Tuesday, November 21, 2017

Medicine moves fast. AFP is keeping up.

- Kenny Lin, MD, MPH

Two decades ago, an article in American Family Physician would appear once in print and thereafter only be accessible in the stacks of medical libraries (or family physicians' homes). Content represented the best science available at the time of publication, but there was no way to incorporate subsequent medical developments or new information, no matter how critical. Then, after archived issues of AFP went online in 1998, we began taking a series of small steps aimed at directing readers to the most current and relevant information on the website, including the AFP By Topic collections, adding links from older review articles to updated reviews on the same topic, and creating search tools for patient handouts and algorithms.

To keep up with the pace of medicine, we have begun selectively updating articles online with information of high public health importance. For example, during its October 25-26 meeting, the Advisory Committee on Immunization Practices (ACIP) voted to recommend preferential use of the recombinant subunit herpes zoster vaccine (Shingrix) over the herpes zoster live (Zostavax) vaccine for adults age 50 and older. The U.S. Food and Drug Administration had approved the Shingrix vaccine on October 23. Coincidentally, the November 15 issue that had just gone to press contained an article on prevention and management of herpes zoster and postherpetic neuralgia. It was too late to stop the presses, but not too late to incorporate the new ACIP recommendation into the online version of the article, along with an editor's note alerting readers about the new information.

In a different situation, after the Centers for Disease Control and Prevention (CDC) published updated guidance about caring for pregnant women with possible Zika virus exposure and diagnosis, evaluation, and management of infants with possible congential Zika virus infection, we decided to add an editor's note to our April 15 article on common questions and answers about Zika virus to direct readers to the most current CDC guidance. In this case, anticipating that public health recommendations will continue to evolve rapidly, we did not revise the online text of the article but instead pointed readers to the CDC website for future updates.

Finally, we will continue to create new collections of articles on related topics. The most recent AFP By Topic collection on Oral and Dental Conditions includes special bonus content on medical aspects of oral health that was produced in a collaboration between American Family Physician and the Academy of General Dentistry. Are there any topic collections that we don't have yet that you would find useful for your practice?