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PubMed1987

Effect of Federal programs on health sciences libraries.

The radical changes and improvements in health sciences libraries during the last quarter century have been primarily achieved through the leadership of the National Library of Medicine (NLM) in the application of technology and in the creation of a biomedical communications network. This article describes principal programs and activities of the National Library of Medicine and their effects on health sciences libraries: the Medical Literature Analysis and Retrieval System (MEDLARS), implementation of the Medical Library Assistance Act (MLAA), and defense of "fair use" of copyrighted material. The article briefly summarizes more recent Federal activities which directly affect access to and dissemination of health information and concludes with a summary of problems for which solutions must be found if health sciences libraries are to be prepared to meet the future. It is clear from comparing the programs described with current government attitudes that, although the Federal government has promoted advancement in the dissemination of biomedical information in the past, this trend is reversing, and Federal funding to libraries is decreasing while the cost of accessing information is increasing.

Forecasting↗

PubMed1987

Technical information programs of the National Cancer Institute.

Since its founding in 1937, the National Cancer Institute (NCI) has supported a substantial program of information dissemination. Two peer-reviewed journals, begun in 1940 and 1959, are supplemented by a congressionally mandated International Cancer Research Data Bank (ICRDB), established in 1972. The NCI has made available online databases of published cancer literature and cancer research in progress for the past decade, using the National Library of Medicine (NLM) MEDLARS system. Recently, a clinical-practice-oriented cancer-information system called Physician Data Query (PDQ) has been developed for access at the NLM, as well as through commercial database vendors. The impact of the NCI information programs is currently under prospective evaluation.

Humans↗

PubMed1993

Electronic networking for nurses.

Electronic networks can provide access to other nurses locally and around the world via electronic mail and on-line interactions. Networks can give nurses access to information and to the data that are processed and stored in computers in their own facility and in computers at remote sites. The major international networks, Internet, FidoNet, and BITNET each offer these opportunities. In addition, Internet, the network most useful to nurses, allows access to Sigma Theta Tau's International Nursing Library, E.T.Net, and the MEDLARS family of bibliographic data bases. Taking advantage of the services and resources networks offer can facilitate nursing practice, education, and research.

Canada↗

PubMedDate not supplied

Medical subject headings used to search the biomedical literature.

The National Library of Medicine's MEDLINE (MEDLARS Online) database was the first database to be searched nationwide via value-added telecommunication networks. Now available on the World Wide Web free of charge from the National Library of Medicine and from many other sources, it is the world's most heavily used medical database. MEDLINE is unique in that each reference to the medical literature is indexed under a controlled vocabulary called Medical Subject Headings (MeSH). These headings are the keys that unlock the medical literature. MeSH multiplies the usefulness of the MEDLINE database and makes it possible to search the medical literature as we do today. This paper commemorates the 40th anniversary of the introduction of MeSH and salutes some of the farsighted persons who conceived and developed the MEDLINE database.

Abstracting and Indexing↗

PubMed1997

Safety of nifedipine in patients with hypertension: a meta-analysis.

Our objective was to compare cardiovascular event rates in patients with mild or moderate hypertension who received nifedipine with active drug controls. We performed a MEDLARS search using the MeSH heading "hypertension" and the text word "nifedipine" to identify all articles that were published between 1966 and August 1995 in English, French, German, Italian, and Spanish languages and that involved human subjects. The computerized search was supplemented by a manual search of article bibliographies. Review of 1880 citations revealed 98 randomized controlled clinical trials that met protocol criteria. Articles were extracted independently by two doctors who were blinded for author, institution, and treatment regimen, using a structured, pretested extraction form. Differences of opinion were resolved by consensus. Fourteen events occurred in 5198 exposures (0.27%) to nifedipine and 24 events in 5402 exposures (0.44%) to other active drug controls. Unadjusted odds ratios for nifedipine versus controls were 0.49 (95% confidence interval [CI], 0.22-1.09) for definitive events (death, nonfatal myocardial infarction or stroke, revascularization procedure) and 0.61 (95% CI, 0.31-1.17) for all events (definitive plus increased angina). The odds ratio for nifedipine monotherapy (sustained- or extended-release in 91% of exposures) was nonsignificantly higher for definitive and all events (odds ratio, 1.40; 95% CI, 0.49-4.03 and odds ratio, 1.39; 95% CI, 0.59-3.32, respectively). The odds ratio for nifedipine in combination with another drug was significantly lower for definitive and all events (odds ratio, 0.09; 95% CI, 0.01-0.66 and odds ratio, 0.15; 95% CI, 0.03-0.65, respectively). Differences in odds ratio for nifedipine monotherapy and combined therapy were statistically significant (P=.02 for definitive events and P=.001 for all events). Results support the safety of sustained- and extended-release nifedipine in the treatment of mild or moderate hypertension when it is used in combination with other drugs.

Adrenergic beta-Antagonists↗

PubMed1988

The information age in concept and practice at the National Library of Medicine.

The evolution of today's information age is mirrored in the growth of the National Library of Medicine's bibliographic services: from the pioneering work of the Library in the last century to develop Index Medicus, to developing the innovative computerized MEDLARS system in the early 1960s, to the easily searchable on-line data bases now available to health professionals. The evolution has not come about without controversy, however, as tension developed between the public sector, where the information was viewed as a social benefit, and the private sector, where it was viewed as a source of profit. The Library has fostered research and development in biomedical communications in the laboratories of its Lister Hill Center and through grants to assist in establishing the field of medical informatics. The future of biomedical communications will be profoundly affected by work now being carried out by the Library: in fields such as biotechnology, through integrative methodologies such as the Unified Medical Language System now under development, and by a grant program to improve the infrastructure for information within academic health science centers.

Diffusion of Innovation↗

PubMed1984

BIOETHICSLINE: an overview for searchers.

The BIOETHICSLINE File (BIOETHICS) is a bibliographic database produced at the Kennedy Institute of Ethics, Georgetown University, and made available online through the the National Library of Medicine's MEDLARS system. BIOETHICS provides multidisciplinary coverage of the ethical, legal, and public policy aspects of medicine, health care, and biomedical and behavioral research. This article describes the content and development of the database, suggests effective strategies for searching, and presents illustrative searches. An appendix lists selected major indexing terms (Keywords) from the controlled vocabulary of the Bioethics Thesaurus.

Bioethical Issues↗

PubMed1990

AIDS information from the National Library of Medicine.

As part of a U.S government effort to combat AIDS, the National Library of Medicine (NLM) is expanding its information services in this area. In response to the Health Omnibus Program Extension Act of 1988, NLM has expanded its AIDS Bibliography, enhanced its DIRLINE file with AIDS-related organizations, and developed three new online MEDLARS (Medical Literature Retrieval and Analysis System) databases: AIDSLINE, AIDSTRIALS, and AIDSDRUGS. NLM's AIDS-related programs and services are discussed.

Acquired Immunodeficiency Syndrome↗

PubMed1978

The on-line user network: organization and working procedures.

The National Library of Medicine's on-line user community has grown from a small group of 25 institutions in October 1971 to more than 900 in January 1978. Management of the MEDLINE User Network, co-ordination of on-line data-bases, and provision of user support services are an important function of the MEDLARS Management Section (MMS). MMS is the point of contact for on-line users; a service desk is maintained to provide immediate assistance; and technical materials describing the various data-bases are prepared including the monthly NLM Technical Bulletin and the On-Line Services Reference Manual. Other management and support activities include the preparation of statistical reports; handling of on-line centre applications received from the Regional Medical Libraries; co-ordination of codes and passwords for users; and the distribution of off-line prints, off-searches, and tape copies of the data-bases. A monthly current awareness service is also provided. The working procedures for these support activities are described.

Fees and Charges↗

PubMedDate not supplied

The evolution of the training policy at IMA.

Training at IMA has been during the last years an expanding activity which reflects the growth of the French MEDLINE network. Initially, before 1973, when IMA was the only centre in France to have access to the MEDLARS system, courses were aimed at increasing the general level of awareness of the biomedical community. After decentralization of the on-line access, it has become necessary to train search analysts for future associate centres, and now IMA organizes two types of course, one for search analysts and one for non-searchers, librarian students or end-users such as researchers for instance. Details of these two kinds of training courses are outlined.

France↗

PubMed1983

Usage patterns of an online search system.

This article examines the usage patterns of the ELHILL retrieval program of the National Library of Medicine's MEDLARS system. Based on a sample of 6759 searches, the study analyzes the frequency of various commands and command options, classifies messages issued by the system, and investigates searcher error rates. The article concludes with suggestions for improving and redesigning both the program and query language.

MEDLARS↗

PubMed1992

Syndrome--a changing concept.

Syndrome is one of the oldest terms in the medical vocabulary. Traditionally, the term has been used mainly as a designation for complex medical entities, such as multiple abnormalities, that are characterized by clusters of concurring symptoms, usually three or more. During the mid-twentieth century, the meaning and the use of the term were altered. First to take place was an attempt to eliminate physicians' names from syndrome nomenclature, resulting in a significant increase in the use of descriptive designations in proportion to eponyms. But the trend was counterbalanced by the creation of new classes of eponyms. Eponymous syndrome nomenclature now includes the names of literary characters, patients' surnames, subjects of famous paintings, famous persons, geographic locations, institutions, biblical figures, and mythological characters. This was followed by a relaxation in the scope of the definition of syndrome, wherein the term could also be used as a modifier indicating a special (sometimes unspecified) complexity of an already named pathological condition. Eventually syndrome changed from its original use as an exclusively medical term and came to mean anything unusual, abnormal, bizarre, or humorous, whether medical, social, behavioral, or cultural. This unrestrained use of the term is the principal cause of an enormous volume of the sometimes irrelevant syndrome literature cluttering databases in the MEDLARS system and of the deterioration of "SYNDROME" as a specific MeSH term and a useful search parameter.

Abstracting and Indexing↗

PubMed1990

Coverage and overlaps in bibliographic databases relevant to forensic medicine: a comparative analysis of MEDLINE.

This study was designed to make a comparative evaluation of the performance of MEDLINE in covering serial literature. Forensic medicine was chosen because it is an interdisciplinary subject area that would test MEDLARS at the periphery of the system. The evaluation of database coverage was based upon articles included in the bibliographies of scholars in the field of forensic medicine. This method was considered appropriate for characterizing work used by researchers in this field. The results of comparing MEDLINE to other databases evoked some concerns about the selective indexing policy of MEDLINE in serving the interests of those working in forensic medicine.

Forensic Medicine↗

PubMed1989

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↗

PubMed1989

Information systems to support medical practice and scientific discovery.

In many educational applications of the computer, systems are designed to contain information or knowledge that is to be conveyed to the student or user via an interactive learning scheme. In contrast, most NLM systems strive merely to increase the user's access to the broad range of published scientific literature, or to link the user to appropriate factual databases. Providing or enhancing access is, of course, made more difficult than in didactic systems because of the relatively large size of the files that make up the bibliographic and factual databases. For example, the MEDLARS files contain over 12 million records, made up of roughly thirty billion online characters. Users send electronic queries to these files on-line via commercial value-added networks (24 hrs/day, 365 days/year), in total about 4 million queries per year. Of the 4 million, approximately half of the queries were (in the opinion of the users polled) prompted by questions that arose in caring for a particular patient. The remaining 2 million queries concerned research, teaching, and public policy.

Biotechnology↗

PubMed1988

Information explosion in radiology.

We studied the increase in the number of articles in the radiologic literature in the years 1970, 1978, and 1985 using the Medlars program which provides reproducibility, a recognized bibliographic pool, and a wide coverage of the medical literature. A dramatic increase in the number of articles was found; the increase has both positive and negative implications for the profession. A similar analysis of monographs using the Catline file and the same subject headings also showed a significant increase in the volume of material relating to certain radiologic subspecialties. The problems arising from the attempt to identify and extract relevant information from this overwhelming mass of radiological data should be addressed.

Books↗

PubMed1988

International programs of the National Library of Medicine.

The National Library of Medicine (NLM) has a broad mission in biomedical information service. There are three major reasons for NLM, as a national institution, having an international program: first, the global nature of disease; second, the international scope of medical literature; and third, the universal goal of better communication. This paper reviews NLM's programs in relation to international medical information exchange: International MEDLARS Centers, collaboration with WHO and PAHO, NLM Special Foreign Currency Program, and development of the NLM collection.

International Cooperation↗

PubMed1987

Evolution of an end-user training program.

The University of Illinois at Chicago Library of the Health Sciences has taught end-user classes on the MEDLARS system since early 1985. Registration, class composition, and, most importantly, class organization evolved continuously during the first year of operation. Several feedback mechanisms were used. An examination of the past training and specialization of participants helped to determine teaching examples and pace; a more varied group of participants necessitated a broader range of examples and increased explanations. Participant evaluation forms and oral comments helped define scheduling, agenda, and the need for additional equipment and practice time. Further evaluation will center on the searching done by the program's alumni.

Computer User Training↗