The quality, breadth, and timeliness of content updating vary substantially for 10 online medical texts: an analytic survey

OBJECTIVE: To evaluate the quality of evidence reporting, breadth of coverage, and timeliness of content updating of 10 selected online medical texts. STUDY DESIGN AND SETTING: Each text was assessed for quality based on an 11-item scale, which included items related to editorial policy and updating, appraisal, and transparent incorporation of newly published clinical research and evidence-based guidelines. Breadth of coverage was determined by the percentage of 60 randomly selected International Classification of Diseases 10 (ICD-10) codes covered by each of the texts. The same 60 ICD-10 codes were used to obtain a sample of topic chapters for the assessment of timeliness of updates. RESULTS: Quality scores ranged from a high of 9 of 11 points (Clinical Evidence) to a low of 0 of 11 points (PEPID), with a mean score of 6.7. Breadth of coverage ranged from 83% of randomly selected topics covered (UpToDate) to 25% (Clinical Evidence), with 6 of 10 texts covering 60% or more; average coverage across all texts was 57%. Variability was also observed with regard to average time since last content update, ranging from 3.5 (DynaMed) to 29 months (First Consult), with an average time since update of 12.4 months. CONCLUSION: No single resource was ideal and those seeking answers to clinical questions are well-advised not to rely solely on a single point-of-care product.