URL: http://www.theanswerpage.com

Publisher: QD Enterprises, LLC

Authors: Dr. B. Scott Segal and Dr. Stephen B. Corn, Department of Anesthesia, Harvard Medical School, Boston, Massachusetts

The purpose of this Web site is to provide anesthesia staff and residents with a new question and answer about an anesthesia topic every day. By visiting the site daily, they should gradually acquire a store of useful information, refresh their knowledge of basic science, and keep abreast of the latest developments.

There is a lot to recommend about the site, but I also have some problems with the way in which it has been implemented.

The questions are interesting and relevant. Each week a new topic is addressed. Questions are categorized by specialty area (e.g., obstetric anesthesia, ambulatory care, pain) and by category (e.g., equipment, pharmacology, coexisting disease). Examples include: "What is the difference between an anaphylactic and an anaphylactoid reaction?" "Describe the umbilical vessels," and "What is the EXIT procedure?" Users are advised to think about the question and attempt a response before moving to the answer page. Answers are approximately one printed page, an appropriate length to provide adequate amounts of information and a few key references without being overwhelming. They are written by board-certified full-time academic physicians on the faculty of Harvard Medical School.

The company that publishes The Answer Page is QD Enterprises (Sharon, Massachusetts). ("QD" stands for quaque die, Latin for "every day"). They have been publishing six new anesthesiology questions and answers every week since September 21, 1998. Pages devoted to neonatology, critical care, and pain management are planned for the spring of 1999.

The site is completely free, and does not require user registration. The anesthesiology section is sponsored by Vital Signs Inc., (Totawa, New Jersey) who have a large logo on most pages. This commercial intrusion is a small price to pay for a valuable resource.

There is a search utility that allows one to search by topic, by category, by date, or for specific words. There is also a syllabus, with links to the week devoted to each topic. There are plans to make continuing medical education (CME) credits available to regular users.

First, the Web may not be the best part of the Internet for this task. If the plan is to send text-based communications to a group of people every day, electronic mail is a more suitable medium, because it requires less activity by the users. For example, "A Word a Day" (http://www.wordsmith.org/awad/) sends out a new word and related information by electronic mail to 160,000 subscribers in 145 countries each day. It has a Web site, but that is used to manage subscriptions, provide an archive, and offer sound files to demonstrate the pronunciation of difficult words.

Second, I found the answers difficult to read on screen, because they are written against a mid blue background, and difficult to print, because they are in a long, narrow column, which wastes paper. I suspect that few anesthesiologists would have the time or patience to read the text on screen. It is much easier to print out the page, then read it on the subway, or during some convenient down-time during the day, and file it in case the references come in handy later. One option that some sites have adopted is a link to an "easy printing" version that contains just the text, with minimal logos or other extraneous information.

Third, the site does not make as much use of the Internet as it could. The manufacturers wisely chose to make the site compatible with older (version 2) Web browsers and to limit their use of "bells and whistles." However, their answers are almost all plain text, without even much in the way of graphics or links. I found one answer with a nice QuickTime video (Apple Computers, Inc., Cupertino, CA) of echocardiography (January 20, 1999), and another that listed emergency contacts for various organizations, including a link to the Malignant Hyperthermia Society Web page (September 23, 1998). Much more use could be made of images, multimedia, and links to provide further information. For example, references could be linked to the relevant entry in the National Library of Medicine's Entrez database. (See http://www.ncbi.nlm.nih.gov/PubMed/linking.html for details about how to do this). The site could also contain multiple-choice tests related to recent topics that would be marked instantly by the Web server.

Finally, the aesthetics of the site could use some work. The color scheme is basically black and white with a few images that look like generic clip art.

This is a good site, which might prove especially useful for academic staff searching for a new tidbit of information to dispense to their residents, or to anyone working in anesthesiology who needs to review basic principles and keep up to date. The authors may even be close to reaching their goal of producing a site that is so compelling that it gives anesthesiologists a reason to log-on to the Internet every day. Certainly, if they ever produce an electronic mail version, I would be delighted to have QD Enterprises send me a page of quality educational information about anesthesiology every day.

John Oyston, M.B., B.S., F.R.C.P.(C).

Department of Anaesthesia; Orillia Soldiers' Memorial Hospital, Orillia, Ontario, Canada L3V 2Z3; oyston@oyston.com

(Accepted for publication March 8, 1999.)

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