Dr. Staab is Acting Diagnostic Radiology Branch Chief in the
Diagnostic Imaging Program at the National Cancer Institute in
Rockville, MD. He is also a member of the editorial advisory
board of this journal.
recently read a well-writen article in The Washington Post about
Parkinson's disease that discussed advances in imaging and
potential treatments. The article was laced with scientific
information, and I stopped to consider if the newspaper article was
scientifically accurate and think about the medical literature I
read. I often find the articles in good consumer newspapers and
magazines very interesting.
Although I try to keep up with the ten peer-reviewed radiology
journals I receive regularly, I confess that several of them are
stacked at the corner of my desk. In the past I had the journals
bound and put on my shelf for future reference. From time to time,
I still use these journals to review a specific subject, but
frankly find the online accessibility of my preferred medical
literature more efficient. Several of my colleagues have admitted
that they too have trouble keeping up with the literature. It is
time-consuming to locate relevant articles and read all of the
details. One radiologist confided that she too enjoys timely
consumer magazines and newspapers. "Perhaps we should offer a
mechanism for peer review of commercial news articles," she
suggested. A novel and interesting idea.
Clearly, the publication of myriad commercial medical journals
and magazines, along with the aforementioned peer-reviewed medical
journals, swamps our ability to digest the literature in our field.
Various mechanisms have been developed to assist the beleaguered
practicing radiologist. Major scientific journals have review
articles, there are excellent journals and books reviewing given
topics, and many continuing education courses are available.
Over the past several decades, a variety of electronic products
have been developed to ease the continuous learning experience,
including video, audio, CD-ROM, and electronic journals. The
National Library of Medicine has made it easier to access important
medical information on the Internet. All of these resources are
designed to distribute information rapidly and help us assimilate
it more easily. However, we still feel overburdened by the amount
of information we face. To date, however, new electronic
technologies have not addressed the primary problem.
This reminds me of the implementation of PACS into a
dysfunctional film-based environment; what you end up with is a
PACS superimposed on a bad system. Improvements in radiology with
PACS came about by first understanding the limitations of our
current processes and determining how they should be changed.
In a similar way, I believe that as radiologists, we must
consider how we can manage our knowledge base better. We must
develop easier ways to access information, probably in a
hierarchical approach. It must be organized to include the
information in all or most of our journals, as well as information
from other sources. The use of professional writers might help make
the information more palatable.
This is not a recommendation to decrease any of the current
written literature, although many people might say that much of our
literature is redundant and less than scientifically rigorous. I do
not recommend that we decrease or eliminate any of the current
literature arbitrarily, for fear that we might stifle creativity by
not having these outlets for communicating scientific discovery,
educational analysis, or hands-on practical information that
assists so many practicing radiologists.
Making the radiological literature more accessible may impact
the fundamental ways this information is currently published, by
altering the advertising and support that sustains many of our
journals. We should be cognizant of this possibility and strive to
create a better system that addresses the problem appropriately.
With careful evaluation and decision-making, changes in the process
of distributing and accessing medical information may benefit us
all and the rewards may truly be outstanding.