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Audiovisual presentations in peer-reviewed medical literature

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Audiovisual presentations in peer-reviewed medical literature
Arthur Huntley MD, Stephen L Comite MD, and Kevin C Smith MD
Dermatology Online Journal 10 (2): 22

For decades peer-reviewed journals in the medical literature have provided the opportunity to describe innovative studies and progressive techniques via written articles that supplement the text with still photographs and diagrams. Using a paper medium, unfortunately, has always had the disadvantage of high expense for publishing images, especially in color. For dermatology, the effects were to limit illustrations and photos, particularly those using color; frequently, this underserved the educational needs of a specialty that uses visual presentation and subtle variations in color to make diagnoses.

Dermatology Online Journal was created 9 years ago in an effort to take advantage of the unique aspects of electronic communication; the use of color illustrations accompanying text did not have to be limited by cost of publication. However, at the time of the first issues, digital images were available only by scanning analog images, the only images that could be used on the Web were in Compuserve.GIF compression format; the color palette was limited, the quality of the images sometimes suffered from over-compression, and the image file sizes were relatively large. File size was definitely an issue in an era when the few physicians who had Internet access outside a university or military facility were connected through a modem providing only limited bandwidth. Even with these limitations, it was clear that the Internet would eventually prove far better than paper as a medium for sharing visual medical information.

In the current issue, the article "Vibration anesthesia: A noninvasive method of reducing discomfort prior to dermatologic procedures"[1] uses movies in addition to still images to demonstrate medical technique. It may be one of the first instances of refereed supplemental audiovisual material in a peer-reviewed medical journal. These video clips complement and supplement the understanding of the written portion, and we hope they aid in understanding of these innovative techniques and help to improve patient care. This new format seems worthy of an open dialogue regarding the advantages, opportunities, perils and conflicts inherent in this new form of technology.

Audiovisual demonstration would seem to be a superior method of demonstrating many techniques, from the laboratory to clinical practice. Bandwidth has improved substantially, the majority of physicians in the United States have excellent Internet access, digital images are now common, and the available file formats for supplementing text now include movies and sound in addition to better compression algorithms for medical images. Publishing and accessing relevant techniques via audiovisual presentations in a peer-reviewed open-access journal may be the best way of sharing such information with the medical community.


1. Kevin C Smith, Stephen L Comite, Suprina Balasubramania, Alan Carver, and Judy F Liu. Vibration anesthesia: A noninvasive method of reducing discomfort prior to dermatologic procedures. Dermatol Online J. 2004 Oct;10(2):1.

© 2004 Dermatology Online Journal