My institution is switching its subscription from UptoDate to DynaMedex. I’ve used UptoDate from day 1 of residency, even 3rd and 4th year of med school, and I still use it nearly daily; I feel like I’ve basically learned medicine from UptoDate! I honestly didn’t even think there were any alternatives to it. For any question I have, I would go first and only to UptoDate.
I’m almost 10 years post-residency now, and now the institution I work for is no longer going to have an UptoDate subscription and is going to switch to DynaMedex. Wanted to hear people’s experiences with DynaMedex, particularly if anyone has switched from UptoDate to DynaMedex. Is it worth it to just purchase my own personal UptoDate subscription or am I being over-dramatic?
EDIT: Thanks everyone! UptoDate for the win. Will just get a personal subscription or find a friends or etc.
We switched to DynaMed and it was fairly mediocre, but maybe that’s because I’m so used to UpToDate. If I were an attending I’d probably just pay for it.
Dynamed is honestly crap. It’s difficult to read and even more difficult to actually find the correct workup and treatment for conditions. It also lacks any semblance of clinical nuance, which is the best part of UpToDate. It takes me like 10-30 seconds to find what I need in UpToDate when I’m using it in practice, and when I’ve tried DM I often don’t even find what I’m looking for.
My organization did a deep dive on this about 4 years ago and UpToDate was the clear winner but a fair number of people actually preferred DynaMed. Wolters Kluwer was rapidly escalating the organizational subscription price so, at our CFO’s request, we looked at DynaMed as a less expensive alternative. We brought reps in from both companies to show us how to best use each product (trying to minimize our familiarity bias towards UpToDate). Docs used each for about a month and then were surveyed.
The clear majority preferred UpToDate finding it easier to use, more readable, and giving expert guidance when clear evidence based recommendations were not available. They also thought the authors were better established experts.
There were a significant number who preferred DynaMed. Those liked it for it’s outline format which they found easier to scan and more organized. They also felt that DynaMed adhered to a more rigid evidenced based approach.
We ended up sticking with UpToDate and explained to our CFO that as a knowledge based organization high quality knowledge tools were an essential investment.
Try them both. Odds are that you will find UpToDate much better but some people like Dynamed which is a reasonable product and is cheaper.
I used both. I prefer UpToDate. It seems to provide guidance on treatment order preference as well as explanations whereas dynamed gave bullet points of everything that is acceptable treatment based on each study but it’s up to you which treatment to choose first. Dynamed was less bias but that’s because they don’t give guidance. I’ve also never been steered wrong with UpToDate.
Never could get into dynamed although I know some people like it. If you’re that used to UTD just get a subscription. You can use CME money to pay for it.
My hospital did the same thing; my colleagues and I all ended up with personal UpToDate subscriptions. As a pediatrician, I found it hard to determine if the recommendations in Dynamed were for adults or kids.
My institution provided UpToDate but I still use my CME money for a personal subscription - worth it just for the ability to access it from my cell phone in my opinion
Several years ago I attended a talk by an EBM specialist who really favored Dynamed over UpToDate (he referred to it as “least up to date”). I tried switching my personal UpToDate subscription to Dynamed for 1 year which was a bad decision - it might be more up to date (I suspect that it is no longer true) but it was impossible to find the information I was looking for.
My network uses dynamed. It’s nice because it’s to the point, and really no fluff. Still get cme for it. That being said, I prefer uptodate generally, because I want to also read more about whatever I’m looking up generally
UpToDate is free access through Iranian servers (I think, my institution doesn’t have a subscription and some colleagues have told me that they use it that way). So if you have a VPN it may be an option.
I’d advise looking that up though, just to confirm if it’s not just some random hear-say
DynaMed can be more to the point in my opinion, but I prefer having both. Sometimes if you take students you can get a subscriptions provided by the universities.
I was on a team that got to trial dynamedex as a potential replacement for UptoDate/Lexicomp for our system… It was unanimous that it was no where close, and we gave the Dynamedex folks a lot of feedback, which was essentially, “be more like uptodate”. Despite our input, our system went with Dynamedex anyway
Make a friend in the military and send them your username and password to login from the DoD network. Will extend your subscription by six months or whatever.
I use dynamed for labs/care that has an obvious next step based on guidelines that im not 100% on. Or even if i know, to make sure im not missing anything.
Labs are the most obvious.
Eg elevated bili, low ca, high k
etc.
it gives flow charts to ensure i dont miss other testing differential.
To me its the equivalent of “the next best step”
I eventually see a chatgpt entrainment w dynamed eventually being incorporated into epic
Uptodate is for synthesis of medicine that involves complex synthesis of imaging labs physical exam and hx to arrive at a reasonable next step.
One is for complex situations
The other for diagnosis that have obvious definitions/cutoffs. Labs etc
