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Managing Information Overload Managing Information Overload: Evolution of CHEST: The Evolution of CHEST FREE TO VIEW

Nicki Augustyn; Stephen J. Welch; Richard S. Irwin, MD, Master FCCP
Author and Funding Information

From the Editorial Office of CHEST.

Correspondence to: Nicki Augustyn, American College of Chest Physicians, 3300 Dundee Rd, Northbrook, IL 60062; e-mail: naugustyn@chestnet.org

Financial/nonfinancial disclosures: The authors have reported to CHEST the following potential conflicts of interest: Ms Augustyn and Mr Welch are full-time employees of the American College of Chest Physicians in their roles of Director, Publications and Senior Vice President, Communications/Executive Editor, respectively. Dr Irwin is Editor in Chief of the Journal and a portion of his salary comes from the College as a stipend.


Financial/nonfinancial disclosures: The authors have reported to CHEST the following potential conflicts of interest: Ms Augustyn and Mr Welch are full-time employees of the American College of Chest Physicians in their roles of Director, Publications and Senior Vice President, Communications/Executive Editor, respectively. Dr Irwin is Editor in Chief of the Journal and a portion of his salary comes from the College as a stipend.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2012;142(1):1-5. doi:10.1378/chest.12-1364
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In 2005, when Richard S. Irwin, MD, Master FCCP took the reins as CHEST Editor in Chief, he wrote an editorial about his goals in taking on the stewardship of the journal.1 We followed up in early 2006 with another editorial that described changes we were instituting to help CHEST continue its evolution as a clinically useful and relevant journal.2 Fast forward to 2010, Dr Irwin described the “Journal of the Future” that would include not only the cutting-edge clinical research our readers have come to expect, but also editorial cartoons and – gasp! – a poetry section to highlight the humanism of medicine.3

As Dr Irwin and the CHEST team regularly update readers in January of each year,4,5 changes, successes, and technological and online advances have been heralded. Now, midway through 2012, we are updating our readers about significant technological advancements we believe will be of great use to our readers who rely on CHEST to provide them with up-to-date, clinically relevant research, education, and multimedia content.

On July 10 of this year, CHEST, in partnership with Silverchair Information Systems, will launch on a redesigned online platform. Our goal? To help you, the reader, better manage, search, and discover relevant content despite the deluge of information that is hitting your inbox, browser, smartphone, and mobile tablet devices every minute of every day.

In 1893, 103 years after the publication of the first medical journal, the International Statistical Institute adopted a classification system known as the International List of Causes of Death.6 As the title suggests, the goal of the list was to categorize causes of death into general diseases and those originating within a particular organ or site. It included 44 distinct classifications. That document later evolved into the International Classification of Diseases. The ninth revision,7 published in 1978, contained 14,000 codes representing specific disease entities or variations of them. The current version of the 2010 10th revision8 contains 68,000 such codes. We detect a trend, and we bet that you do, too.

In March 1935, the first issue of CHEST, then called Diseases of the Chest, was published. The goal articulated by the first Editor in Chief, C. M. Hendricks, MD, was that “this journal will take its place as a leading factor in the fight against tuberculosis.”9 The Journal was founded quite literally in an attempt to halt the spread of a single disease entity.

Today, we doubt that any reader of CHEST has the luxury of maintaining such a singular focus. Certainly, the Journal itself has shifted from its original focus on tuberculosis to cover an enormous range of diverse topics facing health-care providers working in the space we term “chest medicine,” which encompasses the pillars of pulmonary, critical care, and sleep medicine, and the interactions among them, but which, at the same time, can include no less than a 360-degree understanding of the patients served. To date, CHEST has published more than 48,000 articles since 1935 to aide the community in understanding the diagnosis and management of those very patients, the prevention of disease, and the education of those who will serve the patient populations of the future.

The expanded focus of CHEST, like the increase in the number of disease classifications, is merely a reflection of the growth in the field of medicine, our scientific knowledge, and the demands placed on individual health-care providers. Over the last few years, we have tried to arm our readers for this new world through the publication of new series that address particular needs: Ahead of the Curve,10 Topics in Practice Management, Patient Safety Forum, Translating Basic Research Into Clinical Practice,2 and more.

In short, CHEST responded by adding more information. What we have failed to do is add new hours to the day to provide our readers time to absorb all this information. What our recent readership survey data told us is that our readers don’t necessarily need MORE information, they need MORE RELEVANT information. Therefore, to address this request, we have focused on developing efficiencies in the way we store, identify, display, and deliver the information and articles published in CHEST.

The new CHEST home page (Fig 1) features highlighted articles from each issue and immediate access to the podcasts, as well as covering medicine-related societal issues with a bit of comic relief provided by the monthly Second Opinion editorial cartoon. The home page will be updated regularly with announcements and the latest news from the American College of Chest Physicians’ Twitter feed (our new design embraces social media tools that provide convenient ways to share, parse, and curate content). Site-wide navigation has been expanded to allow easy access to important areas, such as Guidelines, Meeting Abstracts, and Online First articles (previously known as Papers in Press), from any page on the site. Search is available from any page in CHEST and can be expanded to include results from the popular Board Review Book series. More than just being available, the new search function is better, using a robust, easy-to-understand medical taxonomy to present you with relevant search results in context.

We have also organized CHEST content in new ways that will allow readers quicker access to the content that is most relevant to them. Topic Collections feature articles in categories such as COPD, critical care, pulmonary function testing, and sleep disorders. Selecting the category of interest allows you to view the most recently published content in that subject area (Fig 2). Further, you need not go to the CHEST site to see what’s new—e-mail alerts and RSS feeds are available for all Topic Collections. In addition to the topics, we will continue to offer Special Series Collections, with the same alert functions, so that you know the moment a new article is published (eg, in Ahead of the Curve, Topics in Practice Management, or Translating Basic Research Into Clinical Practice).

While we haven’t yet mastered the art of mindreading, the new technology backbone of the CHEST site tags content using a 60,000-word medical taxonomy that allows for recommended content to be displayed alongside an article or abstract giving you the opportunity to dive deeper into the literature. We will allow easy access to not only related articles from CHEST and the ACCP Board Review Books, but also from PubMed and the National Guideline Clearinghouse. The relevant Topic and Special Section Collection categories will also be displayed, allowing you to browse similar articles from a broader perspective. Overall, the recommendations aim to bring that seeming intuition and ease of purchase mastered by Amazon.com to the experience of finding the latest clinical information you (and your patients) need when you need it.

Figure Jump LinkFigure 3. CHEST app. A, Table of contents and article view on iPad. B, Figure-viewer screen on iPad. Grahic Jump Location

Medicine has been mobile long before the release of the first smartphone or tablet. Physicians go where the patients are—at the bedside, in the clinic—and we think clinical information should, as well. CHEST has been mobile since late 2010, when we first released the CHEST Journal app for iPad, iPhone, and iPod touch, and with the release of the new Journal site, we are releasing a new and improved app as well (Fig 3-4). The design has not been changed significantly yet (watch for a new look later this year), but we have added access to a full 77 years of CHEST content. While the original app included access to only the three most recent issues of CHEST, the new app includes the entire CHEST archive, fully accessible by browsing or search. Guidelines are accessible from a distinct button. You will also find that monthly CHEST podcasts can be played directly from the app, enabling hands-free multitasking for when there is time only to listen, not look. Much of the best functionality from the original app has been retained, including the ability to save your favorite articles and your viewing history, share articles with colleagues via e-mail, view images in a special figure viewer, type notes or record audio notes, and more.

Of course, CHEST is not just for Apple device users. The entire site is mobile-optimized meaning that you can view a streamlined version of the site from the browser on any web-enabled mobile device or smartphone (Fig 5). In addition to full search capabilities and browsing Online First articles and the current issue, you can browse Topic Collections, Special Section Collections, and all the other areas of the site—nothing is left out. Even the recommendations for further reading in CHEST, PubMed, and other sources are included at the end of the article and search results.

Figure Jump LinkFigure 5. CHEST Mobile Site. A, Homepage. B, Collections page. Grahic Jump Location

We are willing to bet that at no point in the foreseeable future will the amount of available information decrease. The coming days, months, and years will certainly bring the discovery of new disease states to be cataloged and new aspects to this specialty we call chest medicine to be elucidated. We happen to think this is a good thing. At the same time, we understand that the pace of the flow of new information doesn’t always feel like a good thing. Every health-care provider we speak to is suffering from information overload. We believe that the changes we have made will help you cut through the white noise and to zero in on what is most meaningful to you in the moment, wherever you might be. We want to serve both the need for quick answers and deep reading and everything in between.

Our editorial promise is to identify and publish the most relevant information that is of interest to our readers. We hope the new technology infrastructure better serves to connect that information to you and those who need it. We are confident that the changes we have made so far will permit us to be doubly nimble in responding to your evolving needs. We ask only that you keep sharing with us what we can do to best meet your needs.

Other contributions: The authors would like to acknowledge the input and invaluable support of the following individuals in the drafting of this editorial as well as the execution of the initiatives described therein: Cynthia T. French, MS, ANP-BC; Jean Rice; and Vicki Tedeschi.

Irwin RS. The editorial stewardship of CHEST changes hands. Chest. 2005;128(1):1-3.. [CrossRef]
 
Irwin RS. The new “face” of CHEST heralds a new era. Chest. 2006;129(1):1-3.
 
Irwin RS. Becoming the journal of the future. Chest. 2008;133(1):1-4.
 
Irwin RS, Augustyn N Editorial Leadership Team Editorial Leadership Team. The journal and 2011: a time for stocktaking. Chest. 2011;139(1):2-5.. [PubMed]
 
Irwin RS, Augustyn N, French CT, Rice J, Welch SJ Editorial Leadership Team Editorial Leadership Team. Spread the word about the Journal in 2012: from impact factor to plagiarism and image falsification detection software. Chest. 2012;141(1):1-4.
 
World Health OrganizationWorld Health Organization. History of the development of the ICD. World Health Organization website.http://www.who.int/classifications/icd/en/HistoryOfICD.pdf. Accessed April 29, 2012.
 
World Health OrganizationWorld Health Organization. International Classification of Diseases, Ninth Revision. Geneva, Switzerland: World Health Organization; 1978.
 
World Health OrganizationWorld Health Organization. International Classification of Diseases, Tenth Revision.Geneva, Switzerland: World Health Organization; 2010.http://apps.who.int/classifications/icd10/browse/2010/en. Accessed May 13, 2012.
 
Hendricks CM. Foreword. Dis Chest. 1935;1(1):3.
 
Moss J. Ahead of the curve. Chest. 2011;140(2):275-276.
 

Figures

Figure Jump LinkFigure 3. CHEST app. A, Table of contents and article view on iPad. B, Figure-viewer screen on iPad. Grahic Jump Location
Figure Jump LinkFigure 5. CHEST Mobile Site. A, Homepage. B, Collections page. Grahic Jump Location

Tables

References

Irwin RS. The editorial stewardship of CHEST changes hands. Chest. 2005;128(1):1-3.. [CrossRef]
 
Irwin RS. The new “face” of CHEST heralds a new era. Chest. 2006;129(1):1-3.
 
Irwin RS. Becoming the journal of the future. Chest. 2008;133(1):1-4.
 
Irwin RS, Augustyn N Editorial Leadership Team Editorial Leadership Team. The journal and 2011: a time for stocktaking. Chest. 2011;139(1):2-5.. [PubMed]
 
Irwin RS, Augustyn N, French CT, Rice J, Welch SJ Editorial Leadership Team Editorial Leadership Team. Spread the word about the Journal in 2012: from impact factor to plagiarism and image falsification detection software. Chest. 2012;141(1):1-4.
 
World Health OrganizationWorld Health Organization. History of the development of the ICD. World Health Organization website.http://www.who.int/classifications/icd/en/HistoryOfICD.pdf. Accessed April 29, 2012.
 
World Health OrganizationWorld Health Organization. International Classification of Diseases, Ninth Revision. Geneva, Switzerland: World Health Organization; 1978.
 
World Health OrganizationWorld Health Organization. International Classification of Diseases, Tenth Revision.Geneva, Switzerland: World Health Organization; 2010.http://apps.who.int/classifications/icd10/browse/2010/en. Accessed May 13, 2012.
 
Hendricks CM. Foreword. Dis Chest. 1935;1(1):3.
 
Moss J. Ahead of the curve. Chest. 2011;140(2):275-276.
 
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