As a result, Alper turned the information into a database and named it DynaMed—short for dynamic medical information system. The mission he created for the grassroots product—"to provide the most useful information to healthcare professionals at the point of care"—is still used today by EBSCO Publishing, which now owns the product.
Alper says all physicians can benefit from DynaMed regardless of their specialty. "If you were a very specialized clinician, you still have patients who have other conditions that are not within your specialty," he says. "You may want to see what you need to know about these conditions in case they have any relation to what you're doing."
For instance, Alper says DynaMed receives requests from dentists who want to learn more about medical conditions because there is an overlap with the care that they provide. For some medical conditions, dentists may need to change medications due to bleeding or infection risks, for example.
Similarly, DynaMed is also receiving requests from clinicians who would like to access more dental information on topics such as dental abscess. "That's not often talked about in medical school, but if a patient comes to the physician and they have it, you need to know what to do," Alper explains.
As one might imagine, DynaMed also receives many requests for new topics, especially in the infectious diseases category. This trend started when the product began to have global usage.
"There are parts of the world where there are certain infectious diseases that have become common, but it's very focused to that part of the world," says Alper, who cites examples such as Ross River virus and chikungunya fever.
In addition to continuously adding content to DynaMed, EBSCO plans to make improvements that will make it more user friendly, individualized, and accessible.
Each week, DynaMed sends out a weekly update that describes some of the most important articles that are most likely to change clinical practice. In the future, it plans to offer continuing medical education (CME) credit for reading weekly updates. It also plans to individualize the content the updates contain. For example, an asthma specialist would receive content that is relevant to his or her practice.
This would allow DynaMed to inform users when the articles that matter most to them are available, instead of providing a broad variety of articles which may or may not be pertinent to them.
Popping the question
The traditional approach to evidence-based medicine is to start with a question that needs answering, Alper says. From there, researchers conduct a search for all possible answers, choose the best information, analyze and summarize it, and publish it as a systematic review.