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[MEDLINE in the age of Internet].

The use MEDLINE and related resources of literature information has increased significantly with the increased availability and speed of the Internet. However, literature information is presented in many different ways via the Internet and search facilities and web addresses are frequently changed. Many physicians and medical researchers find it difficult to keep track of what is available and many lack skills in effective searching. The present paper presents an overview of the MEDLINE database and related databases available from the National Library of Medicine and searchable through PubMed and Internet Greatfull Med. We discuss strategies for searching MEDLINE and the coverage of MEDLINE related to that of related databases from the NLM and other sources.

Internet↗

Developing optimal search strategies for detecting clinically sound causation studies in MEDLINE.

BACKGROUND: Clinical end users of MEDLINE must be able to retrieve articles that are both scientifically sound and directly relevant to clinical practice. The use of methodologic search filters has been advocated to improve the accuracy of searching for such studies. These filters are available for the literature on therapy and diagnosis, but strategies for the literature on causation have been less well studied. OBJECTIVE: To determine the retrieval characteristics of methodologic terms in MEDLINE for identifying methodologically sound studies on causation. DESIGN: Comparison of methodologic search terms and phrases for the retrieval of citations in MEDLINE with a manual hand search of the literature (the gold standard) for 162 core health care journals. METHODS: 6 trained, experienced research assistants read all issues of 162 journals for the publishing year 2000. Each article was rated using purpose and quality indicators and categorized into clinically relevant original studies, review articles, general papers, or case reports. The original and review articles were then categorized as 'pass' or 'fail' for methodologic rigor in the areas of therapy/quality improvement, diagnosis, prognosis, causation, economics, clinical prediction, and review articles. Search strategies were developed for all categories including causation. MAIN OUTCOME MEASURES: Sensitivity, specificity, precision, and accuracy of the search strategies. RESULTS: 12% of studies classified as causation met basic criteria for scientific merit for testing clinical applications. Combinations of terms reached peak sensitivities of 93%. Compared with the best single term, multiple terms increased sensitivity for sound studies by 15.5% (absolute increase), but with some loss of specificity when sensitivity was maximized. Combining terms to optimize sensitivity and specificity achieved sensitivities and specificities both above 80%. CONCLUSION: The retrieval of causation studies cited in MEDLINE can be substantially enhanced by selected combinations of indexing terms and textwords.

Case-Control Studies↗

Developing optimal search strategies for detecting clinically relevant qualitative studies in MEDLINE.

BACKGROUND: The growing interest in qualitative research within the evidence based practice framework highlights the need for accurate search strategies to enhance the retrieval of qualitative studies. To date, little work has been done on developing optimal search filters for retrieving qualitative studies. The current study extends our earlier work, on developing optimal search strategies, to include qualitative studies. OBJECTIVE: To develop optimal search strategies for detecting clinically relevant qualitative studies in MEDLINE in the publishing year 2000. DESIGN: Comparison of the retrieval performance of methodologic search strategies in MEDLINE with a manual review ("gold standard") of each article for each issue of 161 core health care journals for the year 2000. METHODS: 6 experienced research assistants who had been trained and intensively calibrated reviewed all issues of 161 journals for the publishing year 2000. Each article was systematically classified for "format" (whether it was an original study, review article, general article, or case report), "interest" (whether or not it was of interest to the health care of humans), and "purpose" (whether it pertained to therapy, diagnosis, prognosis, causation, economics, costs, or clinical prediction; was of a qualitative nature; or was about something else). Search strategies were developed for all purpose categories, including qualitative studies. MAIN OUTCOME MEASURES: The sensitivity (recall), specificity, precision, and accuracy of single and combinations of search terms. RESULTS: 49,028 articles were identified after matching the hand search records with the data downloaded from MEDLINE, of which 366 (0.75%) were classified as qualitative. Combinations of search terms reached peak sensitivities of 95%. Compared with the best single term, a three-term strategy increased sensitivity for qualitative studies by 23.6% (absolute increase), but with some loss of specificity when sensitivity was maximized. When search terms were combined to optimize sensitivity and specificity, both these values peaked above 90%. CONCLUSION: Several search strategies can achieve high performance in retrieving qualitative studies from MEDLINE.

Hepatitis, Viral, Human↗

Language and country preponderance trends in MEDLINE and its causes.

OBJECTIVE: The authors characterized the output of MEDLINE papers by language and country of publication during a thirty-four-year time period. METHODS: We classified MEDLINE's journal articles by country of publication (Anglos/Non-Anglos) and language (English/Non-English) for the years 1966 and from 1970 to 2000 at five-year intervals. Eight English-speaking countries were considered Anglos. Linear regression analysis of number of papers versus time was performed. RESULTS: The global number of papers increased linearly at a rate of 8,142 papers per year. Anglo and English papers also increased linearly (6,740 and 9,199, respectively). Journals of Non-Anglo countries accounted for 25% of the English language increase (2,438 per year). Only Non-English papers decreased at a rate of 1,056 fewer papers per year. These trends have led to overwhelming shares of English and Anglo papers in MEDLINE. In 2000, 68% of all papers were published in the 8 Anglo countries and 90% were written in English. CONCLUSIONS: The Anglo and English preponderances appear to be a consequence of at least two phenomena: (1) editorial policy changes in MEDLINE and in some journals from Non-Anglo countries and (2) factors affecting Non-Anglo researchers in the third world (publication constraints, migration, and undersupport). These are tentative conclusions that need confirmation.

Bibliography of Medicine↗

[A brief introduction to MEDLINE and a guide for authors].

Medical literature analysis and retrieval system online (MEDLINE) established by National Library of Medicine, USA (NLM) is the most important biomedical database all over the world. This article introduces the database of MEDLINE and Chinese periodicals indexed in MEDLINE in 2006. Several suggestions are made as well, with the aim of providing a guide for authors to contribute to periodicals indexed in MEDLINE so as to extend the international influence of the articles, authors and related hospitals.

China↗

A study to enhance clinical end-user MEDLINE search skills: design and baseline findings.

OBJECTIVE: To determine if a preceptor and timely, individualized feedback improves the performance of physicians in searching MEDLINE using GRATEFUL MED in clinical settings. DESIGN: Randomized controlled trial. SETTING: A 300 bed primary to tertiary care teaching hospital. Computers were installed in wards and clinics of 6 major clinical services, and the emergency room, intensive care and neonatal intensive care units. SUBJECTS: All physicians and physicians-in-training from the departments of Medicine, Family Medicine, Surgery, Psychiatry, Pediatrics, and Obstetrics and Gynecology were included if they made patient care decisions for at least 8 weeks during the study period. INTERVENTION: All participants were given a 1-hour training class and 1 hour of individualized searching with 1 of the 2 study librarians. After training, participants were randomized to a control group who received no further intervention or to an intervention group in which each person chose a clinical preceptor experienced in MEDLINE searching and received individualized feedback by a study librarian on their first 10 searches, indicating search quality and providing suggestions for improvement. Feedback was mailed the first week day after the search was done. MAIN MEASURES: Baseline characteristics by study group, department and level of training, study participation rates, and searching rates. MAIN RESULTS: 308 of 392 eligible physicians joined the study. Participation was almost 80% with some variation by department and level of training. Excellent balance in the baseline characteristics was achieved for the 2 groups, as well as for the number who did first searches. Intervention group participants searched MEDLINE more often than did controls (3.5 searches per month vs 2.5 per month for controls, P = 0.046). The recall and precision for first searches for both groups was significantly less than that of librarians. The analysis of study data will be completed by September 1991. CONCLUSIONS: Clinicians are willing to do self-service searching of MEDLINE in clinical settings but their precision and recall are less than a trained librarian at baseline. Search skills enhancements are needed and the effect of feedback and preceptors is being tested. SOURCE OF FUNDING: U.S. National Library of Medicine and Ontario Ministry of Health.

Computer User Training↗

Currency of full-text medical journals: CCML and MEDIS vs. MEDLINE.

The authors ask whether full-text versions of medical journals are available for searching sooner than their biblographic counterparts. The journals in question are those found in the Comprehensive Core Medical Library (CCML) from BRS Information Technologies and in Mead Data Central's MEDIS Current Journal Files. All journals in these two files are full-text, and neither file contains any indexing features. Update schedules for the full-text version of the MEDLINE journals in each of these files were compared with the most recent issue available in the National Library of Medicine's (NLM) MEDLINE on five different dates. The data revealed substantial fluctuation in comparative currency for MEDIS/MEDLINE over the period of the test. On the date of the last snapshot, June 8, 1990, MEDLINE and MEDIS were offering the same currency for 43% of the journals, and MEDIS was providing first access to 29% of the titles. The CCML/MEDLINE comparison showed less variation. In the last snapshot MEDLINE and CCML were providing access to the same issue for 36% of the journals, and CCML was offering first access to 14%. Prior to publication, this paper was submitted to all three vendors for comment. Significant portions of their responses are quoted.

MEDLINE↗

Where should the pharmacy researcher look first? Comparing International Pharmaceutical Abstracts and MEDLINE.

This study compared the usefulness of various CD-ROM versions of International Pharmaceutical Abstracts (IPA) and MEDLINE for pharmacy research. Journal coverage as well as the strengths and weaknesses of database structure and contents were considered. The journals indexed in each database were compared to those identified in a survey of the research journals most important to University of Maryland at Baltimore pharmacy faculty and in a similar North Carolina study rating pharmacy journals. In addition, indexed journals were checked against the Institute for Scientific Information's most recent list of high-impact journals in pharmacology and pharmacy. Searches representing a variety of topics relevant to pharmacy were conducted in both databases, and the number and relevance of citations located were analyzed. Results showed that IPA indexed a greater number of pharmacy titles, but that MEDLINE indexed more pharmacy journals designated in studies as significant to the field. There was little overlap in coverage between the two databases. MEDLINE produced larger retrievals for the majority of questions, but many citations retrieved in IPA did not appear in MEDLINE.

Abstracting and Indexing↗

Comparison of fixed-fee Grateful Med database use and searching success rates given the continued availability of MEDLINE in other formats.

This study compared in-house Grateful Med database use and searching success rates for four-month periods at four sites of the Library of the Health Sciences of the University of Illinois at Chicago. Data were collected from Grateful Med workstation uselogs and analyzed. Database use patterns and searching success rates were fairly consistent across the four sites. Though MEDLINE was available in other formats and use in these other formats remained high, 65.48% of all Grateful Med searching was done by using MEDLINE, and an additional 21.34% was done by using the MEDLINE Backfiles. In-house use patterns were similar to the overall use pattern for the University of Illinois, with the exception of MEDLINE Backfiles. Overall, 54.30% of searches were successful.

CD-ROM↗

[The utilization of Medline for the solution of real clinical problems. A prospective study in Italy].

AIM: Measure of usefulness of Medline searches requested for clinical problems. METHODS: open prospective uncontrolled study lasted for 3 months. Collection of online or CD-ROM Medline searches operated by clinicians or librarians at 5 biomedical libraries. User interviews about use and usefulness of Medline, recorded with a closed-answer self-administered questionnaire, adapted from a U.S. National Library of Medicine product. RESULTS: Of the 6 participating libraries, one was excluded from analysis from data collection inadequacies. Among 668 searches, 55 (8.2%) were produced for real patients. Physicians judgement about clinical usefulness of their searches (available for 46 cases) indicate a significant importance for diagnostic evaluation (23%) and therapy administration (46%). After applying search results into clinical practice, clinicians think that positive outcomes are achieved in the doctor-patient-family relationship area (19%), a better use of health care system facilities is obtained (26%) and, less consistently, positive effects are perceived on longevity (5%), abnormality correction (10%), symptomatic relief (7%) and functional recovery (6%). CONCLUSION: Physicians judge that Medline searches actually can contribute to diagnosis and treatment of real patients, with significant benefits on the process of care, on doctor-patient relationship and on patient's health.

CD-ROM↗

An analysis of objective quality indicators on Year Book citations: implications for MEDLINE searchers.

PURPOSE: This study is an analysis of Mosby Year Book citations from Ovid Online's Comprehensive Core Medical Library (CCML). The purpose of this study was twofold: (1) to determine whether Year Book citations were more likely to be judged "key" than non-Year Book citations by clinicians; and (2) to determine whether the MEDLINE record of Year Book citations evaluated as key contained objective quality indicators that searchers might use to target key articles. BACKGROUND: As part of the MEDLINE/Full-Text Research Project, health care professionals evaluated search output from CCML on a five-point scale. The scale included the choice "key" for those items which the evaluator would not want to miss. Because the output contained items from the Year Book series, it was possible to determine whether the Year Book items were evaluated as key more frequently than expected. METHODS: This study analyzes the MEDLINE records corresponding to 110 references from the Mosby Year Book series evaluated as key by clinicians receiving search output from CCML. The records were examined for the presence of such searchable elements as Medical Subject Headings (MeSH) terms and publication types related to study design, evidence of research support, inclusion in the Abridged Index Medicus (AIM) subset, and a comments field. Also noted were the presence of a structured abstract, study design details in the author abstract, and inclusion in more than one Year Book. RESULTS: A chi-square test (p < .001 indicated that the proportion (33%) of Year Book citations marked key on the searches was significantly higher than that of non-Year Book citations (18%). When the occurrence of the searchable elements was compared to MEDLINE as a whole, the following access points appeared more frequently in the key Year Book records: study design terms categorized under epidemiologic methods in the MeSH Tree Structures; the checktag comparative study; AIM subset; comments field; and, publication types (pt) clinical trial, randomized controlled trial, multicenter study, and meta-analysis. CONCLUSIONS: These searchable elements should be helpful in targeting some, but not all, key articles in MEDLINE.

Chi-Square Distribution↗

Mapping from GenBank to MEDLINE.

GenBank has been based largely on literature that provides nucleic acid sequences. To find additional literature that is relevant to a given sequence, a search of MEDLINE can prove helpful. This paper documents some of the similarities between GenBank and MEDLINE that facilitate retrieval of documents from MEDLINE. In particular, techniques and examples are presented which take GenBank information and lead to MEDLINE information that supplements the GenBank information.

Abstracting and Indexing↗

Optimal search strategies for identifying mental health content in MEDLINE: an analytic survey.

OBJECTIVE: General practitioners, mental health practitioners, and researchers wishing to retrieve the best current research evidence in the content area of mental health may have a difficult time when searching large electronic databases such as MEDLINE. When MEDLINE is searched unaided, key articles are often missed while retrieving many articles that are irrelevant to the search. The objectives of this study were to develop optimal search strategies to detect articles with mental health content and to determine the effect of combining mental health content search strategies with methodologic search strategies calibrated to detect the best studies of treatment. METHOD: An analytic survey was conducted, comparing hand searches of 29 journals with retrievals from MEDLINE for 3,395 candidate search terms and 11,317 combinations. The sensitivity, specificity, precision, and accuracy of the search strategies were calculated. RESULTS: 3,277 (26.8%) of the 12,233 articles classified in the 29 journals were considered to be of interest to the discipline area of mental health. Search term combinations reached peak sensitivities of 98.4% with specificity at 50.0%, whereas combinations of search terms to optimize specificity reached peak specificities of 97.1% with sensitivity at 51.7%. Combining content search strategies with methodologic search strategies for treatment led to improved precision: substantive decreases in the number of articles that needed to be sorted through in order to find target articles. CONCLUSION: Empirically derived search strategies can achieve high sensitivity and specificity for retrieving mental health content from MEDLINE. Combining content search strategies with methodologic search strategies led to more precise searches.

Journal Article↗

MEDTUTOR: a microcomputer-based training program for MEDLINE.

MEDTUTOR is an interactive, microcomputer-based training package designed to teach medical and health professionals, as well as librarians and information specialists, how to use MEDLINE effectively. The objective of MEDTUTOR is to provide a comprehensive package for teaching the various commands and search techniques required for utilizing the MEDLINE database through the MEDLARS system. MEDTUTOR's menu-driven design allows novice users to learn about the content and use of MEDLINE, such as author searching, text word searching, MeSH indexing, etc., at their own pace and with considerable program feedback. In addition, MEDTUTOR provides the skilled searcher with a way to reinforce or recall previously-learned search techniques without incurring online charges. MEDTUTOR may be used in place of formal training, as a precursor to or as a refresher following formal training, or for review of a particular concept. It provides inexpensive and easily accessible instruction for searching MEDLINE.

Computer User Training↗

CINAHL and MEDLINE: a comparison of indexing practices.

A random sample of fifty nursing articles indexed in both MEDLINE and CINAHL (NURSING & ALLIED HEALTH) during 1986 was used for comparing indexing practices. Indexing was analyzed by counting the number of major descriptors, the number of major and minor descriptors, the number of indexing access points, the number of common indexing access points, and the number and type of unique indexing access points. The study results indicate: there are few differences in the number of major descriptors used, MEDLINE uses almost twice as many descriptors, MEDLINE has almost twice as many indexing access points, and MEDLINE and CINAHL provide few common access points.

Abstracting and Indexing↗

Comparative usefulness of MEDLINE searches performed by a drug information pharmacist and by medical librarians.

The usefulness of MEDLINE searches conducted by a drug information pharmacist who had received online training was compared with the usefulness of searches conducted by medical librarians. Searches for literature pertinent to select drug information requests received at a university drug consultation service during a three-month period were conducted independently by the pharmacist and one of three reference librarians. The three librarians had received extensive online search training and were experienced in conducting MEDLINE searches; the pharmacist was trained by a fourth experienced librarian-searcher using National Library of Medicine (NLM) training materials. For each drug information request, the pharmacist and the librarian searched two MEDLINE files on the NLM service. The printouts generated by the two searchers were evaluated by two drug information pharmacists in terms of how useful each list of citations would be in enabling the drug information pharmacists to answer the related question. The majority of printouts in 48 sets of searches were judged to be useful. Of the 96 possible "best search" votes (two votes for each of the 48 sets of printouts), the pharmacist's searches received 34 votes, the librarians' searches received 28 votes, and there were 34 tie votes. The numbers of useful primary and alternate citations were found to be the best predictors of whether a given printout would receive the "best search" rating. MEDLINE searches performed by a drug information pharmacist with online training, in response to drug information requests, were judged by drug information pharmacists to be as useful as searches performed by librarians.

Drug Information Services↗

A user study of manual and MEDLINE literature searches in the hospital library.

To determine possible uses for MEDLINE in the hospital library, health practitioners requesting literature searches were provided with both a manual and a MEDLINE search. Patron receptivity to MEDLINE was good, but the manual search was more often preferred. The health practitioners responding to a questionnaire apparently had delegated literature searching and evaluation of material to the hospital librarians, especially when clinically related information was needed. In the community hospitals where both the search and the selection of material are the responsibility of the librarian, MEDLINE can be used as the primary search tool or to supplement material provided.

Evaluation Studies as Topic↗

Comparison of SUNY and MEDLINE searches.

One hundred sixty-five search requests processed through the SUNY Biomedical Communication Network were analyzed to determine how many of the citations thus retrieved would have been retrievable by MEDLINE. The results showed that MEDLINE would have been capable of retrieving 78.7% of the SUNY citations. Almost half of the 21.3% of the citations not retrievable by MEDLINE were from foreign-language journals. A subject analysis of the data showed that in most subject areas MEDLINE was able to provide a relatively small percentage of the journal titles generated by SUNY. These few titles, however, contained a large percentage of the SUNY citations involved in the study.

Evaluation Studies as Topic↗