Abstract

Our understanding of the prevalence of mental health disorders (MHDs) in society is in the midst of a paradigm shift: where MHDs were once considered rare within a population, studies through the last decade have converged to the conclusion that they are, in fact, near universal. Consequently, the demand for mental health treatment has resulted in the training of Primary-Care Physicians (PCPs) to identify, diagnose, and treat common MHDs. As generalists, PCPs require specialised point-of-care clinical resources to educate their patients and provide them with evidence-based treatment plans; UpToDate is one such resource. As a database of synthesized peer-reviewed medical information, written and approved by physician-experts from their review of contemporary peer-reviewed literature, this resource is considered a gold standard. Here, we examine an MHD-specific investigative case study on Generalized Anxiety Disorder where the synthesized UpToDate medical information was found to be in conflict with the original studies. In this era of unrelenting bombardment of digital data, the responsibility of assessing the truth of the information falls to the consumer. While a reliance on reputable information-sharing platforms facilitates both the access and assessment of truth, we discuss the risks of unintended errors, their propagation, and the potential impact at the point-of-care.

Highlights

  • Individuals who experience mental health disorders (MHDs) have been assumed to be relatively rare within a population

  • The lifespans of ten individuals are depicted with portions of their relative lifespans highlighted to represent a period in time when they were diagnosed with an MHD

  • Let’s consider a hypothetical adult patient who has recently been diagnosed with generalized anxiety disorder (GAD) who expresses concerns about going on medication due to its side effects. Their Primary-Care Physicians (PCPs) might wish to consider alternatives to medication such as cognitive behavioral therapy (CBT) and uses UpToDate and related resources to investigate the effectiveness of CBT compared to the first line medication treatment for GAD in adults

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Summary

Introduction

Individuals who experience mental health disorders (MHDs) have been assumed to be relatively rare within a population. PCPs must be trained and provided with clinical resources enabling them to educate patients on their options as part of an evidence-based treatment plan Such resources must consolidate the myriad of peer-reviewed research to represent the state-of-the-art in medical treatment. Let’s consider a hypothetical adult patient who has recently been diagnosed with generalized anxiety disorder (GAD) who expresses concerns about going on medication due to its side effects Their PCP might wish to consider alternatives to medication such as cognitive behavioral therapy (CBT) and uses UpToDate and related resources to investigate the effectiveness of CBT compared to the first line medication treatment for GAD in adults. DynaMed cited the same systematic review as EEP, assigning a “Level 2/Mid-Level” evidence grade to the study conclusion that CBT reduces anxiety symptoms in adults with GAD. DynaMed did not directly compare pharmacotherapy and psychotherapy in its conclusions; rather, it considered them separately

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