Will OpenEvidence Make UpToDate Obsolete?
Recently, extreme opinions have been appearing here and there suggesting that if you have OpenEvidence, you no longer need UpToDate. Is that really the case? In this article, I would like to share my thoughts on these two services.
ChatGPT was announced by OpenAI in 2022. Since then, AI has rapidly permeated our lives. For us doctors, who deal specifically with knowledge, AI has a high affinity, and more and more of us are using it in our daily practice.
■ OpenEvidence and UpToDate
In the medical world, where information is updated day by day, how you acquire information is a major weapon.
UpToDate is a medical textbook service that can be accessed over the internet. Medical information in every field is written based on reviews by experts in those fields. Its greatest feature is that information is updated daily online. It used to be said that even when the latest English textbooks were released, by the time they were translated into Japanese, the information was 10 years out of date. Compared to the days when we obtained information from paper-based textbooks, it has become significantly more convenient. UpToDate was revolutionary as a textbook that allowed access to the newest information possible.
And now, we are in the golden age of AI. Even with the flood of medical information, we can now reach answers instantly with AI. A prime example of this is OpenEvidence. OpenEvidence is a groundbreaking service that presents the information you want to know, primarily from major journals, along with evidence. You don't even need to search for what you want to know yourself. You just ask, and some kind of answer is returned.
On the internet, because of the convenience of OpenEvidence, voices are even starting to be heard saying that UpToDate is no longer necessary.
■ Laser Beams and Flashlights
OpenEvidence is certainly convenient. It answers what you ask immediately. However, it only answers what you literally "ask." The information that OpenEvidence points to is, so to speak, information in a very narrow range illuminated by a laser beam—in other words, a "point."
On the other hand, with UpToDate, you have to read through it yourself. Even if you have a rough idea of the field, you don't necessarily just see the information you want; you also see peripheral information, and eventually, you arrive at the information you were looking for. Sometimes, it becomes necessary to make comprehensive judgments based on that peripheral information. In other words, where UpToDate shines is on the peripheral information you have vaguely targeted. It is like a flashlight, illuminating a "surface."
Laser beams and flashlights have completely different roles, and neither can be a substitute for the other. When you want to extract only the information you want to know as quickly as possible, the sharp light of a laser beam is good. On the other hand, it is the soft light of a flashlight that brings you unexpected information, making you think, "I didn't know that was a possibility."
■ Are you getting the "fish" or the "way to fish"?
I once asked a student a medical question. The student proudly entered my question into ChatGPT or Gemini and read the answer to me. Now, what did the student learn from this?
Medicine is an information war. Information does not exert much power if it is just a "point." It demonstrates its true value when you understand the interrelationships and background. The reason we study past exam questions when studying for tests as students is to learn the background knowledge and build a foundation to derive answers. It is not to memorize the answers by rote.
In other words, in the learning phase of cultivating the soil of knowledge, the work of "searching" with your own eyes and "connecting" knowledge is still necessary. That leads to "understanding" and exerts power when the time comes.
In my initial question to the student, was I looking for medical information? Of course not. I wanted them to learn the "way to fish"—how to reach that information. The student just acted as an intermediary between the AI and me to get uncertain information, and the learning was significantly diluted.
On the other hand, in situations where you want the "fish" right now, AI is a powerful partner. In areas you are already well-versed in, or in situations other than learning where you require speed, fishing for answers with AI is extremely effective.
■ The downside of knowing only what you want to know
There is another downside to fishing for information with AI. If you only search for what you want to know, there will be bias. That is exactly where self-study is inferior to systematic, formal education. I believe that opportunities for systematic learning have a significant "leveling" effect, smoothing out biases and helping you acquire universal knowledge.
If you keep asking AI only what you want to know, there is a risk that your knowledge will become biased. The starting line for AI begins with the user's own inquiry. If you make an arbitrary inquiry at this point, the AI will create an answer that follows it. Furthermore, users may adopt only the parts of the AI's concise answer that are convenient for them, and as a result, their judgment may be significantly distorted. This is fatal in medical judgment. Even more frighteningly, it is difficult to notice this yourself.
I don't want to be misunderstood; there is nothing wrong with using AI. Like medicine, if you don't follow the prescribed usage and dosage, you will experience side effects.
■ A Prescription for Information Tools
Here, let's look at the usage and dosage for instant-answer tools like OpenEvidence and systematic tools like UpToDate.
“What was the dosage for that antibiotic again?”
“Is it okay to use XX for this treatment these days?”
These are questions you suddenly encounter in daily practice. In such cases, the laser beam of OpenEvidence is likely powerful. It tells you exactly what you want to know, right at the center of your query.
“What is the underlying cause of this condition?”
“Is there a link between this disease and these symptoms?”
When exploring such 'background understanding,' it is better to use a flashlight like UpToDate to illuminate the surroundings. In learning the background, you may encounter unexpected information and relationships.
■ Conclusion
We live in an era of information overload. From now on, the key will not just be the information itself, but how well you can handle the 'tools' used to manage that information. Keep the laser beam at hand for when you really need it, and use the flashlight to illuminate your path for your daily walk. Only doctors who know how to use their tools will be able to avoid drowning in the flood of information.