Best Practice content

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Best Practice has been designed and built from the ground up for use specifically as a decision-support tool at the point of care. Every decision about what kind of content to include and how to organise the information was made with this guiding principle in mind, making Best Practice uniquely quick and intuitive to use.

Below we have outlined how the content of Best Practice is structured and what is included in each section

Condition monograph

The Condition monograph provides comprehensive information on a specific condition or group of conditions. It covers all aspects of the disease, including treatment, presented in the following format:

• Basic information: definition, epidemiology, aetiology, pathophysiology and classification
• Prevention: primary, secondary and screening
• Diagnosis: history and exam, risk factors, differential diagnosis, step-by-step treatment approach, diagnostic guidelines and case histories
• Treatment: detailed by patient groups with links to medication formularies; treatment approach; emerging treatments; treatment guidelines; and evidence from BMJ Group's Clinical Evidence, and for other clinical questions via brief sumamries of key trials and systematic reviews.
• Follow up: recommendations, complications and prognosis
• Resources: references, images, online resources, patient leaflets from BMJ Group's consumer health resource, Best Health.

Details on each section are as follows:

Highlights

• Summary of key highlights that present the essential facts on the condition.
• Overview listing history and exam factors, diagnostic tests and patient groups with treatment types are listed to provide a brief synopsis of diagnosis and treatment.

Basics

• Fundamental information on the topic through definition, epidemiology, aetiology, pathophysiology and classification sections.

Prevention

• Information on primary and secondary prevention, as well as population screening is provided for applicable topics.

Diagnosis

• Guiding the user through the process of diagnosis, addressing history and examination, including risk factors, and diagnostic tests, before elaborating on any possible differential diagnosis.
• Step-by-Step (diagnosis) section leading the reader through a verbal algorithm of the diagnostic approach.
• Diagnostic guidelines from international and regional organisations, with the option for institutional administrators to upload local guidelines.
• Case history describing one or two typical patient vignettes in some cases also less common presentations.

Treatment

• Treatment Details provided according to recognised patient groups and, if appropriate, tiered according to primary, secondary and tertiary treatments as well as adjunctive or add-on treatments: incorporating comments with salient information regarding the treatment type, and drug dosing detail with the option to access integrated links to online medical formularies (BNF, Martindale, ASHP) for more information on dosing, availability, formulations, side effects and contraindications
• Step-by-Step (treatment) section leading the reader through a verbal algorithm of the treatment approach, providing an overview of how to treat the condition, as well as additional information on specific treatment types or medications.
• Emerging treatments discussing interventions still undergoing trials or those that may have gained official approved but are not yet widely used in routine clinical practice
• Treatment guidelines from international and regional organisations, with the option for institutional administrators to upload local guidelines
• Summaries of the current evidence, provided via the Evidence page and, where available, throughout the treatment section in the form of evidence pop-ups that link the reader to discussion of the evidence on the Clinical Evidence website or, for other clinical questions, within key trials or systematic reviews.

Follow-up

• Recommendations for monitoring and patient instructions
• Bulleted complications section including expected timeframe and likelihood
• Prognostic information for spontaneous resolution, treated and/or untreated disease.

Resources

• Reference list highlighting key references, and providing direct links to PubMed abstracts and/or full text if available
• Thousands of images listed within the condition-specific image library and presented either as full-view inline images within the text or as image tags and pop-up images, particularly in the diagnosis section
• Online resources  including organisations providing further information on the condition, and useful diagnostic resources such as patient questionnaires or algorithms
• Patient leaflets provided by Best Health 
• Credits listing author and peer reviewer details, and any conflicts of interest.

Assessment monograph

The Assessment monograph presents information on how to evaluate a clinical problem, be it a symptom (e.g., chronic cough), clinical finding (e.g., peripheral oedema) or diagnostic test finding (e.g., metabolic acidosis). ‘Urgent considerations’ highlight conditions that need to be considered as first priority, to prevent rapid deterioration or serious complications. A ‘Step-by-step’ approach to diagnosis supports the reader with reaching a differential diagnosis, with the same content being presented in a concise, bulleted format in the ‘Differential diagnosis’ section, providing details of relevant options that are extendable for easy comparison, and allow the reader to consider a patient’s findings in light of the most likely differential diagnoses.

Asessment monographs are presented in the following format:

• Overview: summary and aetiology
• Emergencies: urgent considerations
• Diagnosis: step-by-step and differential diagnosis
• Resources: references, images, online resources, patient leaflets from Best Health and credits.

Details on each section are as follows:

Overview

• Summary  section with key information on the condition, including definition, epidemiology, pathophysiology and classification
• Aetiology section discussing the various causes for the symptom, clinical or test finding.

Emergencies

• Urgent considerations dealing with high-priority conditions that need immediate attention to prevent rapid deterioration or serious complications (i.e., "step away from the computer and go straight back to the patient or get in touch with them urgently"); may contain brief information on emergency treatment links to associated Condition monograph(s) for further treatment information

Diagnosis

• Step-by-step differential section guiding the reader through a verbal algorithm of the diagnostic approach and helping them arrive at the most probable differential diagnosis
• Differential diagnosis section listing each with extendable details on history, examination and tests for easy comparison.

Resources

• Reference list highlighting key references, and providing direct links to PubMed abstracts and/or full text if available
• Thousands of images listed within the condition-specific image library and presented either as full-view inline images within the text or as image tags and pop-up images, particularly in the diagnosis section
• Online resources  including organisations providing further information on the condition, and useful diagnostic resources such as patient questionnaires or algorithms
• Patient leaflets provided by Best Health 
• Credits listing author and peer reviewer details, and any conflicts of interest.

Overview monograph

The Overview monograph provides a general synopsis on a group of conditions (for example, Acute coronary syndrome) and also acts as a navigation hub with links to associated Condition or Assessment monographs. It provides introductory information that can include background, pathophysiology, history and evaluation. Links to the evidence from Clinical Evidence systematic reviews are provided for relevant and available topics. References, relevant images and credits (incl. conflict of interest declarations) are also presented.

Sections are as follows:

• Introduction
• Conditions
• Evidence
• References
• Images
• Credits

Drugs database

Drug content is provided via direct links to online medical formularies (BNF, Martindale, ASHP), allowing the reader to click through to more information on dosing, availability, formulations, side effects and contraindications. Users and institutions subscribing to more than drug formulary have now the option to either set a default formulary via My Best Practice, or let users decide each time they click a medication which drug formulary to access in that particular instance.

Patient education leaflets

Patients and carers will appreciate the ability to print off these user-friendly patient leaflets provided by BMJ Group’s consumer health resource Best Health. Each handout summarises information on the condition and available treatment options, supporting shared decision making between patients and healthcare professionals.

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