- Email: [email protected]
Handheld use increasing for e-learning and clinical decision making
DISSECTING ROOM
Books A bumpy journey through endocrinology and diabetes ew will argue with this book’s opening statement that it is better to be healthy and well rather than ill or dead. This promising start leads into almost 2000 pages that span a wide range of topics, including diabetes, lipid disturbances, and (beyond the remit of endocrine training in the UK at least) inborn errors of metabolism.
F
Oxford Textbook of Endocrinology and Diabetes John A H Watts, Stephen M Shalet, eds. Oxford: Oxford University Press, 2002. Pp 1952. £245.00. ISBN 0 192 63045 8.
Despite its scope, this is not quite a textbook, but rather a series of reviews bundled together into sections of variable cohesiveness. Some individual sections succeed admirably, and those on the pituitary, calcium metabolism, and neuroendocrine tumours are especially good. Other parts of the book, however, do not hang together so well. The balance is erratic throughout, with some contributors wallowing in fine print while others sacrifice key facts in the pursuit of brevity. Hypothyroidism occupies five chapters,
Software Handheld use increasing for e-learning and clinical decision making About 40% of US physicians will be using handheld computers in 2003, up from 34% in 2002 and 29% in 2001, according to the latest data from Manhattan Research (http://www. manhattanresearch.com; formerly Cyber Dialogue). The company will formally assess European physicians’ use of handhelds this year, says president Mark Bard, who adds that his experiences at conferences suggest that many European countries “are pushing the envelope with respect to technology at the point of care, including the use of handhelds”. But all physicians, irrespective of country of origin, seem to be using their handhelds for similar activities— most notably, for personal and professional scheduling (84% and 68%, respectively) and, at the point of care, for information access and support for clinical decision making (panel).
whereas adrenal failure merits only one chapter. Coverage of diabetes is patchy, with good chapters on the diabetic foot and future treatments. Obesity remains a Cinderella subject; the roles of leptin and hypothalamic peptides in rodents are well described, but the causes of common human obesity and how obesity might produce its most important complication (type 2 diabetes) are not discussed at all. Unfortunately, the book is monochrome throughout, apart from a slim section of colour plates in the chapter on pituitary development. Line diagrams are generally sparse and many seem to be reproduced as submitted by the contributor. Some of the clinical images (radiographs and photographs) are also disappointing. The colour plates contain some puzzling enigmas. If there had only been one photograph of the glucagonoma rash, could we have had a picture of Cushing’s syndrome? What did the conjunctival flushing look like before the patient’s eyes were blacked out? Accurate indexing and crossreferencing are essential in a book of this size. It is, therefore, disconcerting to discover that “testicular volume index” is followed (in sequence) by “the clitoris”, “the diabetic foot” and,
after diverting into “the nephron” and elsewhere, “testis maintenance”. Perhaps I have missed something here—or maybe a computer did the indexing? Overall, the impression is of rather loose editorial grip. This could also explain the frequent typographical errors and Swedish-derived neologisms that have crept through. All textbooks are out of date from the moment they are committed to proof, and this one is no exception. For most chapters, the defining moment seems to have been some 3 years ago, although a few chapters contain references from 2000 and even 2001. Nowadays, with easy electronic access to up-to-date reviews, big medical textbooks have to prove more convincingly than ever that they are worth the investment. A good textbook can still have the edge, if it provides a balanced, authoritative, and pleasurable voyage of discovery. Although excellent in parts, this textbook does not succeed in steering us smoothly through this subject.
What does this mean for Lancet readers? An increasing number will be purchasing their first handheld (see the website of Consumer Reports at http://www.consumerreports.org for buying tips); existing users are expected to find new uses for their handheld computers, especially if they are part of a health-care network.
Clinical guidelines, abstracts, and encyclopaedias are among the offerings.
Many companies are trying to lure physician users by offering free access to content and low-cost software for handhelds. An excellent starting point is AvantGo (http://www.avantgo.com); after a free registration, users can choose from among hundreds of “channels” (content providers) in categories that include news, health, technology, and travel. Handhelds at the point of care Access drug information 67% Access clinical decision support 22% Prescribe medications 13% Access medical records 4% View lab results 3% Most point-of-care applications are available mainly for networked practices. More than half of users expressed interest in being able to do all the functions listed above.
THE LANCET • Vol 361 • January 4, 2003 • www.thelancet.com
Gareth Williams Diabetes and Endocrinology Research Group, Department of Medicine, Clinical Sciences Centre, University Hospital Aintree, Liverpool L9 7AE, UK
Other sites that offer medical software include: CollectiveMed (http://www. collectivemed.com), Handheld Med (http://www.handheldmed.com), Healthy Palm Pilot (http://www.healthy palmpilot.com), Peripheral Brain (http://pbrain.hypermart.net/index. html), Palm Gear (http://www.palm gear.com/software/answer_category. cfm?categoryIDs=120), and Tucows PDA (http://pda.tucows.com). Universities are increasingly providing medical education for handhelds (see, for example, http://www.georgetown. edu/uis/rcd/resources/projects/ medical_pda.html), as are medical publishing companies. To help readers choose from the many offerings, The Lancet will start publishing product reviews of handheld software available at these and other sites in this new section. Suggestions are welcome.
Marilynn Larkin e-mail: [email protected]
93
For personal use. Only reproduce with permission from The Lancet Publishing Group.
Books A bumpy journey through endocrinology and diabetes ew will argue with this book’s opening statement that it is better to be healthy and well rather than ill or dead. This promising start leads into almost 2000 pages that span a wide range of topics, including diabetes, lipid disturbances, and (beyond the remit of endocrine training in the UK at least) inborn errors of metabolism.
F
Oxford Textbook of Endocrinology and Diabetes John A H Watts, Stephen M Shalet, eds. Oxford: Oxford University Press, 2002. Pp 1952. £245.00. ISBN 0 192 63045 8.
Despite its scope, this is not quite a textbook, but rather a series of reviews bundled together into sections of variable cohesiveness. Some individual sections succeed admirably, and those on the pituitary, calcium metabolism, and neuroendocrine tumours are especially good. Other parts of the book, however, do not hang together so well. The balance is erratic throughout, with some contributors wallowing in fine print while others sacrifice key facts in the pursuit of brevity. Hypothyroidism occupies five chapters,
Software Handheld use increasing for e-learning and clinical decision making About 40% of US physicians will be using handheld computers in 2003, up from 34% in 2002 and 29% in 2001, according to the latest data from Manhattan Research (http://www. manhattanresearch.com; formerly Cyber Dialogue). The company will formally assess European physicians’ use of handhelds this year, says president Mark Bard, who adds that his experiences at conferences suggest that many European countries “are pushing the envelope with respect to technology at the point of care, including the use of handhelds”. But all physicians, irrespective of country of origin, seem to be using their handhelds for similar activities— most notably, for personal and professional scheduling (84% and 68%, respectively) and, at the point of care, for information access and support for clinical decision making (panel).
whereas adrenal failure merits only one chapter. Coverage of diabetes is patchy, with good chapters on the diabetic foot and future treatments. Obesity remains a Cinderella subject; the roles of leptin and hypothalamic peptides in rodents are well described, but the causes of common human obesity and how obesity might produce its most important complication (type 2 diabetes) are not discussed at all. Unfortunately, the book is monochrome throughout, apart from a slim section of colour plates in the chapter on pituitary development. Line diagrams are generally sparse and many seem to be reproduced as submitted by the contributor. Some of the clinical images (radiographs and photographs) are also disappointing. The colour plates contain some puzzling enigmas. If there had only been one photograph of the glucagonoma rash, could we have had a picture of Cushing’s syndrome? What did the conjunctival flushing look like before the patient’s eyes were blacked out? Accurate indexing and crossreferencing are essential in a book of this size. It is, therefore, disconcerting to discover that “testicular volume index” is followed (in sequence) by “the clitoris”, “the diabetic foot” and,
after diverting into “the nephron” and elsewhere, “testis maintenance”. Perhaps I have missed something here—or maybe a computer did the indexing? Overall, the impression is of rather loose editorial grip. This could also explain the frequent typographical errors and Swedish-derived neologisms that have crept through. All textbooks are out of date from the moment they are committed to proof, and this one is no exception. For most chapters, the defining moment seems to have been some 3 years ago, although a few chapters contain references from 2000 and even 2001. Nowadays, with easy electronic access to up-to-date reviews, big medical textbooks have to prove more convincingly than ever that they are worth the investment. A good textbook can still have the edge, if it provides a balanced, authoritative, and pleasurable voyage of discovery. Although excellent in parts, this textbook does not succeed in steering us smoothly through this subject.
What does this mean for Lancet readers? An increasing number will be purchasing their first handheld (see the website of Consumer Reports at http://www.consumerreports.org for buying tips); existing users are expected to find new uses for their handheld computers, especially if they are part of a health-care network.
Clinical guidelines, abstracts, and encyclopaedias are among the offerings.
Many companies are trying to lure physician users by offering free access to content and low-cost software for handhelds. An excellent starting point is AvantGo (http://www.avantgo.com); after a free registration, users can choose from among hundreds of “channels” (content providers) in categories that include news, health, technology, and travel. Handhelds at the point of care Access drug information 67% Access clinical decision support 22% Prescribe medications 13% Access medical records 4% View lab results 3% Most point-of-care applications are available mainly for networked practices. More than half of users expressed interest in being able to do all the functions listed above.
THE LANCET • Vol 361 • January 4, 2003 • www.thelancet.com
Gareth Williams Diabetes and Endocrinology Research Group, Department of Medicine, Clinical Sciences Centre, University Hospital Aintree, Liverpool L9 7AE, UK
Other sites that offer medical software include: CollectiveMed (http://www. collectivemed.com), Handheld Med (http://www.handheldmed.com), Healthy Palm Pilot (http://www.healthy palmpilot.com), Peripheral Brain (http://pbrain.hypermart.net/index. html), Palm Gear (http://www.palm gear.com/software/answer_category. cfm?categoryIDs=120), and Tucows PDA (http://pda.tucows.com). Universities are increasingly providing medical education for handhelds (see, for example, http://www.georgetown. edu/uis/rcd/resources/projects/ medical_pda.html), as are medical publishing companies. To help readers choose from the many offerings, The Lancet will start publishing product reviews of handheld software available at these and other sites in this new section. Suggestions are welcome.
Marilynn Larkin e-mail: [email protected]
93
For personal use. Only reproduce with permission from The Lancet Publishing Group.