By the year 2020, paper biomedical journals will be extinct. This was a view expressed at an international meeting of medical editors last year. It put a time-scale on the earlier prediction that information technology will lead to the death of biomedical journals.1
If this prediction is to come true, then there will need to be an increased acceptance of computers into medical practice. At present, in Australia, we have not yet reached the critical mass of computerised medical practices that will lead to paperless medicine. Professor Moulds, in his editorial, has outlined the vision of integrating electronic prescribing packages with a variety of drug information databases. Unfortunately, such a system does not yet exist and there are technical difficulties to overcome before we reach this therapeutic Utopia.
While a fully integrated system lies in the future, the Internet is a reality in 1998. Vast amounts of information are available, but there is no control over the quality. Many people search the Internet for health information. A significant proportion of these people are likely to be looking for drug information. They can access information about any number of drugs and may even obtain supplies of these drugs. This bypasses the protection of the local doctors and pharmacists.
There is no protection from bad information on the Internet. Anyone can publish anything, so the information may be wrong, vexatious or conceal conflicts of interest. A review of web pages giving advice about fever in children found poor concordance with published guidelines.2 Should the anxious parent rush the child to hospital, give aspirin or even a naturopathic treatment?
Medical journals such as Australian Prescriber contain high quality peer-reviewed articles. The information they contain is likely to be reliable, but it is usually not generally accessible to the public. In an effort to improve access to information, Australian Prescriber was one of the first medical journals to make its full text freely available on line. This experiment has been a great success. For example, the electronic journal can assist health professionals in countries with few independent sources of drug information. The importance of providing this service was underlined when the role of Australian Prescriber was reviewed last year.
The Australian Prescriber web site has now been redeveloped. We can be found at www.australianprescriber.com. Although Australian Prescriber is written for health professionals, anyone will be able to visit the web site. It is inevitable that patients will access the information.
The Editorial Board recognises that the public has a large unmet need for information about their medicines. To meet this demand and to reduce the potential for confusion when members of the public read medical literature, brief consumer comments will accompany some of the articles. These comments will be written in plain language with the aim of increasing people's knowledge of some of the topics reviewed in Australian Prescriber.
The Australian Prescriber web site will try to meet the standards that have been proposed for electronic medical information.3,4 Your feedback will be welcome to support the continuing evolution of the journal in these testing times. Although the vision may have altered, Australian Prescriber will be alive and well in 2020.
- LaPorte RE, Marler E, Akazawa S, Sauer F, Gamboa C, Shenton C, et al. The death of biomedical journals. Br Med J 1995;310:1387-90.
- Impicciatore P, Pandolfini C, Casella N, Bonati M. Reliability of health information for the public on the world wide web: systematic survey of advice on managing fever in children at home. Br Med J 1997;314:1875-9.
- Silberg WM, Lundberg GD, Musacchio RA. Assessing, controlling, and assuring the quality of medical information on the Internet. Caveant lector et view or - Let the reader and viewer beware [editorial]. JAMA 1997;277:1244-5.
- Wyatt JC. Commentary: measuring quality and impact of the world wide web [comment]. Br Med J 1997;314:1879-81.