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eMedicine Otolaryngology: An online textbook for ENT specialists.

Abstract

A new online publishing effort, eMedicine Otolaryngology-Facial Plastic Surgery (FPS), is a comprehensive textbook now being developed on the Internet (www.emedicine.com). This book is one of a series of 15 electronic textbooks written by a worldwide panel of authors and editors, and it is distributed free of charge to anyone with a computer and a modem. Advantages of online textbooks such as eMedicine Otolaryngology-FPS are that they provide readers with easy accessibility to reliable, up-to-date information, and they allow authors to quickly edit and revise editorial content and supplement traditional text with sound, graphics, and video. An ambitious undertaking, eMedicine Otolaryngology-FPS represents a significant advance in the way medical information is written, edited, and distributed. Although it is unlikely that electronic textbooks will replace traditional textbooks any time soon, these types of publishing efforts will continue to proliferate.

Introduction

The distribution of medical information over the Internet has grown exponentially in the past few years. The "information explosion" has fostered the proliferation of online journals, medical information Web sites, and Web-based continuing education programs.

Research has shown that more than 40% of Internet searches done by the general public relate to healthcare issues. The primary concern that Internet users have is the quality of information they find. The vastness of the number of Internet healthcare Web sites is confusing to patients, and they find it difficult to know which information is accurate and worthwhile. As a result, the search for reliable medical information can be time-consuming and frustrating.

Online publishing is also of benefit to physicians, who have traditionally been educated from textbooks that often are already years out of date when they are published.

The eMedicine site at www.emedicine.com offers free, up-to-date, peer-reviewed medical information on otolaryngology, surgery, emergency medicine, pediatrics, neurology, sports medicine, physical medicine, ophthalmology, dermatology, and other topics. The sites integrate photos, x-rays, video, and audio, adding a dimension to education that printed texts cannot offer.

Producing an electronic textbook presents several challenges. This article details some of the efforts that went into producing the eMedicine site in general and eMedicine Otolaryngology-FPS in particular. It also explains the advantages of using an online publishing system in which thousands of authors and editors around the world can simultaneously produce a current, comprehensive, easily edited, and free resource for physicians and patients. Table 1 outlines some of the advantages offered by the eMedicine textbooks.

The rationale for online textbooks

Traditional medical textbooks have several drawbacks. For example, textbooks require substantial time and effort to update. New editions of standard medical textbooks can take from 2 to 5 years to progress from concept to the bookstore. As a result, physicians almost invariably learn from and refer to textbooks that are years out of date. And, of course, medical textbooks are expensive. Finally, the logistics of soliciting authors and monitoring the progress of manuscripts is cumbersome and time-consuming.

As for patients, before the proliferation of healthcare Web sites, they had limited access to the information commonly used by physicians and other healthcare professionals to make clinical decisions. This lack of knowledge made it difficult for patients to understand how clinicians think about clinical problems.

The eMedicine Web site is being developed to address some of these shortcomings. For example, despite the rigorous review process, the content of eMedicine Otolaryngology-FPS, as well as that of the other books in the series, can be assembled relatively quickly. These online books are designed for both the medical community and the general public, and the Web site contains direct links to other medical information resources through Medline. Search functions have been designed to facilitate the diagnostic process. Users can type in symptoms, for example, and receive a set of potential etiologies or a differential diagnosis. A built-in e-mail feature allows readers to communicate directly with authors and editors. Additional features, planned for the near future, are listed in table 2.

The production process

The new paradigms of electronic publishing have streamlined the process of soliciting manuscripts, editing and reviewing them, and eventually posting and distributing them. The patented, user-friendly group publishing system (GPS) software makes the mechanical aspect of writing eMedicine Otolaryngology-FPS easy. Otolaryngologists who might be interested in contributing to this book can learn more details by logging on to the www.emedicine.com page. Potential authors can view a list of topics and see which chapters are still available for assignment. Authors can then register online.

Chapters are formatted in one of three ways: as surgical chapters, as medical chapters, and as open-format chapters. To assist authors in putting together a well-organized chapter, all three formats are standardized and already include relevant subheadings such as etiology, differential diagnosis, surgical technique, and complications.

When an author has completed a chapter, he or she transmits the electronic file via e-mail to a series of editors, all of whom have been selected for their expertise in a particular area. A copy editor assists the author with the structure of the chapter and the use of software. A medical editor, who is typically assigned to edit eight to 10 chapters, assists the author with style and content issues. A section managing editor reviews the chapter to ensure stylistic consistency in a given subspecialty area. Each chapter is also reviewed by a pharmacology editor and a continuing medical education editor.

Finally, the editor-in-chief, who is responsible for recruiting authors and editors, determines the overall structure of the text and oversees the entire process. The finished product is posted on the Web site only after it has been approved by every one of these editors. Chapters can be updated at any time, and they can include sound as well as video clips and other graphics.

There are substantial production hurdles and editorial, design, and coordination challenges. In order to remain current, chapters undergo continual monitoring and revision. To maintain high standards and consistency of format, authors and editors must stay in continual communication. Finally, recruiting authors and editors who are recognized experts requires persistence.

The eMedicine site would not have been possible without the interactive GPS software used to produce and store electronic files and without the persistence of several visionary entrepreneurs. The GPS software was designed and developed by Scott Planz, MD; Jonathan Adler, MD; Joanne Berezin; and Jeff Berezin. The startup and operating costs are substantial, but thanks to corporate sponsorship, individual investment, and grant support, eMedicine Otolaryngology-FPS and the other texts in the series are posted on the Web and distributed to users without charge; and authors and editors are paid appropriately for their intellectual property.

From the Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Denver.

Facts and figures

Three eMedicine series represents a significant advance in the way medical information is distributed over the Internet. The numbers are impressive:

* 85% of the editors are residency program directors, department chairs, or research directors.

* Each topic is peer-reviewed by four physicians and a doctor of pharmacy.

* More than 6,000 academic authors and editors are currently working on the project. They represent almost 1,000 of the top medical schools, medical societies, and medical institutions in the world, and they will contribute more than 250,000 hours to finishing this project.

* Approximately 85% of users are medical professionals.

* There are currently 2 million users per year, a figure that doubles every 6 months. The average duration of a user's visit to the site is 13 minutes. At the current rate, the site will register 40 million hits per year.

* eMedicine has won more than 30 national and international awards.

What's in store

Online eMedicine has an exciting future. Some of the new technological features that it plans to introduce soon:

* An editing system tied to Microsoft Word, which will enable users to more easily edit copy.

* A system that automatically e-mails new articles in the literature to authors and editors.

* A system that keeps focused track of editorial revisions. When chapters are edited, this system will allow editors to concentrate on individual changes rather than rereading the entire chapter.

* A revolutionary new search engine. When a medical term is highlighted on the screen, the system will provide its definition in about one-half second, initiate a Medline search in 1 second, and automatically search 25 other medical sites that contain additional data such as x-rays, photographs, ECG tracings, etc.

* A system to allow the reader to be notified automatically whenever an eMedicine topic is updated.

* A system to globally check spelling and grammar in the entire databank of topics. This system will allow a small team of copy editors to maintain editorial quality over the long term.
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Article Details
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Title Annotation:ear, nose, and throat
Comment:eMedicine Otolaryngology: An online textbook for ENT specialists.(ear, nose, and throat)
Author:Meyers, Arlen D.
Publication:Ear, Nose and Throat Journal
Article Type:Product/Service Evaluation
Geographic Code:1USA
Date:Apr 1, 2000
Words:1440
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