What We Publish

Information about our content

Overview

DynaMed publishes clinically-organized topics which are continuously updated as new information indicates a need for change in practice. DynaMed content ranges from comprehensive reviews of diseases, conditions, and abnormal findings to highly focused topics on evaluation, differential diagnosis, and management. Drug and laboratory monographs developed and maintained by IBM Micromedex are also included.

Content Types

Condition

Condition topics focus on specific diseases or conditions. They provide a comprehensive review and best available evidence for all aspects of the disease or condition, including epidemiology, pathogenesis, diagnosis, management, and prognosis. The content is organized to support learning about the condition, with easy access directly to key areas in the clinical workflow like diagnosis and management.

Approach to Patient

Approach to Patient topics focus on the evaluation and initial management of an undifferentiated symptom, sign, or abnormal laboratory finding. The content is organized to support the clinical workflow in differential diagnosis.

Evaluation

Evaluation topics focus on assessment, evaluation, and diagnostic testing to confirm or exclude a diagnosis. The content is organized to support the clinical workflow.

Lab Monograph

Lab Monographs contain pertinent information related to the basics and procedures of laboratory tests, including indications, reference ranges, and collection/storage information. Lab Monographs are developed and maintained by IBM Micromedex.

Management

Management topics focus on treatment and management of a specific condition. They provide the best available evidence and relevant recommendations from clinical practice guidelines related to all aspects of managing a condition, including emergency department, inpatient and outpatient management, when to consult a specialist, and palliative care (where applicable). The content is organized to support the clinical workflow.

Drug Review

Drug review topics focus on drugs or drug classes that is not specific to use for a single disease or condition. Content includes efficacy, relevant recommendations from clinical practice guidelines, adverse effects, and inappropriate prescribing criteria for older adults. The content is organized to support learning about the drug/drug class.

Drug Monograph

Drug Monographs contain prescribing information for specific drugs, including dosing, indications and contraindications, drug interactions, and adverse effects. Drug Monographs are developed and maintained by IBM Micromedex.

Device

Device topics focus on the therapeutic use or application of a device that is not specific to use for a single disease or condition. The content is organized to support the clinical workflow.

Procedure

Procedure topics focus on surgery or procedures used for therapeutic purposes that is not specific to use for a single disease or condition. Procedures used to support diagnosis are considered as Diagnostic/Diagnosis/Evaluation topics. The content is organized to support the clinical workflow.

Shared Decision Making

Shared Decision Making topics focus facilitating shared decision making between clinicians and patients. The content is organized according to patients’ frequently asked questions and compares different treatment or screening options.

Prevention

Prevention topics focus on primary prevention or screening for a specific disease or condition. This also includes content related to health maintenance, concentrating on general prevention and routine care such as wellness visits, immunization schedules, and preventive tests. The content is organized to support the clinical workflow.

Quality Improvement

Quality Improvement topics focus on information related to optimizing care and minimizing unnecessary or harmful interventions.

Tools 

DynaMed provides tools to facilitate the clinical workflow.

Calculators

DynaMed interactive calculators provide a fast and efficient way to input patient data and calculate a variety of relevant scores and indices. DynaMed calculators are developed and updated by EBMcalc . EBMcalc references hundreds of medical journal and textbook articles comprising a wide array of medical equations, clinical criteria sets, and decision trees.

All of the calculators can be accessed from primary navigation available on all product pages. They may also be embedded into relevant DynaMed topics.

Featured Content Elements

Overview and Recommendations

The Overview and Recommendations is the entry point for many users. It provides a concise summary with guidance and recommendations designed to answer the most common clinical questions. Links within the Overview and Recommendations provide easy access to the supporting details and evidence.

Recommendations are developed using the internationally-accepted Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The Overview and Recommendations undergoes an additional review by an independent Recommendations Editor chosen for his or her expertise in evidence-based medicine, methodology, and guideline development. These Recommendations Editors ensure that all recommendations are sound, supported, and evidence-based.

Some Overview & Recommendations related to conditions in internal medicine also undergo additional review by our partners at the American College of Physicians (ACP).

Evidence Summary

A DynaMed evidence summary is a brief and clinically-oriented description of a clinical research study, placed in context within the clinical framework. Key elements of a DynaMed study summary include the study conclusion, level of evidence rating, study type, reference, and study details. The study conclusion is written in language that reflects the soundness of the findings, with more directive language being associated with Level 1 evidence. Clicking on the study details will expand the summary to show additional information about the rationale for the level of evidence rating, methods, and pertinent results.

Evidence summaries undergo a rigorous writing and review process that includes methodologists trained in evidence-based medicine and critical appraisal of scientific/medical research, physician experts or specialists, and experts in evidence-based medicine.

Evidence summaries may not be included if the data is of lesser methodological quality or if it does not add substantially new or different information. Evidence summaries may be removed when newer or higher-quality data becomes available, or when the information is no longer relevant.

Evidence and Guideline Ratings

Levels of Evidence: DynaMed applies Level of Evidence labels (ranging from Level 1 to Level 3) to evidence summaries using a systematic critical appraisal process. This simple rating system makes it easy for users to quickly understand the quality of the evidence being reported, and the primary rationale behind the rating.

Level 1 (likely reliable) evidence represents research results that address clinical outcomes and meet an extensive set of quality criteria that minimizes bias.

Level 2 (mid-level) evidence represents research results that address clinical outcomes and demonstrate some method of scientific investigation but do not meet the quality criteria to achieve Level 1.

Level 3 (lacking direct) evidence represents either of the following:

  • Reports that are not based on scientific analysis of clinical outcomes (e.g., case series, case reports, conclusions extrapolated indirectly from scientific studies)
  • Research results that do not address clinical outcomes, regardless of the scientific rigor

Synthesized Recommendation Grading System: DynaMed synthesizes current evidence, current clinical practice guidelines, and clinical expertise to provide recommendations to support clinical decision-making in the Overview and Recommendations. The internationally-accepted Grading of Recommendations Assessment, Development and Evaluation (GRADE) system is used to classify synthesized recommendations as Strong or Weak.

  • Strong recommendations are used when, based on the available evidence, clinicians (without conflicts of interest) consistently have a high degree of confidence that the desirable consequences (health benefits, decreased costs and burdens) do, or do not, outweigh the undesirable consequences (harms, costs, burdens).
  • Weak recommendations are used when, based on the available evidence, clinicians believe that desirable and undesirable consequences are finely balanced, or appreciable uncertainty exists about the magnitude of expected consequences (benefits and harms). Weak recommendations are also used when the range of patient values and preferences suggests that informed patients are likely to make different choices.