CD-ROMs for the Practicing FP

Florida Family Physician / January 1996 / Volume 46 / Number 1

Why, grab a handful of CD-ROMs, of course. Cousins of music CDs, each 3.5 inch disc holds over 600 megabytes of data, or roughly 300,000 single-spaced typed pages. This enormous capacity means that you can carry an entire medical library in your pocket--citations, full-text journals, books, CME or a combination. CD-ROMs are more durable than floppy discs. They aren't sensitive to magnetic fields, and as they are read only, you can't inadvertently erase them. Do protect them, though, from dust, sticky fingers and scratches.

CDs come in DOS, Windows, Macintosh, and UNIX flavors. "Hybrid" discs are compatible with two or more systems. Be sure to check for compatibility before you buy. A typical CD-ROM includes software to search its contents, save a bookmark or print a selection to read later. Products vary in the level of sophistication used to find references; most use familiar Boolean logic statements (AND, OR, NOT), while some also allow natural language queries and incorporate expert systems to aid in finding relevant materials.

Journals on Disc

MacMillan New Media offers the five major internal medicine journals in two formats. The Internal Medicine Series includes full text and tables for Annals of Internal Medicine, British Medical Journal, Journal of American Medical Association, New England Journal of Medicine and The Lancet for one year. The Full Text Archives discs also include the full text and tables, but for one of these journals for eight years. Both product lines are updated annually and come on a single disc.

Table 1 summarizes journals to consider. Prices run from $195 to $295 for individual purchasers. Prices for institutional use tend to be $100 more, with network prices varying depending upon number of users.

Books on Disc

Other Products

Developed especially for primary care physicians, STAT!-Ref from Teton Data Systems contains over 250,000 pages from medical texts and abstracts from 10 years of MEDLINE from selected journals. What's unusual about STAT!-REF is that you can create a custom library from the shelves of texts they have available, paying only for those to which you subscribe. Price varies depending upon which collection of texts you select.

As an example of a highly focused topical disc, the AIDS Compact Library from MacMillan New Media includes the full text and tables of more than 10,000 AIDS related articles and 115,000 abstracts and citations form sources such as AIDS, JAMA, NEJM, and AIDSLINE from the National Library of Medicine databases. Updated quarterly, the initial subscription costs $695 for institutions, $495 for individuals.

Another specialized disc is Clinical Pharmacology by Gold Standard Multimedia, Inc.. The program contains over 1000 drug monographs with full color pictures of various dosage forms and more than 10 specialized indexes covering indications, adverse effects, interactions, etc. The product also includes innovative features such as patient education handouts, interactive continuing education quizes, an electronic prescription writer, and a patient database.

Continuing Medical Education

PrimePractice, for example, is a quarterly "multimedia journal" targeted at primary care physicians. Developed by Mayo Clinic and IVI Publishing, each quarterly issue features four cases reviewing a specific subspecialty in detail. Each issue is approved by the AMA and the AAFP for up to 10 hours of Category 1 credit. Requesting credit is easy, as PrimePractice automatically tracks your progress. When you're done with an issue, just mail in the diskette included for that purpose. Topics to be covered include Pulmonary, Internal/Preventive Medicine, Gastroenterology, Oncology/Hematology and Endocrinology. Available for either the Macintosh or the PC, pricing for an annual subscription depends on whether you want the CME credit: with credit, it costs $495; without, $210.

Several other journals and texts also offer CME credits. For example, American Family Physician includes clinical quizzes at the end of each issue. However, the CD lacks the reply card found in its paper-based cousin, which means you need to take the initiative to receive credit.

Table 3 summarizes products which provide CME credit.

Purchasing Pointers

Individual vs. Institution vs. Network If you want to use a disc at your office, ask the publisher or reseller what price level you must pay. For example, CMEA defines "personal" usage as one person using the product on one computer, "institutional" as multiple people sharing the disc on one computer. Network pricing allows you to share the disc on a network, subject to the terms of the license agreement for each product. Prices for institutions tend to be $100-$200 more than prices for individuals, networks generally cost more than institutions.

Browse a Catalog. For example, the fall Continuing Medical Education Associates catalog featured more than 70 CD-ROMs. The examples of computer screens, photos and art work included with the product descriptions can help give you a better feel for the media.

Shop around for the best prices. Resellers can be more expensive, especially for institutions. Ask publishers about discounts, especially if you work in education.

Try Before You Buy. Before investing in a disc, check with your local hospital's library--they may own the full-fledged version of a MEDLINE product, for example, that you can test-drive. Some resellers, such as CMEA, also offer a 30 day money back guarantee, so you can try a disc risk free. Ask about demo discs. Aries Systems, for example, now offers a free demonstration CD-ROM. And if you're an Internet user with access to the World Wide Web, you can try out Physician's Silver Platter 'Family Practice' (5-year subset of MEDLINE) on the Web for free.

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