Information Overload

Today, for the first time, I was asked to dictate a letter. This came after a following clinic encounter with a patient who had been referred to hospital by her GP. Having never dictated a letter before, I asked my supervisor what to include. I was told that a useful way to structure a clinic letter is to have the patient's details, followed by three headings:

Diagnosis

Management

Follow-Up

The bulk of the text should then follow. The reason for this is that it means the GP can read the headings and get a summary of the outcome of the clinic appointment without spending a lot of time reading all of the text. The rest of the letter is available in the patient's notes, should the GP or a doctor need to refer to it in the future.

I realised that this approach is almost exactly the same as how many doctors must try to keep up with new guidelines and evidence. Work is busy and often there is rarely enough time to trawl through journal articles to try to keep up-to-date with all of the medical news. With evidence changing all of the time there are lots of ways to keep up. Guidelines produced by the SIGN or NICE are developed by researchers who collate all of the relevant research into easy to access guidance. These guidelines are now being made more widely and easily available through websites, apps and publications. The BMJ offers a useful summary of some of the most relevant articles. BBC News will pick up on major new studies as they break however will often present them in a way which is more suited to the lay public. Another way to keep up is through reading publications from more specialty specific organisations, such as the British Journal of General Practice. Lectures, talks and presentations from experts are also a useful way to learn new information.

In my opinion, the weekly BMJ offers one of the best ways to keep up with new developments. It summarises key evidence with a 'study question', 'summary answer' and 'what this paper adds'. Realistically this is a sensible way to condense a large amount of information into a more digestible amount. For example one of this weeks articles relates to the risk of pneumonia associated with the use of ACE inhibitors.

Study question: Do ACE inhibitors and ARBs decrease the risk of pneumonia?

Study answer: ACE inhibitors may be important in reducing the risk of pneumonia. This data could discourage the withdrawal of ACE inhibitors in some patients with cough who are at particularly high risk of pneumonia.

What is known and what this paper adds: ACE inhibitors have secondary effects on the respiratory system, which may protect against pneumonia. In pooled results from interventional and observational studies, ACE inhibitors had a significant protective role against pneumonia.

In an attempt to do my bit to reduce the amount of information overload which is often starting to occur in medicine, I'll try and keep my letters, presentations and discussions short, because the danger is that if there is too much information, the key points of most importance could be lost.

And of course this week wouldn't complete without mentioning some of the amazing successes of Team GB in the Olympics! Congratulations to all of the medal winners - so great to see all of the hard work pay off.