Wednesday, December 21, 2011

UpToDate versus Harrison's and other traditional text books---it's about apples and oranges

You wouldn't criticize an orange for not being a good apple. In terms of taste, texture and many other attributes an orange isn't supposed to be a good apple. So why in the world would you criticize Harrison's or Cecil's for not being good “look up” treatment references like UpToDate is? They're not supposed to be. They are mainly background references, not point-of-care references. So they have a different role.

An interesting exchange of tweets between Ves, the author of Clinical Cases and Images and Joel, who blogs at Precious Bodily Fluids seems to ignore this point:

@DrVes: UpToDate is likely the most read medical reference tool, at least in the U.S. - how did Harrison's, Cecil's, etc. manage to lose that war?

Thus a false dichotomy is set up between UpToDate and the traditional textbooks. It's both-and, not either-or. The resources should not be in competition. They are complementary. When I'm rounding and need a quick look up of the latest and best information on the treatment of interstitial lung disease complicating systemic sclerosis I go to UpToDate. At home that night I might want to review some background information on the pulmonary complications of systemic sclerosis---pathophysiology, radiographic patterns, disease characteristics, natural history and the like. For that, my best bet is Harrison's or Cecil's.

Don't get me wrong, I love UpToDate. It may even save lives. But UpToDate by itself is not enough. You need additional resources. If your Harrison's is serving primarily as a booster seat for one of your kids at the dinner table you could put it to better use. What do you think? (I'm opening up comments again in hopes the spammers will stay away).


Dr AR said...

I've always wondered about this topic. I find that traditional textbooks are not as "uptodate" as Uptodate, and feel that I might be missing critical info when reading textbooks at night. On the other hand, I feel reading Uptodate not as comprehensive as reading a textbook. I've been debating hard which I should choose to read (and hence searching on this topic) so I would agree with your conclusion; I just have to road test it to see if it works for me.

Anonymous said...

I find myself using uptodate almost for everything. However, here is my logic in when to read either Harrison's or UpToDate: Harrison's = physical findings, diagnosis and quick reference stuff. UpToDate = anything pertaining to treatment or management.