Computers and Software

Evidence and the Internet

This paper comments on the early signs of convergence between the evidence-based decision-making and the Internet. The authors cite examples such as the Cochrane Collaboration, which uses the Internet to make tools available and to provide access to peer reviewed articles, the CATmaker, which helps physicians produce summaries of articles called "critically appraised topics" (CATs), and the ScHARR Internet site, which offers calculators for interpreting studies as well as regularly updated links to evidence-based resources around the world. According to the authors these advances represent merely the transition from paper-based to electronic media. They foresee a true revolution with technological advances in information processing and "ubiquitous" computing. Collaboration and rigorous evaluation will be necessary, they conclude, to ensure that Internet-related developments in health and health care are taking us in the right direction. CMAJ 2000;162(3):362-5.

Nearly a quarter of Canadians go online for health info

According to a PricewaterhouseCoopers survey, 22% of adult Canadians used the Internet to find health information during the past year and 79% believed the quality of that information needs to be improved. CMAJ 2000;163(10):1328.

Ottawa U embraces "high-tech, high-touch" medical education

Medical students at the University of Ottawa were spending more time cracking their "notebooks" than their textbooks while wending their way through the new U of O Web-based curriculum this year. The new curriculum, called "meded," is based on problem-based learned but takes the concept a step further with the integration of Web-based images, test results, and videos, all accessible through notebook computers supplied to each student. CMAJ 2000;163(9):1181.

Speed of change

The extraordinary revolution in health care informatics can be likened to the advent of printing during the 16th century. The Internet allows simultaneous and interactive exchange of information around the world. According to two authors, our discomfort with the pace of change may arise not from being too slow, but from being too fast to jump on the electronic bandwagon. We may be forsaking our primal sources of understanding, developed over thousands of years, such as our reliance on anecdotal knowledge. CMAJ 2000;162(13):1826-8.

The authors then set out to harness the power of the anecdote by blending anecdotal stories with evidence-based medicine. The result is a cocktail party conversation. CMAJ 2000;162(13):1839-41.

Telemedicine and ultrasonography

Difficulties in delivering health care services in isolated, remote and underserviced areas led researchers to evaluate the efficacy and reliability of teleobstetric ultrasonography services provided from an urban centre to a remote hospital. Forty-nine women underwent two second-trimester screening ultrasound examinations. The first was conducted at the local hospital by a technologist and the images were reviewed by a radiologist at the urban centre using two personal computers, a modem and a conventional (analog) telephone line. The second required the women to travel 200 km to a regional hospital, where the examination was performed under direct supervision of a radiologist. The authors found that, by using only conventional analog telephone lines, teleobstetrical ultrasound services can be provided reliably and in a timely manner from an urban tertiary centre to a remote rural hospital. The authors also predict this service may help alleviate the problem of recruiting and retaining specialists in rural areas. CMAJ 2000; 162(2):206 -7.

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