Another letter to the editor of the British Medical Journal proposes a peer-reviewed, not-for-profit, global medical knowledge database.

Realistically it is practical for a clinician to question, search, select, acquire the paper(s) and appraise them, and act only three or four

times a year. Importantly, the knowledge acquired remains inaccessible to any other professional. If we could share these appraisals on a

web based (and CD Rom) database we could avoid a massive duplication of effort. We could also make access to the knowledge much

faster.

The global medical knowledge database will match each clinical query as closely as possible with both answered and unanswered

questions. If there is an answer the software will display it automatically, in the form of a critically appraised topic. If the question is

unanswered the doctor will be able to see whether someone is trying to answer it (and could offer to help). If the question is not on the

database then the doctor will be prompted to post it.

I know that I, in the course of my medical practice, do several dozen literature searches a year to answer clinical dilemmas I face. The gathered citations remain on a hard drive of a machine at the hospital, and my synthesis and conclusions remain in my head. Occasionally I summarize them for a small community of medical peers on a mailing list in my subspecialty. But, I agree, it would be powerful and not that much extra work for each of us to make the results of these queries accessible to one another worldwide.