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Creating and curating a pediatric radiology digital library to make the internet a useful reference tool for the radiologist.

BACKGROUND: To practice pediatric radiology optimally, radiologists need convenient access to organized and authoritative pediatric radiology information. The Internet has the potential for offering such convenient access, but the majority of information on it is poorly organized and of questionable authority. OBJECTIVE: The goal of this project was to create and curate a pediatric radiology digital library that will make the Internet a useful reference tool for the radiologist at the point-of-care. MATERIALS AND METHODS: A pediatric radiology digital library containing organized and authoritative pediatric radiology information from the Internet was created and has three components : (1) PediatricRadiology.com (http://pediatricradiology.com)--a catalog of pediatric radiology Web sites; (2) The MetaTextbook of Pediatric Radiology (http://www. vh.org/Providers/TeachingFiles/MetatextbookPedRad/MetaTBP edRad.html)--a catalog of pediatric radiology teaching file cases on the Internet; and (3) Paediapedia (http://www.vh. org/Providers/TeachingFiles/PAP/PAPHome.html)--an imaging encyclopedia of pediatric disease. The pediatric radiology digital library is curated regularly. RESULTS: Over 7 months, 223,689 pages of information were read and 26,972 images were viewed in the pediatric radiology digital library by 69,866 individual users, with 20% of the users from outside the United States. CONCLUSION: Creating a pediatric radiology digital library that identifies and organizes authoritative pediatric radiology information and makes it conveniently available can allow radiologists to use the Internet productively as a reference tool.

Child↗

Reinventing a health sciences digital library--organizational impact.

What is the organizational impact of becoming a digital library, as well as a physical entity with facilities and collections? Is the digital library an add-on or an integrated component of the overall library package? Librarians see sweeping environmental and technological changes. The staff members feel exhilarated and challenged by the pressures to adapt quickly and effectively. Librarians recognize that a Web presence, like other technology components, must be continuously enhanced and regularly re-engineered. The Health Sciences Library, University of North Carolina at Chapel Hill, is reinventing its digital presence to better meet the needs of the community. This paper provides a case study focusing on major changes in planning processes, organizational structure, staffing, budgeting, training, communications, and operations at the Health Sciences Library.

Computer Communication Networks↗

Electronic health record meets digital library: a new environment for achieving an old goal.

Linking the electronic health record to the digital library is a Web-era reformulation of the long-standing informatics goal of seamless integration of automated clinical data and relevant knowledge-based information to support informed decisions. The spread of the Internet, the development of the World Wide Web, and converging format standards for electronic health data and digital publications make effective linking increasingly feasible. Some existing systems link electronic health data and knowledge-based information in limited settings or limited ways. Yet many challenging informatics research problems remain to be solved before flexible and seamless linking becomes a reality and before systems become capable of delivering the specific piece of information needed at the time and place a decision must be made. Connecting the electronic health record to the digital library also requires positive resolution of important policy issues, including health data privacy, government encouragement of high-speed communications, electronic intellectual property rights, and standards for health data and for digital libraries. Both the research problems and the policy issues should be important priorities for the field of medical informatics.

Internet↗

Creating a pediatric digital library for pediatric health care providers and families: using literature and data to define common pediatric problems.

The goal of this study was to complete a literature-based needs assessment with regard to common pediatric problems encountered by pediatric health care providers (PHCPs) and families, and to develop a problem-based pediatric digital library to meet those needs. The needs assessment yielded 65 information sources. Common problems were identified and categorized, and the Internet was manually searched for authoritative Web sites. The created pediatric digital library (www.generalpediatrics.com) used a problem-based interface and was deployed in November 1999. From November 1999 to November 2000, the number of hyperlinks and authoritative Web sites increased 51.1 and 32.2 percent, respectively. Over the same time, visitors increased by 57.3 percent and overall usage increased by 255 percent. A pediatric digital library has been created that begins to bring order to general pediatric resources on the Internet. This pediatric digital library provides current, authoritative, easily accessed pediatric information whenever and wherever the PHCPs and families want assistance.

Computer Systems↗

Using argumentation to retrieve articles with similar citations: an inquiry into improving related articles search in the MEDLINE digital library.

The aim of this study is to investigate the relationships between citations and the scientific argumentation found abstracts. We design a related article search task and observe how the argumentation can affect the search results. We extracted citation lists from a set of 3200 full-text papers originating from a narrow domain. In parallel, we recovered the corresponding MEDLINE records for analysis of the argumentative moves. Our argumentative model is founded on four classes: PURPOSE, METHODS, RESULTS and CONCLUSION. A Bayesian classifier trained on explicitly structured MEDLINE abstracts generates these argumentative categories. The categories are used to generate four different argumentative indexes. A fifth index contains the complete abstract, together with the title and the list of Medical Subject Headings (MeSH) terms. To appraise the relationship of the moves to the citations, the citation lists were used as the criteria for determining relatedness of articles, establishing a benchmark; it means that two articles are considered as "related" if they share a significant set of co-citations. Our results show that the average precision of queries with the PURPOSE and CONCLUSION features is the highest, while the precision of the RESULTS and METHODS features was relatively low. A linear weighting combination of the moves is proposed, which significantly improves retrieval of related articles.

Abstracting and Indexing↗

McMaster PLUS: a cluster randomized clinical trial of an intervention to accelerate clinical use of evidence-based information from digital libraries.

BACKGROUND: Physicians have difficulty keeping up with new evidence from medical research. METHODS: We developed the McMaster Premium LiteratUre Service (PLUS), an internet-based addition to an existing digital library, which delivered quality- and relevance-rated medical literature to physicians, matched to their clinical disciplines. We evaluated PLUS in a cluster-randomized trial of 203 participating physicians in Northern Ontario, comparing a Full-Serve version (that included alerts to new articles and a cumulative database of alerts) with a Self-Serve version (that included a passive guide to evidence-based literature). Utilization of the service was the primary trial end-point. RESULTS: Mean logins to the library rose by 0.77 logins/month/user (95% CI 0.43, 1.11) in the Full-Serve group compared with the Self-Serve group. The proportion of Full-Serve participants who utilized the service during each month of the study period showed a sustained increase during the intervention period, with a relative increase of 57% (95% CI 12, 123) compared with the Self-Serve group. There were no differences in these proportions during the baseline period, and following the crossover of the Self-Serve group to Full-Serve, the Self-Serve group's usage became indistinguishable from that of the Full-Serve group (relative difference 4.4 (95% CI -23.7, 43.0). Also during the intervention and crossover periods, measures of self-reported usefulness did not show a difference between the 2 groups. CONCLUSION: A quality- and relevance-rated online literature service increased the utilization of evidence-based information from a digital library by practicing physicians.

Evidence-Based Medicine↗

Evaluating digital libraries in the health sector. Part 2: measuring impacts and outcomes.

This is the second part of a two-part paper which explores methods that can be used to evaluate digital libraries in the health sector. Part 1 focuses on approaches to evaluation that have been proposed for mainstream digital information services. This paper investigates evaluative models developed for some innovative digital library projects, and some major national and international electronic health information projects. The value of ethnographic methods to provide qualitative data to explore outcomes, adding to quantitative approaches based on inputs and outputs is discussed. The paper concludes that new 'post-positivist' models of evaluation are needed to cover all the dimensions of the digital library in the health sector, and some ways of doing this are outlined.

Information Systems↗

Digital library research and application.

The last decade has seen an exponential rise in the amount and the nature of information that is available on the Internet. Internet and World Wide Web technology have raised many technical as well as social and economic issues. The paper begins with a description of the recent digital library research initiative funded by the U.S. federal government. Digital library research addresses a host of informatics issues relevant to the current Internet-based environment. The paper continues with a discussion of some problems in information access, including a discussion of the potential of the Unified Medical Language System for navigating among multiple biomedical information systems. Next, some issues in creating Web-accessible resources for health care consumers are addressed, with a focus on recent work at the National Library of Medicine, including a description of the MEDLINEplus system. The paper ends with a brief discussion of some implications of digital library research for the health informatics community.

Internet↗

The development of digital library system for drug research information.

The sophistication of computer technology and information transmission on internet has made various cyber information repository available to information consumers. In the era of information super-highway, the digital library which can be accessed from remote sites at any time is considered the prototype of information repository. Using object-oriented DBMS, the very first model of digital library for pharmaceutical researchers and related professionals in Korea has been developed. The published research papers and researchers' personal information was included in the database. For database with research papers, 13 domestic journals were abstracted and scanned for full-text image files which can be viewed by Internet web browsers. The database with researchers' personal information was also developed and interlinked to the database with research papers. These database will be continuously updated and will be combined with world-wide information as the unique digital library in the field of pharmacy.

Database Management Systems↗

Using narrative reports to support a digital library.

The vast amount of information collected and stored in clinical systems can be a significant challenge in the integration of digital libraries and electronic medical records, especially the selection of clinical data to be used in the search, retrieval, and summarization processes. In this study, we describe the use of information retrieval measures with natural language processor output to identify critical information in narrative reports. Our hypothesis is that clinical data that occur often in narrative reports are less important to clinicians than findings that occur rarely. We used the information retrieval methods to analyze one year of discharge summaries. We then conducted a performance study, using physicians as subject. Results show that the methods can be used for filtering critical information from reports. Further studies need to be done on evaluation of the method based on an evaluation of the system performance in the context of a digital library.

Humans↗

The Virtual Naval Hospital: the digital library as knowledge management tool for nomadic patrons.

OBJECTIVE: To meet the information needs of isolated primary care providers and their patients in the US Navy, a digital health sciences library, the Virtual Naval Hospital, was created through a unique partnership between academia and government. METHODS: The creation of the digital library was heavily influenced by the principles of user-centered design and made allowances for the nomadic nature of the digital library's patrons and the heterogeneous access they have to Internet bandwidth. RESULTS: The result is a digital library that has been in operation since 1997, continues to expand in size, is heavily used, and is highly regarded by its patrons. CONCLUSIONS: The digital library is dedicated to delivering the right information at the right time to the right person so the right decision can be made, and therefore the Virtual Naval Hospital functions as a knowledge-management system for the US Navy Bureau of Medicine and Surgery.

Health Education↗

Evaluating digital libraries in the health sector. Part 1: measuring inputs and outputs.

This is the first part of a two-part paper which explores methods that can be used to evaluate digital libraries in the health sector. In this first part, some approaches to evaluation that have been proposed for mainstream digital information services are examined for their suitability to provide models for the health sector. The paper summarizes some major national and collaborative initiatives to develop measures for digital libraries, and analyses these approaches in terms of their relationship to traditional measures of library performance, which are focused on inputs and outputs, and their relevance to current debates among health information specialists. The second part* looks more specifically at evaluative models based on outcomes, and models being developed in the health sector.

Benchmarking↗

A secure Web-based medical digital library architecture based on TTPs.

In this paper, a secure medical digital library architecture is presented, that is based on the CORBA specifications for distributed systems. Special attention is given to the distinguished nature of medical data, whose integrity and confidentiality should be preserved at all costs. This is achieved through the employment of Trusted Third Parties (TTP) technology for the support of the required security services.

Computer Security↗

Cost effectiveness of a medical digital library.

The rapid increase in the price of electronic journals has made the optimization of collection management an urgent task. As there is currently no standard procedure for the evaluation of this problem, we applied the Reading Factor (RF), an electronically computed indicator used for consultation of individual articles. The aim of our study was to assess the cost effective impact of modifications in our digital library (i.e. change of access from the Intranet to the Internet or change in editorial policy). The digital OVID library at Rouen University Hospital continues to be cost-effective in comparison with the interlibrary loan costs. Moreover, when electronic versions are offered alongside a limited amount of interlibrary loans, a reduction in library costs was observed.

Cost-Benefit Analysis↗

Building a digital library for the health sciences: information space complementing information place.

In 1990, the University of California, San Francisco, dedicated a new library to serve the faculty, staff, and students and to meet their academic information needs for several decades to come. Major environmental changes present new and additional information management challenges, which can effectively be handled only through the widespread use of computing and computing technologies. Over the next five years, a three-pronged strategy will be followed. We are refining the current physical, paper-based library through the continuous application of technology for modernization and functional improvement. At the same time, we have begun the planning, design, and implementation of a "free-standing" Digital Library of the Health Sciences, focusing on the innovative application of technology. To ensure complementarity and product integrity where the two libraries interface, we will look to technology to transform these separate entities into an eventual, integral whole.

Computer Communication Networks↗

The Internet: will this highway serve the digital library?

The future of the biomedical enterprise and the biomedical libraries that serve it is tied closely to digital information. The changing nature of this type of information will create new pressures on libraries, particularly in health care organizations. Libraries must learn to deal with these pressures. Currently, libraries depend on the Internet primarily for connections to resources and other libraries; thus enhancements to the Internet will impact the libraries of the present and future significantly. This paper provides an overview of the technical capabilities that will be available in the near to midterm, what libraries will be able to do with those capabilities, and how libraries can position themselves to take advantage of the impending changes.

Computer Communication Networks↗

A medical digital library to support scenario and user-tailored information retrieval.

Current large-scale information sources are designed to support general queries and lack the ability to support scenario-specific information navigation, gathering, and presentation. As a result, users are often unable to obtain desired specific information within a well-defined subject area. Today's information systems do not provide efficient content navigation, incremental appropriate matching, or content correlation. We are developing the following innovative technologies to remedy these problems: 1) scenario-based proxies, enabling the gathering and filtering of information customized for users within a pre-defined domain; 2) context-sensitive navigation and matching, providing approximate matching and similarity links when an exact match to a user's request is unavailable; 3) content correlation of documents, creating semantic links between documents and information sources; and 4) user models for customizing retrieved information and result presentation. A digital medical library is currently being constructed using these technologies to provide customized information for the user. The technologies are general in nature and can provide custom and scenario-specific information in many other domains (e.g., crisis management).

Database Management Systems↗