Medical Information for Physicians and Consumers:
Medscape versus Mediconsult
Copyright © 1998 Ed Robinson. All rights reserved.
In past issues of WWWiz, several sites devoted to medicine have been reviewed, including Health Insight and The Doctor's Guide. These two sites are targeted largely at the consumer, rather than health professionals. In this issue, two other services receive attention: Medscape and Mediconsult. Both of these sites are targeted largely at health care providers rather than the consumer. Both contain direct links to Medline, now a free service that allows anyone to search the National Library of Medicine for information. This service allows free searches but, if you want to request an article, it will cost you a small fee. You can also directly access Medline via CliniWeb, via Pubmed, or via the Internet Grateful Med. These latter two sites can be reached from the National Library of Medicinepage.
Of these two medical Web sites, the more consumer-oriented of these, Mediconsult, is organized with a "Destinations Patients Use Most" toolbar along the top of the page. Immediately below this toolbar is a Medical News section and a Medical Topics search engine. The default topic is AIDS/HIV (alphabetical, of course). When that topic was selected, a page titled AIDS/HIV appeared but had little useful information displayed directly. In fact, other than the results of a Net survey, the only topic directly displayed was a link to HIV-related Medical News. When this topic was selected, a number of recent articles were summarized by a short abstract. None could be accessed via the Internet but references were cited. All were recent 1998 references. Back on the AIDS/HIV page, a small toolbar along the left side of the page allowed specific entries to be accessed. For example, clicking on Journal Articles transferred me to a Web page listing a number of HIV-related articles available on the Internet. My only really strong complaint about this entry is that the page was outdated. The most recent article cited was 1996.
A related toolbar topic, clinical trials, was extremely useful both to the patient and to the physician. The HIV result gave a general overview of clinical trials, including the total number and the number in each state. When a specific state was picked, a list of the sites and the specific trial were listed. Selecting the trial gave a page that included an overview of the trial, its location, and the specific contact person. One could even email from the page to receive information concerning participation in the trial. This was an extremely helpful site; however, there was no information about confidentiality of a request for information so I would recommend caution when responding via email.
When another disease, breast cancer, was selected, the page had the same general appearance. Selecting journal articles, as with the HIV selection above, generated a similarly outdated list of 1996 publications. Likewise, selecting clinical trials generated a listing of 65 ongoing breast cancer clinical trials across the United States. Thus it would appear that the same strengths and limitations exist for all of the medical topics listed.
Other selections include the ability to shop for medical devices directly from the site, access Web pages for a large number of medical/health-related societies and organizations, and even get specific, disease-related educational materials and drug information. One of the most intriguing features is the ability to "ask the experts" (Mediexperts) for specific treatment guidelines. The list of experts by disease category is impressive. The cost of the service is $195. At that price it will have limited utility but for some physicians at some times, it may be worth the cost. In all, this is an excellent site with some limitations.
The second site, Medscape, is more physician-oriented. This site is organized in a similar manner with a toolbar across the top of the page, and specific hyperlinks down the left and right sides of the page. The prominent feature, running down the center of the page, is today's medical news. There are some problems with this page, however. First, you have to register to use it. It is free and you can have your computer "remember" your name and password, but it still aggravates me to have to register to use a site. More critical, though, is the speed with which the server works. I have a Pentium 300 MHz computer and an Ethernet connection running at 10 Mbytes per second. As you can imagine, this machine runs significantly faster than the average home computer operating over a modem. However, it took nearly a minute to load most of the topic pages. The information on those pages, once loaded, however, was excellent. Nevertheless, even if you were accessing the Web site at midnight you had better plan on a long and eventful evening.
As with Mediconsult, there was a medical topics bar along the right side. However, the number of topics was severely limited when compared to the Mediconsult page. Selecting the AIDS page, there were a number of articles covering numerous topics. It was graphics-oriented and had some informative photographs. The editors of the page are accomplished HIV/AIDS physician-scientists. Several of the linked sites were for Continuing Medical Education (CME) credit. In other words, physicians can read the articles, answer questions on the topic, submit their answers via computer and receive credit for the education beyond their specialty medical training. In most states, and for most hospitals, such CME is required for physicians to maintain their medical licensing and for them to practice at the hospital.
Other highlights of the Medscape page were news from recent medical conferences such as the 34th Annual Meeting of the Society for Clinical Oncology (cancer). There is a Medscape bookstore for purchasing medical books online and even QuickTime video for viewing surgery online. The size of the downloadable file is 1.4 Mb so you may need to plan on a few minutes of download time.
In summary, both sites are good ones and of use to physicians as well as patients. Are they any better than the Doctor's Guide or Health Insight? I would say no. However, each of these four sites offers unique materials and differing opinions of what is medically newsworthy. Therefore, if you have the time and want to keep well informed on medical breakthroughs, routine perusal of each site will be beneficial. If you have questions concerning a specific disease entity and its treatment, searching the appropriate topics on all four sites is likely to generate far more useful information than only one site.
Ed Robinson earned his M.D. and Ph.D. at Vanderbilt University School of Medicine and Vanderbilt University Graduate School in Nashville, Tennessee. Dr. Robinson has spent over ten years studying HIV and the immune response to HIV in infected individuals. He is currently an assistant professor in the Department of Pathology at the University of California at Irvine, where he continues his research and teaches undergraduate, graduate, and medical students about HIV and the immune system.