Abstract
The Arbor Clinical Nutrition Updates (ACNU) is a weekly electronic nutrition journal for health professionals. Each issue summarises several recent clinical research papers appearing in the general medical and nutrition literature and which deal with a common nutrition topic. A commentary is added on how this research fits in with previous work, and what it all means for the practising clinician. ACNU is the world's most widely read electronic nutrition publication, with over 100 000 largely health-professional readers in 186 countries. It is published in nine languages and distributed by email without charge in both plain text and Acrobat formats. ACNU utilises a number of the Internet's unique characteristics to facilitate broad reach, currency and active reader feedback. This, together with its brevity and summarising format, helps to maintain its relevance to the nutrition education needs of health professionals, particularly those in clinical practice, and to overcome the factors most commonly reported by health professionals as obstacles to their greater adoption of evidence-based medicine. ACNU is intended to be a collaboration with the primary research journals to extend the reach of new nutrition research findings to a wider community of researchers, academics and clinicians than each journal might otherwise reach individually. As such, ACNU utilises the Internet to promote the goals of open-access publishing and evidence-based medicine.
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Summerbell: I am interested in the interface between those people who read and those people who are publishing. I do know the editor of the Journal on Human Nutrition and Dietetics; that journal is read by every dietician in the UK. Because you get it free as part of your professional subscription. And unlike something that comes through on e-mail, you have it there and you cannot delete it as such. It is lying around and you are much more likely to read it. I also take your point about the GPs, that most of them do not read the research journals. So I wondered if in terms of creating better access to something as good as this particular publication, whether or not you could insert this publication into the hard copy of some other journals. For instance in the JHMD, we pay the dieticians to review the literature, and then that gets published in each edition of the journal.
Helman: I think it is fascinating, because people get swamped with stuff. But it is a two way thing. The advantage of hard copy journals is as you say that they are not easy to delete. The advantage of an e-mail document is that you cannot really flip through it; you have read it from top to bottom. And it does allow for greater selectivity. I think what we have going for us is a lot of credibility. We have done a lot of surveys, and unlike commercial stuff we have an extraordinarily high level of credibility. Credibility for a journal is very hard to earn and very easy to throw away. So we are very careful. I think your suggestion could work; we already do it with the East African Journal of Nutrition. We are in an active collaboration with journals such as AJCN and BJN; we could expand that collaboration.
Lodge: The question of evidence, Cochrane has been kicking around for some time. We said that evidence is one of the partners around the table now. The other partners are the needs, the priorities, and the resources. Historically, when we started looking at evidence, three corners of the table were already fixed. The needs were always pressing, priorities were fixed, resources were scarce. It was the evidence that was flopping; you did know where it was. Many of the settings that you are actually talking about, like the third world, you cannot do anything about, or even know about their needs, resources, policies and priorities. But at least you are providing that general service. Getting the evidence there is possibly as far as you can go in practical terms.
Van Woerkum: Do you include also discussions and controversies between scientists in your updates? And invitations to think about problems, to make your own mind up?
Helman: We certainly do. Quite often. We present two sides of a problem, and then come up with the conclusion that we do not really know yet, and that we need more clinical trials. What we have not yet done so far, as they do in some journals, is to ask commentaries for opposing views; this would probably be a fascinating thing to do.
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Helman, A. Arbor Clinical Nutrition Updates: evidence-based clinical nutrition education using the Internet. Eur J Clin Nutr 59 (Suppl 1), S117–S121 (2005). https://doi.org/10.1038/sj.ejcn.1602184
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DOI: https://doi.org/10.1038/sj.ejcn.1602184
