It is evident that Medicine is becoming increasingly complex, and doctors have to face two fundamental challenges. The first is to satisfy the needs of patients who are becoming progressively better informed, and the second, which may be even more of a challenge, is to keep up-to-date so that they can offer evidence-based medicine that is able to improve the quality of care. The medical and non-medical literature available unrestrictedly online (in Internet) means that patients are increasingly more and potentially better informed, although often unsuitably. The number of medical lawsuits due to supposedly poor praxis or negligence is growing every day, and it is risky to practice medicine without an insurance policy to cover lawsuits.1,2

It is easy to obtain medical information quickly, although this is not the case for high quality medical information. The majority of high quality journals are not open access, and this often results in a high cost for the medical community, most especially in developing countries or for doctors who do not work for institutions. Medical literature is full of poor quality information, even in high-impact peer reviewed journals. All of the above considerations, together with the lack of critical analysis of published information, do not favour high quality evidence-based medicine. Additionally, and in spite of the advantages of having large-scale studies which are usually supported by the pharmaceutical industry, many studies are biased and bear the sponsor’s hallmark. Their conclusions are not necessarily drawn from proper analysis, which even with statistically significant differences may not infrequently have a poor clinical impact and minimum importance.3,4

Medical societies in any branch of medicine have worked to keep their members permanently updated. On-line course, web sessions, annual conferences and regular re-certifications are all used as strategies with this aim. Annual conferences are a way of bringing together a good proportion of members for a few days to offer them relevant, evidence-based information, controlled clinical trials and expert opinions, among other things. These are usually selected by experts on the basis of critical analysis, with the core aim of raising the quality of medical care for the population.

We are obliged to regularly evaluate the academic content of conferences, the relevance and quality of the information that is offered together with its impact on the medical community and its eventual role in leading to better evidence-based medicine.

To evaluate the academic content of 4 Rheumatology conferences, covering their main topics and subjects, the most commonly treated diseases and the types of work presented.

The summaries published in the following journals were used as the objective sources of information: the supplements of the journal Reumatología Clínica, SE1 Vol. 12, February 2016,5 SE 1 Vol. 13 of February 2017,6 the electronic media application of the ACR/ARHP 2016 of the American Congress of Rheumatology 20167 on the works presented in the XLIV Congreso Mexicano de Reumatología (CMR 44), the XLV Congreso Mexicano de Reumatología (CMR 45) and the 2016 ACR/ARHP Annual Meeting (ACR 2016) and the electronic page of files and summaries of EULAR 2017,8 respectively; information was extracted from each work on the main pathology covered, the type of information contained and the type of work. It should be pointed out that some works covered combined pathologies or designs, so that the one which in our judgment was the most important was selected.

Working in medicine using evidence-based decisions is a challenge, as much of the medical information that is available does not meet quality standards. The workload in some institutions and doctors’ lack of interest in keeping up-to-date do not favour high level medical practice. Although permanent updating is the main goal of medical institutions, associations and societies, this task is not easy. The amount of medical information constantly generated every day is such that it easily surpasses the capacity of doctors, associations and institutions. Medical information platforms (PUBMED, EMBASE and others) are tools that make it possible for doctors to obtain information that is precise, concise and up-to-date, with the intrinsic risk that it will not be good quality information; making decisions based on this data without critical analysis would not seem to be reasonable, and it would put our clinical practice at risk.

The small number of works on diseases such as fibromyalgia, gout or osteoarthritis in comparison with RA, SLE and vasculitis stands out; The aforementioned diseases are almost equally present in the everyday practice of rheumatologists as the latter, showing a preference for mainly autoimmune pathologies over others that chiefly involve the locomotive apparatus, and which may be an important cause of morbidity and disability in economically active populations. It is therefore necessary to underline the need to include larger studies of these diseases, thereby spreading knowledge of their physiopathology, treatment and prognosis, which could improve the rheumatological medical care of this group of patients.

The predominance of works on RA in the Mexican population is understandable for several reasons: it is highly prevalent and many patients are treated by Rheumatology departments for long periods of time, patients are willing to take part in research studies, and interest in this pathology has increased due to biological therapies and small molecules. SLE as the prototype autoimmune disease is still a highly attractive pathology for rheumatologists, as its complex physio- and immunopathogenic routes, the range of clinical manifestations and in particular its high level of morbimortality all justify and explain the number of works presented in conferences.

It should be underlined that pathologies that are highly prevalent in the general population, such as gout, which is considered to be the most common inflammatory arthropathy in men over the age of 40 years old, and which increases in incidence and prevalence with age, and fibromyalgia, which is more prevalent (at from 3% to 8%) than RA, have been the subjects of very few studies in the CMR 44 (Table 1) with 4 and 2 works, respectively. Osteoporosis, which is very common and has a high rate of morbimortality, was the subject of few presentations.

The prevalence of clinical subjects stands out for presentations. This can be explained by the special interest felt by the rheumatological community in offering information on the most important clinical aspects of several nosological entities within the speciality, sharing their experience of rare manifestations of some entities or underlining clinical aspects that are relevant for Mexican patients.

To conclude, although Rheumatology conferences are a good source of evidence-based knowledge, some challenges have to be overcome; in Mexican conferences the lack of controlled studied and the poor proposal of therapeutic challenges are weakness, and to solve them the institutions will have to work together. Multicentre studies are the most viable options for rare diseases, and controlled double blind studies require the cooperation and participation of several centres and institutions to obtain results that are able to modify and improve therapeutic behaviour. Although isolated efforts against entities as complex as lupus, interstitial lung disease, vasculitis and inflammatory myopathies are laudable, they do not achieve their goals. Interest in basic studies has to be encouraged, as these may lead to better measurements of outcomes based on translational medicine. We have to be aware of the lack of more information about the other locomotive apparatus diseases, not restricting ourselves to autoimmune pathologies, given that the former represent a large percentage of our everyday practice.

The authors have no conflict of interests to declare.