Generalists in medicine, particularly those in rural family practice, have to be able to cope with uncertainty. Because we do not have an exhaustive mastery of every topic in medicine, we must develop tools to help us when information is required urgently at point of care. Although computerized access to knowledge has improved information retrieval significantly, this knowledge is not always immediately available, nor is it always organized for instant access. Programs such as UpToDate® are beginning to appear, which improve speed of knowledge transfer with extensive hyperlinks, but, because the topics are covered very completely, they tend to be more difficult to navigate. The PDA has the potential to be a rapid and appropriate source of information if we take care to select and present our information carefully.
Over time I have developed a number of different formats unique to my areas of ignorance. I tend to research topics using a problem oriented approach. Some are checklists such as the Canadian CT Head Rules. Some are guidelines such as the B.C. Guidelines for Screening for Colorectal Cancer. Some are outlines of common disorders which I can never seem to include in my differential diagnosis such as Hemochromatosis and Celiac Disease. There are other common problems which I manage poorly and for me need constant organization such as Falls in the Elderly,The Febrile Child and Dizziness. Some are uncommon diagnoses which I have to be reminded of frequently such as Posterior Infarction and the 15-lead ECG. I still can’t do Procedural Sedation without looking it up every time. The topics reflect some of my unique deficiencies and, I suppose, some of my efforts to improve.
Levels of evidence are worth considering. It is desirable to have referenced a systematic review on a topic if one is available, however this is rarely the case. Lesser levels of evidence such as consensus or expert opinion are easier to obtain, and are the substance of most guidelines, even today. Higher levels of evidence rarely pertain to the isolated or rural practice, however, and there is a distinct place for individual opinion and integration which may lend a more pragmatic approach to a given topic. The material you choose to incorporate may reflect a range of personal integration ranging from raw data (glucose levels for various classes of glucose intolerance) to information (material obtained from others without much verification of accuracy) to knowledge (material which you have researched, internalized , and which reflects your world) to wisdom (material which you have connected to everything else in your universe and which others feel you need to share).
You are invited to review some of these topics, which have been accumulated and revised over decades of full-service rural family practice. The information is not extensively referenced, and you must draw your own conclusions as to levels of evidence and as to my level sophistication in selection and integration of the material. You are free to download the topics you choose and to make them your own by editing, augmenting and massaging the information so that it suits your purposes uniquely. If you find that you have done a particularly brilliant job of revision, or if, indeed, you have done a topic of your own which you wish to share, please consider submission to this site. The author reserves the editorial privilege of deciding what material will appear on these pages. Bear in mind that, once on the web, there is no hope that this material will remain your intellectual property.
Individual topic files for the Palm Pilot® can be downloaded as .pdb files from the page describing that particular topic. The appropriate web files for that topic are also available in .zip format for downloading from the same location. These can be used for viewing in a web browser or loaded into another document reader capable of using hyperlinks for use in Pocket PC® format. Care must be taken to keep these zipped files in the same directory so that your browser will know where to find them. iSilo is now available for the Pocket PC®, and this text reader is highly recommended.