Electronic publishing: now and tomorrow.

used to help make patient care decisions’ [1]. The On the verge of the information revolution information needed by physicians has been schematized into six categories [2] (Table 1). Of these, medical The current biomedical publication system—journals, knowledge is the most burdensome because its rate of textbooks and scientific meetings—started in the early change is rapidly increasing. It has been calculated years of this century. Since then it has grown at an that during a professional lifetime (40 years) medical exponential rate but until 10 years ago it was always knowledge will increase fourfold [3]. Part of the based on the same media: meetings, biomedical periodinformation that forms the knowledge of doctors is icals and books. With an almost countless series of inevitably bound to be outdated or wrong. Connecting speciality and subspeciality medical journals, we are probably living the peak moment of the journal system the expanding knowledge base of medicine to treatment as we know it now. We have more than a dozen of an individual patient is a particularly difficult task. international peer reviewed nephrology journals and In a survey of the questions generated by 24 doctors ~50 biomedical journals publishing papers on kidney caring for 90 patients during 17 h of clinical activity diseases or giving important news in basic sciences or 454 ‘strictly clinical’ questions were formulated (five in fields strictly related to nephrology. Catalogues of for each patient). Seventy-five per cent of the questions medical textbooks are so large that a major publisher were related to patient care, most of which were related has decided to compact and distribute his titles on to specific patients. Twenty-five per cent were about optic disk. Harrison’s Principle of Internal Medicine is treatment (16% about drug treatment). The doctors at the thirteenth edition in 28 years at the pace of one anticipated that, for about one quarter of these quesevery 3 years, while previous editions appeared every tions, they needed to consult a textbook, a journal or fourth year. The calendar of biomedical congresses is Medline [4]. In other words, clinical practice generates exceedingly long and the opportunities to present or several questions that cannot be answered immediately receive scientific information sometimes appear to be and require a later access to medical knowledge data frankly redundant. Doctors are literally overburdened bases. This study also unveiled that many information with information. The hard copy journal and textbook needs of doctors remain unexpressed: doctors often system has started to show the first signs of decay needed support, guidance and approval of what they because it is costly and bound to become even costlier were doing. Although this interesting study does not in the face of a growing number of appealing electronic give information on how many of the expressed questextbooks offered at a competitive price. The computer tions remained unanswered, it emphasizes the need of and telecommunication technology that has revolutionaccurate, up-to-date information about the effectized many sectors of our society is now pervading the iveness of a variety of therapeutic interventions and medical information system. With the visual angle of a nephrologist, I will present an overview of the type of information that clinicians and scientists need, conTable 1. Information needed by doctors necting these information needs with the new opportunities for scientific communication. A glimpse into Categories Comment the foreseeable future will close these notes.