Medical webwatch.

JointZone (http://www.iam.ecs.soton.ac.uk/users/mhn99r/learn/userlogin/index.jsp) is a comprehensive and structured overview of rheumatology. It can be accessed via "Free Browsing" or via "Personalized Learning," where an up-to-date history of your reading as a percentage of the material available is offered. The web site is funded by Arthritis Research Campaign UK, and was developed at the University of Southampton. The sections are: "Case Studies," "Basic Science," "Rheumatic Disorders," "Approach to Patient," "Investigations," and "Disease Management." All sections are accompanied by a plethora of excellent illustrations and there is an illustrated glossary. The expanding menu to the left of the page offers a reassuring confirmation of your position within the site, but this is not pedantic overkill, because this structured dissertation is extensive. Finally, for relaxation there is a list of 29 videos illustrating patient examination techniques.

Centre for Reviews and Dissemination (CRD), established January 1994 and based at University York, UK (www.york.ac.uk/inst/crd/crddatabases.htm) provides research-based information on the effects of interventions in health and social care. There are three databases: "Database of Abstracts of Reviews of Effects (DARE)" covering the effects of interventions; "Economic Evaluations Database (EED)" offering health care decision-makers easy access to information about costs, as well as the effects of drugs, treatments and procedures; and "Health Technology Assessment (HTA)" containing information on health care technology assessments. Each database has a latest addition page for the previous month, which is a good entry point. There are comprehensive descriptions of the studies with both author's conclusions and CRD comments, along with the implications of the findings.

The ECG Learning Centre (http://medstat.med.utah.edu/kw/ecg/index.html) by Frank G. Yanowitz, Professor of Medicine, University of Utah Medical School, is an interactive electrocardiogram tutorial and introduction to clinical electrocardiography. Mastery of ECG interpretation, one of the most useful clinical tools in medicine, can only occur if one acquires considerable experience in reading ECGs correlated to specific ECG findings and the pathophysiology and clinical status of the patient. This excellent, 12-step, in-depth tutorial follows a standardized sequence to avoid missing subtle abnormalities in the ECG tracing. Learning is facilitated by multiple choice self-tests, with questions based on the traces illustrated. Although concise and well presented, considerable practice will be required to achieve clinical competence. To assist, the accompanying "Clinical Competence in ECG Interpretation" describes various pathologic ECG changes.

Online Case Database from the Department of Pathology, University of Pittsburgh (http://path.upmc.edu/cases.html) presents cases that represent the broad scope of the department's clinical and diagnostic expertise. The cases are explored via "Diagnosis" or by "Patient History" to reveal variously, "Clinical History," "Gross Description," "Pathologic Findings," "Radiology," "Laboratory Findings," and "Histology." After assimilating the information, the "Final Diagnosis and Discussion" can be viewed. The discussions are weighted toward diagnosis, with only brief mention of subsequent treatment and outcome. There is also a "Case of the Month" section.

Tricks of the Trade (www.mdchoice.com/emed/main2.asp?template=1&page=toc&type=2) is edited by Donald B. Middleton, MD., and presents monthly collections of useful tips contributed by readers. These practical tips are intended to ease diagnosis, treatment, or patient examination.

Diversity Rx (http://www.diversityrx.org/HTML/ESWEL.htm) is a clearinghouse of information on how to meet the language and cultural needs of minorities, immigrants, refugees, and other diverse populations seeking health care. Sections include "Models and Practices," "Policy," and "Legal Issues." It has subsections on "Interpreter Practice" and "Research Reports." This web site may help meet the challenge of finding resources and technical assistance when designing and implementing linguistically and culturally appropriate health care programs and policies. The site is supported by the National Conference of State Legislatures, Resources for Cross Cultural Health Care, and the Henry J. Kaiser Family Foundation.

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