By Demosthenes G. Katritsis
As Charles Darwin elegantly demonstrated, survival depends on the ability for adaptation. This principle, however, can be conceptualized beyond species evolution. By reference to contingent or contextual considerations, adaptation is also relevant to the need of human activity, in general, to correlate with the speed of scientific progress and technological innovation.
This is particularly true for medicine. Although both a science and an art since the days of Hippocrates, the recent explosive expansion of knowledge and technological progress argues in favour of science. Numerous randomized clinical trials, new tools and applied innovation, novel drugs and therapeutic schemes, and updated practice guidelines by major professional societies continually appear, almost on a daily basis, and rationalize our practices. This amazing progress, however, imposes a new set of challenges for the practicing physician who struggles to stay informed and provide evidence-based medicine amidst the current environment of rapidly disseminating scientific knowledge. In addition, classic medical textbooks, as excellent they are, when they appear in print may already be obsolete at parts. Thus, most of the time physicians go through their phones, iPads, or laptops in search of relevant clinical trials, scientific reviews, and guidelines from learned societies.
Even electronic access, however, is not as straightforward as one may hope; information is often not easy to retrieve and, by its nature, when retrieved is often complex and occasionally conflicting, as is the case with results of clinical trials. Guidelines are not always readily accessible, and overlapping guidelines often appear advising different practice regarding the same condition. And when updates do inevitably appear, the situation is compounded.
Thus, there still remains a need for a textbook that organizes our essential knowledge as it disseminates into the medical mainstream. Simultaneously, there is a need for expert opinion to guide the busy physician to the appropriate areas of our evidence-base with advice on how to incorporate it into practice. But, in order to avoid obsolescence, it has to be capable of continuous updating with no time restrictions: immediately as new information appears it should be incorporated into the online version that is now an invariable companion of most scientific publications.
Such an attempt has been recently put into trial with the publication of Clinical Cardiology: Current Practice Guidelines. There were three goals we tried to accomplish with this manual. First to consolidate our knowledge of clinically necessary points and information, to be organized in a “user-friendly, at a glance” way, providing a clinical tool both to our readers and us. Second, to scrutinize, summarize, and present in succinct and clear tabulations the most recent guidelines in the field of cardiology, such as those by the American College of Cardiology Foundation / American Heart Association (ACCF/AHA) and the European Society of Cardiology (ESC), among many others. Third, and more importantly, to commit ourselves to continuously update our book as new information disseminates. This is now accomplished by biannual online updates and frequent revised versions of the book in the printed form. We are confident that, in the future, an innovative and visionary publishing house as OUP will allow us a continuous access to an online version that can be revised any time by the authors, as happens with a personal website or blog.
We hope that, in authoring this book, the busy physician will have the entire essential and, according to the authors at least, necessary information for his clinical practice available at the click of a button or the turn of a page. As happens with any novelty and revolutionary approach in life, practical and financial considerations and obstacles have always to be addressed and resolved — we hope to evolve through these. The 1860 evolution debate took place at the University of Oxford after all.
Demosthenes G. Katritsis, MD, PhD (London), FRCP, is Director of Cardiology at Athens Euroclinic, Greece, and Visiting Professor at the City University, London, UK. He is co-author of Clinical Cardiology: Current Practice Guidelines.
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