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MEDLINEplus andConsumer Health Initiatives
at NLM/NIH
October 20, 2000
Annual Meeting, Mid-Atlantic Chapter
of the Medical Library Association
Adam Glazer, Reference Librarian
National Library of Medicine
Overview• MEDLINEplus
• NLM Gateway
• ClinicalTrials.gov
• AgePage
• Electronic Health Information Projects
• HEALTHINFOQUEST
• Consumer Health: An Online Manual
• The Public Library and Consumer Health: Meeting Community Needs Through Resource Identification and Collaboration
MEDLINEplus
• History and development• Components and technology• Content arrangement, selection guidelines• Evaluation and feedback• Future plans
What is MEDLINEplus?http://medlineplus.gov
• Service to organize health information on the Internet
• From the National Library of Medicine/ National Institutes of Health
Why MEDLINEplus?
• General public searching MEDLINE
• NLM’s main Web site– 90% of searches for medical terms– Diseases, drugs, conditions
• Customer service questions– Health reference
October 22, 1998
• Public Library pilot project • 22 health topics• Where did the topics come from?
– MeSH– Planetree– Consumer health Web sites– User searches
• 116,000 hits first month
October 22, 1998 - September 21, 1999
September 22, 1999 - August 23, 2000
August 24, 2000 - present
MEDLINEplus Today
• Comprehensive health resource– 414 topics (diseases, wellness issues)– Links to organizations, libraries, directories– Drug information– Encyclopedia
• Over 2.5 million page hits/month
Statistics
Major Components
• Health Topic pages– Links - full text on NIH and other sites – Prepackaged MEDLINE searches– ClinicalTrials.gov links
• Drug information via USP DI®
• Medical encyclopedia via adam.com
Technology• Database of records (Oracle)
– Includes information on sites and contacts– Over 13,000 records
• Web-based input system (Cold Fusion)– Remote access
• Authorities and rules• Review and approval process• HTML generated nightly for Web
MEDLINEplus W eb sitemedlineplus.gov
Oracle databasefor input andmaintenance
Input system(Cold Fusion)
Selectors/Maintainersw ith W eb brow ser
Static HTML files
Nightlyprocess
creates staticHTML files
Health Consumersw ith W eb brow ser
MEDLINEplus System
Quality Checks
• Broken links fixed nightly
• Individual records reviewed before approved
• Pages reviewed before release to public
• Pages reviewed after release
MEDLINEplus Strengths• User-driven topics • User-driven design• NIH collaborations• Authoritative information• Private• Semi-annual topic evaluation• Nightly link checking
• Selective, not comprehensive resource
User-Driven Topics• Customer driven
– NLM Web page usage and search log evaluation• NLM Web medical topic searches >90%
– Pilot project with public libraries
• Builds on NLM strengths – Selecting and organizing information – MEDLINE
• Created looking at several vocabularies– NLM’s Medical Subject Headings (MeSH)– Planetree Classification– Other consumer health Web sites– What users are searching
Content Arrangement
• Multiple access points (A-Z, categories) • Related categories; related topics• Topic pages have table of contents
arrangement; point to full text information• Prepackaged MEDLINE searches
using PubMed• Links to ClinicalTrials.gov
Selection Issues
• Abundant health information on the Web– Not always authoritative– Often with agenda
• Nature of Web sites: constant change
Selection Guidelines
• Linked from “About MEDLINEplus”
• Emphasis on resources from government health organizations, especially NIH Institutes
• Collaborate with NIH Institutes on content development and review
Selection Guidelines (2)
• Must be authoritative, accurate and well maintained
• Educational, not selling product• NLM contacts organizations about
– displaying advisory boards– technical issues (frames)
NIH Collaboration
• Focus on NIH information • Information Officers and staff
– Organizations– Sites– Topics and arrangement
• Institute staff reviewing topic page
30 Most RequestedSeptember 2000 (1-15)
• Diabetes
• Shingles
• Fibromyalgia
• AIDS
• Skin Diseases
• Breast Cancer
• Foot/ankle Injuries
• Thyroid Diseases
• Multiple Sclerosis
• Parkinson’s Disease
• Back Pain
• Knee Injuries & Disorders
• Gallbladder & Bile Duct Diseases
• Sexually Transmitted Diseases
• Sleep Disorders
30 Most RequestedSeptember 2000 (16-30)
• Arthritis
• Depression
• Heart Diseases
• Anemia
• About Your Medications
• Spinal Stenosis
• Mouth & Throat Disorders
• Cancer (general)
• High Blood Pressure
• Insect Bites & Stings
• Sinusitis
• Bipolar Disorder
• Stroke
• Nutrition
• Lymphoma
MEDLINE Searches
• “Canned” searches created by NLM Reference Staff
• Tailored for the consumer– Current, English, clinical– 20-70 references– Cover selected aspects of topic
• Search PubMed each time
Canned PubMed Search
Consumer Health Titles Subsetconsumerj[sb]
• Alternative Medicine Review
• Breastfeeding Review• FDA Consumer• Harvard Health Letter• Harvard Heart Letter• Harvard Men's Health
Watch
• Harvard Mental Health Letter• Harvard Women's Health
Watch• Health News• Johns Hopkins Medical
Letter, Health After 50• Medscape Women's Health• Mayo Clinic Health Letter
ClinicalTrials.gov Links
• Introduced - February 2000
• Mutual links through MeSH
MEDLINEplus MeSH ClinicalTrials.gov
Online TourReleased September 13th
Frequently Asked QuestionsReleased September 13th
Feedback and Evaluation
• Customer Service (phone, E-mail)
• Comment link on every page
Comments - Jan - Sep 2000N=1195
Link requests21%
Suggestions 16%
Health information
41%
Compliments7%
Miscellaneous9%
Technical6%
Recent Comments
“I am very impressed with your website. The layout is very clear and easy to navigate... Now that I have visited, I will surely return. Many thanks to you and your staff for the creation of a truly worthwhile site.” (9/21/00)
Recent Comments
“Your information has been very helpful to my wife and I and we want you to know we greatly appreciate it. Thank You!!!” (9/18/00)
Recent Comments
“I wanted to tell you what a wonderful web site you have created and continue to develop. You have helped me, my students and our patients/families more than you might know… I wish there was a way to better thank you.” (9/3/00)
Experience to Date
• Over 13,000 records in system
• Over 1000 organizations– over 400 for display
• Over 100 organizations contacted
• Sites change
• Hard to keep up
Future• Health news• Patient education
modules• AgePage (National
Institute on Aging)• Additional drug
information• Share links with local /
regional Web sites
• Terminology server to improve searching
• Spanish language• Consumer health
libraries from DOCUSER
• Cooperation: sharing health resources
Coming Soon - Health News
Full News Story
Topic with News
Summarizing MEDLINEplus...
MEDLINEplus is:
• Selective
• Highly reviewed
• Private
• Responsive
• Growing
NLM Gatewayhttp://gateway.nlm.nih.gov/
• Launched October 16th
• A single Web interface that searches multiple NLM retrieval systems
• Includes limits for consumer health (MEDLINEplus)
ClinicalTrials.govhttp://clinicaltrials.gov/
• Provides patients, family members, health care professionals, and members of the public easy access to information on clinical trials for a wide range of diseases and conditions
• Collaborative effort between NLM, other NIH institutes and the Food and Drug Administration (FDA)
AgePage
• Cooperative effort between the National Library of Medicine and the National Institute on Aging
• Reflects NLM’s efforts of reaching out to special populations
Electronic Health Information Projects
• Announced in January 2000• Projects will run from 12 to 18 months• More than $1 million invested• Projects target people who lack access to
computers and computer skills• Originally involved 49 projects; four more
were recently added
http://www.nlm.nih.gov/news/press_releases/ehip.html
http://www.nlm.nih.gov/nno/hipprojects.html
http://www.nlm.nih.gov/news/hipprojects2.html
JAMA 2000 Apr 5;283(13):1675-6.
HEALTHINFOQUESThttp://www.nnlm.nlm.nih.gov/healthinfoquest/
• Series of pathfinders primarily for public librarians and health educators
• Joint effort of– King County Library System (Bellvue, WA)– NN/LM Pacific Northwest Region (University of
Washington Health Sciences Library and Information Center)
Consumer Health: An Online Manualhttp://www.nnlm.nlm.nih.gov/scr/conhlth/manualidx.htm
• Includes information about– Planning a consumer health library– Evaluating consumer health Web sites– Consumer health materials in Spanish
• Coordinated by the NN/LM South Central Region (Houston Academy of Medicine--Texas Medical Center Library)
The Public Library and Consumer Health:Meeting Community Needs Through
Resource Identification and Collaborationhttp://www.pla.org/consumerhealth.html
• January 10-11, 2001 at the Hyatt Regency, Washington, DC
• Presented by the Public Library Association (PLA), NLM and MLA
• Provides library staff with an introduction to health information resources, collection development and searching health and medical information databases
• Examples of collaborative projects that public libraries can model will be presented
• Special tours of NLM will be offered
• Get the word out to your local public libraries!
For more information...