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A clinical conundrum that rheumatologists often face is making a diagnostic or therapeutic decision in the absence of evidence-based data to guide clinical decision making. MedNet is a digital community of physicians created to improve knowledge sharing among physicians and help ensure patients get the highest quality care. The goal of the platform, according to the MedNet website (themednet.org), is to “help physicians get answers to questions where there is no clear answer in guidelines or published research and expert opinion is necessary.” Answers on the website are indexed and searchable.
The platform was originally developed and co-founded by siblings Nadine Housri, MD, and Samir Housri, and launched in the field of oncology in 2014. As the inaugural rheumatology deputy editor, Sarah Fantus, MD, assistant professor of medicine and rheumatology, and associate program director at Northwestern University Feinberg School of Medicine, Chicago, launched the rheumatology subsection of MedNet in 2020.
Dr. Fantus explains the original idea was conceived after Nadine and Samir’s father was being treated for cancer but did not have access to experts to help answer advanced questions for his care. As a radiation oncology trainee, Dr. Housri accessed her personal network and sought experts to answer questions about her father’s care. The idea was born to increase access to national experts who do research and are subspecialists in niche fields and help improve the care of patients nationwide.
Expanding MedNet to Rheumatology
Dr. Fantus
After success in the areas of hematology and oncology, Dr. Fantus says rheumatology was the first field they expanded to. “Rheumatology is a specialty where many of our decisions are based on clinical experience and expert opinion because we do not have an excellent evidence base to guide us for a lot of the conditions we treat. This is a great way to disseminate expert opinion more widely and encourage discussion and debate on issues we encounter every day in the clinic.”
With biologics and other new drug approvals released every few months, treatments often rapidly outpace guidelines. This type of platform offers a unique avenue to share cutting-edge research and find consensus on tough clinical questions.
What Is MedNet?
Figure 1: MedNet Question & Responses
MedNet is a question-and-answer platform available as a physician-only site. Registration is required, and an individual’s identity as a practicing physician is confirmed before they can ask a question on the platform, Dr. Fantus explains. The question is sent to a team of physician editors who ensure no patient-specific information is revealed, and then they send the questions to specific experts who answer by posting a response on the site.
“We often acknowledge that there is more than one answer to a question,” notes Dr. Fantus. Having multiple experts answer the same question is encouraged to provide perspective. “The questions and answers are searchable, so people can have access [long] after they are posted and answered.”
As of March 2022, the rheumatology community had grown to 1,375 physician members, and more than 170 practicing rheumatologists or rheumatology fellows had asked a question; 367 rheumatology questions have been answered on the site, with more than 58,000 total views.
An example of a popular question on the rheumatology MedNet platform is: “What is your initial treatment of choice in patients with RA and associated interstitial lung disease?” The question and response, plus other MedNet user comments, can be viewed after registering. See an excerpt of the response in Figure 1.
