaryngology diagnoses are Wikipedia, MedlinePlus, and eMedicine. Online information varies in quality, with a 46-84% concordance with current textbooks. eMedicine has the most accurate, comprehensive content and fewest errors, but is more challenging to read and navigate. Both Wikipedia and MedlinePlus have lower content accuracy and more errors, however MedlinePlus is simplest of all to read, at a 9th Grade level.

In 2012 Laraway and Rogers reported a structured review of journal articles that quoted The University of Washington Quality of Life Scale for head and neck cancer patients.

"The University of Washington Quality of Life Scale (UW-QoL) is one of the most frequently reported health-related quality of life (HR-QoL) questionnaires in head and neck cancer, and since its first publication in 1993 has been used in many different cohorts. There is a considerable amount of information to assimilate and, to date, we know of no attempt that has been made to summarise publications specific to its use in a peer review journal. The aim of this review was to systematically search published papers that report its use, identify common themes, and present a tabulated summary. Several search engines were used (PubMed, Medline, Medical-Journals.com, eMedicine), and 222 abstracts were found and hand searched. A total of 66 papers were eligible for inclusion, 21 on functional outcome, 25 on predictors of HR-QoL, 19 on development or validation of the questionnaire, and one clinical trial. The review includes a diversity of studies and a range of HR-QoL outcomes following head and neck cancer. It provides clinicians and their colleagues in multidisciplinary teams with a source of quick reference to relevant papers reporting the UW-QoL, and gives a short summary of the pertinent conclusions drawn from each paper."

What is significant for eMedicine, is that Laraway and Rogers used PubMed, Medline Medical Journals.com and eMedicine as primary sources of information.[5] This is significant because medline is the compendium of all NIH sponsored research. Emedicine is made up of articles translating the body of current research in medline into clinical practice guidelines from the perspective of each subspeciality.[1]

Cao, Liu, Simpson, et al revealed that medline and emedicine were used as primary resources in developing the online system AskHERMES.[6] Physicians were asked to solve complex clinical problems using three different sources of information: AskHermes, Google and UpToDate. Surveys of the physicians who used all three systems were asked to score the three systems by ease of use, quality of answer, time spent, and overall performance.

A 2009 study showed that "89.1% of ophthalmologist respondents accessed peer-reviewed material online, including Emedicine (60.2%)."[7]

A 2007 study showed that 12% of radiology residents used eMedicine as their first source when doing research on the Internet.[8]

A 2005 study ranking 114 sites rated it the second-highest Internet-based source of information for pediatric neuro-oncology, after the site of the National Cancer Institute.[9]

A 2002 study described the site's coverage of dermatology as "excellent and comprehensive."[10]

In 2000 an article in the Journal of Ear Nose and Throat by AD Meyers from the University of Colorado School of Medicine, Denver, CO, announced the unveiling of the ENT textbook online at emedicine.com.[1]

References

  1. 1 2 3 4 Meyers, AD (Apr 2000). "eMedicine Otolaryngology: an online textbook for ENT specialists". Ear, nose, & throat journal. 79 (4): 268–71. PMID 10786388.
  2. ↑ Hunt, Katherine. "WebMD acquires eMedicine.com for $25.5M". MarketWatch. Retrieved 2017-08-28.
  3. ↑ Platt, AF (2008). Evidence-Based Medicine for PDAs: A Guide for Practice. Jones and Bartlett Publishers. pp. 80–82. ISBN 0-7637-5476-5.
  4. ↑ Volsky, PG; Baldassari, CM; Mushti, S; Derkay, CS (Sep 2012). "Quality of Internet information in pediatric otolaryngology: a comparison of three most referenced websites". International journal of pediatric otorhinolaryngology. 76 (9): 1312–6. doi:10.1016/j.ijporl.2012.05.026. PMID 22770592.
  5. ↑ Laraway, D.C.; Rogers, S.N. (2012). "A structured review of journal articles reporting outcomes using the University of Washington Quality of Life Scale". British Journal of Oral and Maxillofacial Surgery. 50 (2): 122–31. doi:10.1016/j.bjoms.2010.12.005. PMID 21239091.
  6. ↑ Cao, Yonggang; Liu, Feifan; Simpson, Pippa; Antieau, Lamont; Bennett, Andrew; Cimino, James J.; Ely, John; Yu, Hong (2011). "AskHERMES: An online question answering system for complex clinical questions". Journal of Biomedical Informatics. 44 (2): 277–88. doi:10.1016/j.jbi.2011.01.004. PMC 3433744. PMID 21256977.
  7. ↑ Somal, K; Lam, WC; Tam, E (2009). "Computer and internet use by ophthalmologists and trainees in an academic centre". Canadian journal of ophthalmology. Journal canadien d'ophtalmologie. 44 (3): 265–8. doi:10.3129/i09-057. PMID 19491979.
  8. ↑ Kitchin, Douglas R.; Applegate, Kimberly E. (2007). "Learning Radiology". Academic Radiology. 14 (9): 1113–20. doi:10.1016/j.acra.2007.06.002. PMID 17707320.
  9. ↑ Hargrave, D. R.; Hargrave, UA; Bouffet, E (2006). "Quality of health information on the Internet in pediatric neuro-oncology". Neuro-Oncology. 8 (2): 175–82. doi:10.1215/15228517-2005-008. PMC 1871939. PMID 16533758.
  10. ↑ Maibach, HI; Bashir SJ; McKibbon A (2002). Evidence-based dermatology. PMPH-USA. pp. 289–91. ISBN 1-55009-172-7.
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