knowledge path Mosl how to search for medical information - methods (out of date under revision)

How to Search for Medical Information

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Presented for the Rhode Island Reference Round Table on January 29, 1998 as Medical Information for the Layperson in cooperation with the Rhode Island Office of Library and Information Services by Frank Kellerman -Brown University, Mary Zammarelli - St. Joseph Hospital, and Robert Balliot
Last update -  4 September 2001

Abstract

Changes in the ways that medical information is stored, accessed, and retrieved have created a wealth of health care information from which the consumer may choose. Librarians can play a critical role in supplying timely, accurate, and relevant medical information to health care consumers by understanding the print and electronic resources now available to aid their research. This presentation is meant to advance the ability of librarians to serve the health care information needs of the layperson.
 
 

Part 1 Orientation to the Web Environment
Part 2 Specific Diseases, Drugs, and Treatments
Part 3 Medical Statistics, Medicine in the News, and Doctors' Credentials
Bibliography

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Part 1 - Orientation to the Web Environment

Research Process

Medical questions from library patrons can cover a wide variety of topics. Changes brought about by access to digital information can allow those topics to be explored in great detail. Some typical approaches to medical information sources specific to Rhode Island libraries are explored here.

1. Because of the highly specialized language of medical questions, it is important to use reputable dictionaries and guides to affirm the spelling and nature of a medical query. There are a number of good dictionaries and guides that are available for this purpose in most small libraries. Included are the Merck Manual and Current Medical Diagnosis and Treatment. The Merck Manual is available as an on-line resource at http://www.merck.com/.

2. The next step should be to consult the catalog utility to find reputable print resources, which may be located in the library holdings. Three main methods of classifying medical resources are Dewey Decimal (used by many public libraries), Library of Congress Classification Schedule (used by public, hospital, and academic libraries), and the National Library of Medicine Schedule (used by the NLM and hospital libraries).

 

 

Major Medical Classification Schedules

    Dewey Decimal

    • 610 Medical encyclopedias, dictionaries, directories, careers
    • 611-612 Anatomy & physiology
    • 613 Environment, diet, hygiene, fitness
    • 615 Pharmacology & drugs
    • 616 Specific diseases
    • 617  Surgery
    • 618  Pregnancy & childbirth, other branches of medicine
    • 619  Experimental medicine

    Medical careers:

    • 331.702   Encyclopedias of careers & study guides for licensing examinations
    • 374.8  Directories of medical schools
    • 610.69  Books describing specific medical careers.

 

    Library of Congress

    • R Medicine
    • R Medicine (general)
    • RA Public aspects of medicine
    • RB Pathology
    • RC Internal medicine
    • RD Surgery
    • RE Ophthalmology
    • RF Otorhinolaryngology
    • RG Gynecology and obstetrics
    • RJ Pediatrics
    • RK Dentistry
    • RL Dermatology
    • RM Therapeutics; pharmacology
    • RS Pharmacy and materia medica
    • RT Nursing
    • RV Botanic, Thomsonian, and eclectic medicine
    • RX Homeopathy
    • RZ Other systems of medicine

National Library of Medicine

Preclinical Sciences:

    • QS Human Anatomy
    • QT Physiology
    • QU Biochemistry
    • QV Pharmacology
    • QW Microbiology and Immunology
    • QX Parasitology
    • QY Clinical Pathology
    • QZ Pathology

Medicine and Related Subjects:

    • W Health Professions
    • WA Public Health
    • WB Practice of Medicine
    • WC Communicable Diseases
    • WD 100 Nutrition Disorders
    • WD 200 Metabolic Diseases
    • WD 300 Immunologic and Collagen Diseases. Hypersensitivity
    • WD 400 Animal Poisons
    • WD 500 Plant Poisons
    • WD 600 Diseases and Injuries Caused by Physical Agents
    • WD 700 Aviation and Space Medicine
    • WE Musculoskeletal System
    • WF Respiratory System
    • WG Cardiovascular System
    • WH Hemic and Lymphatic Systems
    • WI Digestive System
    • WJ Urogenital System
    • WK Endocrine System
    • WL Nervous System
    • WM Psychiatry
    • WN Radiology. Diagnostic Imaging
    • WO Surgery
    • WP Gynecology
    • WQ Obstetrics
    • WR Dermatology
    • WS Pediatrics
    • WT Geriatrics. Chronic Disease
    • WU Dentistry. Oral Surgery
    • WV Otolaryngology
    • WW Ophthalmology
    • WX Hospitals and Other Health Facilities
    • WY Nursing
    • WZ History of Medicine 19th Century Schedule

 

3. Thes three classification schedules lend themselves to browsing of the stacks for medical topics where the collections are fairly small. So, familiarity with the general headings can allow the librarian to pull a relevant title from the shelves without consulting the catalog. If the librarian is not familiar with the subject headings, the collection is large, or the information is not locally available the search should proceed though the OPAC (Online Public Access Catalog).

A. In most public libraries of Rhode Island the OPAC will be the CLAN system, the members of which use variations of Dewey and Library of Congress schedules. Because of the limited information attached to many of the cataloging records, the options of title key word along with subject headings should be used to search.

Search the Public libraries of R.I.

CLAN via Telnet http://seq.clan.lib.ri.us/clan/telnet.html

B. When the public libraries do not yield enough information, the next step is to consult the HELIN consortium catalog which includes the holdings many of the college and University catalogs in Rhode Island - including Roger Williams University, The University of Rhode Island, Johnson & Wales University, Salve Regina University, Rhode Island College, and Providence College.

Search Rhode Island College and University catalogs

HELIN  http://library.uri.edu/

C.When the HELIN Consortium fails to provide enough information, the next step is to consult Josiah - the Brown University Library catalog - the holdings of which are not included in the HELIN catalog.

Search the on-line catalog of the Brown University Library

Josiah http://library.brown.edu/screens/mainmenu.html

D.  Finding appropriate resources may require using the National Library of Medicine (NLM) catalog. The NLM has a very large database and the efficiency of a search can be aided by review of the Mesh (medical subject heading) Trees at http://www.nlm.nih.gov/mesh/meshhome.html The Mesh Trees incorporate the specialized language of the NLM classification system. Failure to use the appropriate language can create a null search. For example: the phrase kidney calculi should be used instead of kidney stones.

Search the on-line catalogs of the National Library of Medicine

NLM Locator http://locatorplus.gov/

Grateful Med http://igm.nlm.nih.gov/  

E. If the medical topic is fairly recent and the subject of a current news program, the search may lead to Amazon Books at http://www.amazon.com/or another bookseller. Amazon Books has an excellent search mechanism by authors, subjects, and titles along with a featured in the media selection.

4. The next step could be to run a literature search of articles and news stories from reputable sources. Rhode Island Librarians have the opportunity to use a large number of resources that will provide them with articles. These include:

    • EBSCO - http://search.epnet.com/
      • EBSCO is available through many public libraries in Rhode Island at many levels of service.
    • IAC Searchbank - http://infotrac.galegroup.com/itweb/provid_main?id=
      • IAC Searchbank is currently available at Rhode Island public libraries by remote access with a CLAN bar code. Searchbank is made available through a grant to the Providence Public Library
        and includes full-text articles through its Health Reference Center.
    • FirstSearch - http://newfirstsearch.oclc.org/
      • First Search is available through LoriPro to librarians in Rhode Island. First Search provides
        bibliographic information and holdings records along with full-text document services.
    • Ingenta (CarlUncover) - http://www.ingenta.com/
      • Ingenta offers free searches of its extensive article database. Documents can be obtained by setting up a debit account. Ingenta incorporates the CarlUncover database.

5. The next step should be to determine the location of any articles that may be of assistance. Again, journal titles may be searched in CLAN and HELIN and Josiah for local holdings.

A. The CRIARL Union list gives librarians the ability to search most of the serial holdings of the research facilities in Rhode Island at one time to effect a very efficient search. The ARIHSL database, which also includes the hospital library holdings in Rhode Island, was added to the CRIARL catalog in 1998.

Search the Consortium of Rhode Island Academic and Research Libraries
Union List of Serials

CRIARL via Telnet (login as criarl) telnet://library.brown.edu/ 

CRIARL via the WWW http://library.brown.edu:81/

  • CRIARL allows searches by TITLE of Journal or Serial, WORDS from subjects, titles, names, ISSN and other standard numbers

B. By using First Search through LoriPro http://www.lori.state.ri.us/ with the products such as World Cat, Medline and ArticleFirst coverage of libraries outside of Rhode Island is also available.

6. The next step to finding medical information could be a broad based internet search using any logical combination of search engines and directories. Some of the best resources are reviewed here. Each search engine has its strengths and weaknesses. It is important to build some familiarity with each engine in order to get the most from internet searches. For a more in depth look at using search engines and directories see How to Search the Word Wide Web: A Tutorial for Beginners and Non-Experts at http://middletownpubliclibrary.org/tutor.htm .

AltaVista
Home Page Address: http://www.altavista.com/
Help Page Addresses: Simple Query http://www.altavista.com/sites/help
Advanced Query- http://www.altavista.com/sites/search/adv
Search Method: Primarily keyword, with a subject option that draws on LookSmart subject directories. Also provides Popular Sites on its Home Page under "Specialty Searches".
Database: Full text with one of the largest and most inclusive directory indices.
Operators: Employs Advanced Search that uses both simple and advanced operators. The latter are comprehensive and sophisticated.
Features: Provides ways of narrowing a search. Can limit search by date and retrieve references by last date modified. Translates text into a number of languages. Also employs "Ask Jeeves" that accepts queries in simple question form. Also can be configured to filter objectionable material from searches.
Comments: A leading search engine. Has one of the largest databases and most effective search systems. If not used properly, can produce an extraordinary number of irrelevant hits. Serves as the default search engine for Look Smart and Britannica Internet Guide

EXCITE
Home Page Address: http://www.excite.com/
Help Page Address: http://www.excite.com/Info/searching.html?a-n-t
Search Method: Primarily keyword with subject option. Provides long lists of Popular Sites under several headings.
Database: Full-text search of about 75 million documents.
Operators: Supports simple and advanced searches.
Features: Offers keyword searches for literal or concept queries, but does better with concept searches. Concept search is the default. [A concept search looks for ideas related to a literal query. Use of Boolean Operators turns off concept searching. Its channel sites are approved by editors and sometimes have reviews.
Comments: It is easy to use, its headings and links are well organized and the instructions for its use are clearly presented. Includes current news related items with the search results. Excite runs Webcrawler as an independent meta search tool.

Google
Home Page Address http://www.google.com/
Help Page Address: http://www.google.com/help.html
Advanced Query- http://www.google.com/advanced_search?hl=en&safe=off
Search Method: Primarily keyword. Also provides web directory by major topic heading. By selecting ‘I'm feeling lucky’ as an option one may limit the search to the most relevant site.
Database: Very large.
Operators:"Simple Search" operators are suitable. The plus operator [+]is automatic.
Features:Returns only pages that match all the terms in the query. Also, tries to return results where the terms are in close proximity. Ranks hits based on their use popularity.
Comments:Has a very sophisticated database, yet it provides a very uncluttered and easy-to-use format. Can limit searches to particular categories, such as Government and Linux related sites. Has joined with Yahoo! to become the default search engine for that directory.

NORTHERN LIGHT
Home Page Address: http://www.northernlight.com/
Help Page Address: http://www.northernlight.com/docs/search_help_optimize.html
Search Method: Primarily subject with auxiliary keyword
Database: Among the largest
Operators: Supports "Simple Search" operators.
Features: Provides a Special Collection listing by subject derived from 1800 journals, reviews, books, magazines and news wires. These documents are not readily accessible to other search engine robots. Search is free, and cost to utilize its database is comparatively modest.
Comments: A well-organized search tool. Searches the WWW and its Special Collection separately.

YAHOO!
Home Page Address: http://www.yahoo.com/
Help Page Address: http://www.yahoo.com/docs/info/help.html
FAQ: http://www.yahoo.com/docs/info/faq.html
Search Methods: Primarily subject with coordinated keyword option. In keyword searches, selects only sites that contain all search words. If no exact match is found switches automatically to Inktomi.
Database: Reviews its own keyword database. Has at least 1 million subject sites listed.
Operators: When a search defaults to the Inktomi search tool, both "Simple Search" and "Advanced Search" are applicable.
Features: Can search by title [t] and URL [u]. Lists Popular Sites.
Comments: It has the largest subject database on the Web. Its headings and links are well- organized and easy to use. Yahoo is a great place for beginners to originate a search.

7. The next step could be searches of specific medical encyclopedic sites and dictionaries. Much of the information available through the Internet is not indexed by search engines but may be included within specialized internet resources. Medical encyclopedias of the Internet include:

8. The next step is to make a reasonable effort to conclude that the information meets the criteria for a reputable site. One group that has done a great job putting together a web site that meets reputable criteria is BodyWise http://www.bodywise.com/  BodyWise has its own criteria for review of websites and including information with their service - these include:

    • Content:
    • Quality of Information:
    • Relevance to Health:
    • User-friendly:
    • Accessibility:

When sites are reviewed by people conducting an individual search or for placement in a specialized directory such as the Librarians Guide to the Internet, the generally accepted methods of collection development should be applied. According to Jan Alexander and Marsha Tate of the Widener Library the main criteria for evaluating any information resource include:

    • Accuracy
    • Objectivity
    • Authority
    • Currency
    • Coverage

Reviewing Web Sites or print resources effectively requires that each of these elements be tested against each resource.   With the internet accuracy should always be suspect. There is greater possibility for errors without editorial control.  And, where there has been editorial control in the past it may be lost because of the medium being used.  The people who are able to write in hypertext may not understand the subject they are writing on and if they are have final control over the document errors can occur.  Objectivity may be lost. It  is easy to find a professionally designed and elegantly manufactured Web Site where the opinion offered is totally biased.  Authority for the work may come from an eighth-grader who knows a lot about chickens or a Ph.D. who knows nothing about social issues.  If the works are not signed and dated, then determining authority can be very difficult. But, for the first time the scope of coverage and the currency can be all encompassing and immediate.  When a name is searched through Switchboard all of the United States can be covered. When a news story is accessed through AP NewsWire or a stock fund is reviewed through Yahoo Quotes the news is now and the stock price may also be within the last twenty minutes.  James Rettig has noted that we are able to find out such things as time and population as they exist now.  Timely information from the Internet has greatly enhanced potential reference services. But, as with any reference resource and medicine in particular reasonable care should be taken to make sure that the information meets standards of quality.

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Part 2 - Specific Diseases, Drugs, and Treatments

Traditional reference tools and specific internet sites can be used to locate information on specific diseases, drugs, and treatments. Many excellent sites have appeared on the internet that should be reviewed for content and application in the library environment. Because of the methods of indexing databases by the search engines and directories, much of the content of web pages is not included in the databases. Quality sites must therefore be reviewed separately. These sites can be of great assistance to the small library in that the high cost of medical works in the print form can be highly prohibitive to collection development in medicine.

Specific Diseases