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.

I 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.