The physician as consumer of medical literature.
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It is pointed out in this paper that an optimal exchange of resources requires a maximum availability of materials and services at minimum cost. The author is of the view that each activity of the biomedical information network will have to be subjected to critical scrutiny including a calculation of its costs. The overall plan will determine whether current activities can be maintained or expanded and new activities launched. The primary given to access to materials rather than to their possession is a step toward user-oriented networks, and therefore means that future development will be assessed in relation to the customer. The author is convinced that the recording and analysis of the use actually made of services by the user will generate many of the criteria that will govern some of the most important decisions to be taken in the future in connection with the network.
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The design and implementation is described of MultiLink, a desktop system for direct enduser access to remote bibliographic information. The system is an application of a client-server technique based on a campuswide network, with the objective to assist end-users to accomplish the information--retrieval process by capturing knowledge and expertise for searches in query formulations. MultiLink, via intelligent interfaces, allows users to access several dozens of bibliographic databases. The application integrates regional, national and international resources, and brings library services to the user's desktop level.
VTMEDNET is the health information network for the state of Vermont. In response to a needs assessment of rural health care providers, it supports e-mail, access to knowledge-bases, and the ability to request library services for health care providers across the state, regardless of their location or affiliation. For Fletcher Allen Health Care affiliates, it also supports access to in-patient hospital records. Two thirds of the state's physicians are using the network as well as many other health care providers, and, with minimal cost, it has begun to meet its goal of improving health care delivery to many of Vermont's citizens.
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In the popular rush to provide electronic consumer health information, particularly via the Internet, one system has been largely overlooked-the free-net. Free-nets are often text-based systems from which users choose topics from "menus." While the World Wide Web can be more graphically appealing, it can also be overwhelming. Medical information resources are available to diverse populations through free-nets, which are convenient, free services. The amount of information and range of topics they offer are vast. A study of Florida's free-nets during a six-month period involved five free-net systems. Survey items included user demographics, interlibrary loan services, attitudes toward providing medical advice, and availability of medical librarian expertise. Comparisons include the number of user queries on medical and health-related free-net menus, user-friendliness, and the type of health information provided.
BACKGROUND: In a literature-based discussion of research on the information behaviors of life and health scientists and health care practitioners, the problem of characterizing this complex literature is discussed. The issue of terminology for this interdisciplinary area is raised. The paucity of models for information seeking behavior that have been tested in a health care population is discussed, as are the frequently used methods of investigation and data collection methods. METHODS: By analyzing a large number of information behavior research studies, the questions of who does the research and where the research is published are answered. The characteristics of this research are discussed. Studies are cited that investigate the information behavior of physicians, multidisplinary groups of health professionals, medical students and faculty, nurses and other allied health personnel, life scientists, and basic science researchers. Two short case studies--on the diffusion of medical knowledge and on drug information and physician behavior--are used as examples of information behavior research. CONCLUSIONS: The importance of studying the information behavior of health and life scientists and health care providers is underscored by a discussion of the implications for further study.
Evidence-based practice (EBP) is spreading in popularity in many health care disciplines. One of its main features is the reliance on the partnership among hard scientific evidence, clinical expertise, and individual patient needs and choices. Librarians play an important role in the spread of EBP because of the importance of identifying and retrieving appropriate literature from various sources for use in making health care decisions. This article gives an overview of how to search for therapy, diagnosis, etiology, and prognosis both for original studies and secondary publications such as systematic reviews, meta-analyses, and clinical practice guidelines. Understanding how this research is done, how it is indexed, and how to retrieve the clinical evidence are an important set of skills that librarians can provide for clinicians interested in EBP.
Designing information resources that actually meet the information needs of individuals requires detailed knowledge of these needs. This poses a challenge for developers. Because the meaning of particular terms can vary by field, professional knowledge differs to some extent in different disciplines, and the questions that people ask assume a certain amount of unarticulated background knowledge, understanding the information needs of life scientists is not a trivial undertaking. One source of help in meeting this challenge is ethnography, a set of research methods and an associated conceptual stance developed and used by anthropologists for investigating uncontrolled real-world settings. Drawing on the author's experience in using ethnographic techniques to study clinicians' information needs, this paper describes why such research is necessary, why it requires particular research methods, what an ethnographic perspective has added to the study of information needs, and what this broader approach has revealed about the types of information sought by clinicians in the course of their daily practice.
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SETTING: In summer 2002, the Health Sciences Library System (HSLS) at the University of Pittsburgh initiated an information service in molecular biology and genetics to assist researchers with identifying and utilizing bioinformatics tools. PROGRAM COMPONENTS: This novel information service comprises hands-on training workshops and consultation on the use of bioinformatics tools. The HSLS also provides an electronic portal and networked access to public and commercial molecular biology databases and software packages. EVALUATION MECHANISMS: Researcher feedback gathered during the first three years of workshops and individual consultation indicate that the information service is meeting user needs. NEXT STEPS/FUTURE DIRECTIONS: The service's workshop offerings will expand to include emerging bioinformatics topics. A frequently asked questions database is also being developed to reuse advice on complex bioinformatics questions.