It is claimed that 50% of North American pulmonologists subscribe to UpToDate. I have no idea whether this is true or not but most of the pulmonologists I know do have access to UpToDate either via personal subscription or through their institution.

One of the features of UpToDate is that there is a handheld version of the software, currently only available for Windows Mobile devices, which I have reviewed previously. As a reminder, it is free to anyone requesting it with an UpToDate subscription. A number of changes have been made which makes it reasonable to provide a description of the changes.

The first change is that it is now possible to include the figures and images in the handheld version. This requires more than 1 Gigabyte so you need a 2 Gigabyte (or larger) storage card. The prices have continued to drop and a 2 GB card can be purchased for less than $100. With the larger storage card, the entire contents can be installed which actually only requires about 1.1 GBytes so there is plenty of room left over. Clicking on a link to a table provides a display similar to that shown on the left below. Clicking on a link to an image provides a display similar to that shown on the right below.

Under menu, there is a setting to display the table or image in a magnified format as shown below. Only the two sizes shown are available.

A number of other changes have occurred. These apply to both the regular version of UpToDate as well as the PDA version. The first is that there is now a new section in the table of contents to display what is new in this version. This is shown on the left below. It has subsections for various specialties as shown on the right below.

Clicking on “What’s new in pulmonary and critical care medicine” brings up the information shown below for version 14.1 of UpToDate.

The other change is that UpToDate is planning to include the level of evidence for recommendations. These will be appearing as the topics are updated and a number have already had this change made starting in version 14.1. An example is shown below taken from the management of non-small cell lung cancer. Clicking on the Grade link brings up a table with a description of the grade listed as well as a description of the grading system which is a modification of the GRADE system originally described in the British Medical Journal in 2004. Full information as well as the complete reference is available in the help section for UpToDate. They note that only a few of the current articles have been updated as of this version.

If you are running Windows Mobile 5 on your Pocket PC, you may need a special update that fixes a problem with the system UpToDate uses for their PDA version. They sent it to me on a CD and, once I installed it, I have had no problems even through the recent upgrade.

For PalmOS users, the PalmOS version of UpToDate has made it through beta testing and should be available later this year.