UpToDate: A comprehensive clinical database

Pocket version

UpToDate also provides a Pocket PC version. The Pocket PC version searches the same database with a search engine similar to the other versions. It lacks the search history offered in the CD version. Although faster than searching through a textbook, an average UpToDate search on Dell Axim X5 400 mHz (Intel PXA250) with 64 MB RAM and a SanDisk 1G CompactFlash card took about 10 to 27 seconds, plus more time to navigate through the long and sometimes cumbersome submenus.

The primary intent for palmtop medical software is point-of-care use. The extensiveness of UpToDate’s text—occupying 800 MB of the 1G card—and limited speed of palmtop computers often makes this impractical. However, it should be emphasized that this rich, inclusive database is a valuable reference when time is not at a premium. Certainly, the Pocket PC version provides ultimate portability. Users contemplating use of UpToDate/Pocket PC should budget for a highend Pocket PC and a 1G card.

Conclusions

UpToDate is a clinically useful, searchable database of medical information updated every 4 months and available on CD, online, and for souped-up Pocket PC palmtop devices. It is almost as if UpToDate purposely incorporated an unsophisticated search engine and did not optimize the electronic environment to flaunt its forte—the clinical database.

For family physicians, the database is of sufficiently high quality, and it will be even more useful as the pediatric module expands. We hope that future enhancements to UpToDate will include clinical bullets for point-of-care use and optimization of the electronic environment. The latter should include implementation of Boolean searches; bookmarks; highlighters; a user-added note facility; copying and pasting of references; links to drug cost information; and—the whole point of Windows! — multi-window capability and conventional window resizing.

Patient information needs to be more accessible to be clinically useful. Also, versions of the patient information handouts with less complex language to appeal to the average patient would be helpful. As is, UpToDate’s importance will only increase. Highly recommended.

Correspondence
Gary N. Fox, MD, Mercy Health Partners Family Practice Residency Program, 2200 Jefferson Ave, Toledo OH 43624-1117. E-mail: foxgary@yahoo.com.