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Archive for February, 2008

Web Geekery in Recent Literature – 2/17/2008

More about online consumer cancer information

Cancer Invest. 2008 Mar;26(2):202-7.
Internet health resources and the cancer patient.
Huang GJ, Penson DF.
Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California 90089, USA.
The last decade has witnessed an explosion of online information regarding cancer and healthcare. Accompanying this has been a large body of research analyzing the quality of this information, how patients perceive these data and how this affects the doctor-patient relationship. This report reviews this literature, summarizing the current state of internet health resources available to the cancer patient and identifying areas for future research. Studies indicate that there are considerable internet resources available to cancer patients and that patients are using these resources as secondary information sources. Specifically, studies indicate that 16-64% of patients are using the internet to obtain health information. For the most part, patients perceive the online information to be reliable but maintain a healthy degree of skepticism. Studies objectively evaluating cancer information on the internet indicate that there is reasonable quality, although the language level of many sites is higher than that of the average American, which may limit the utility of the websites. Finally, while there is widespread internet use by physicians, healthcare providers are skeptical of their patients’ ability to use the internet and may even be somewhat threatened by it. In summary, while there is a fairly large literature on internet resources available to the cancer patient, more research is needed. Specifically, it is important to better understand how patients access health information online and their associated preferences so that we can improve cancer patient’s access to high quality health information on the internet to facilitate decision-making and health outcomes.
PMID: 18259953

Webcasting for dentistry education!

Br Dent J. 2008 Feb 9;204(3):145-9.
Webcasting: casting the web more widely.
Reynolds PA, Mason R, Eaton KA.
Centre of Flexible Learning in Dentistry, King’s College London Dental Institute, Floor 3, Strand Bridge House, 138-142 Strand, London, UK. P.A.Reynolds@kcl.ac.uk
In the search for a cost-effective method of delivering teaching to dispersed groups of students, webcasting is proving successful. By taking video streams and transmitting them over the Internet it allows events such as lectures, seminars, webinars and tuition sessions to be made accessible to participants in many different, remote locations. Moreover, the webcasts can be stored on a normal PC to give, those unable to see the original broadcast, the opportunity to watch it at a later, more convenient time; similarly it can be used by students for revision purposes. New developments have allowed a useful level of interactivity between presenters and students, and between students themselves. As part of a recent project at a UK dental school, webcasting was trialed amongst undergraduates and postgraduates to measure its value for dental education. The results have been very encouraging, with the latter group especially benefiting from being able to see the webcasts in their own time, on their PCs at home or work. However, as befits an ever-changing scenario, a new web-oriented facility is beginning to play a role in education: podcasting provides a more personal, individual interaction with the web.
PMID: 18264069

The Doctor’s Channel: YouTube for Doctors (again)

New to me, The Doctor’s Channel appears to be another video site for clinicians and scientists. Berci has a list of similar sites here.

John Halamka on Facebook

John Halamka on Facebook:

“In my next generation of portal frameworks, I will support our own versions of all the Web 2.0 functionality (forums, wikis, groups, multimedia uploads) that is in Facebook, but I will also ensure that Facebook itself is used strategically. Staying agile and responsive to my customers requires that I embrace Facebook, not resist it.”

Read the rest.

In case you’re not yet familiar with Dr. Halamka or his excellent blog:

John D. Halamka, MD, MS, is Chief Information Officer of the CareGroup Health System, Chief Information Officer and Dean for Technology at Harvard Medical School, Chairman of the New England Health Electronic Data Interchange Network (NEHEN), CEO of MA-SHARE (the Regional Health Information Organization), Chair of the US Healthcare Information Technology Standards Panel (HITSP), and a practicing Emergency Physician.

Dr. Halamka is frequently mentioned in Paul Levy’s Running a Hospital, and absolutely understands the value of hospital libraries…though I wish he’d answered Mark Funk’s question (hint-hint, nudge-nudge, wink-wink, fingers crossed).

Web Geekery in Recent Literature – 2/15/2008

On the internet and patient education:

Clin J Oncol Nurs. 2008 Jan;12(1):55-63.
The internet: friend or foe when providing patient education?
Anderson AS, Klemm P.
James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY.
The Internet has changed how patients with cancer learn about and cope with their disease. Newly diagnosed patients with cancer often have complex educational and informational needs related to diagnosis and treatment. Nurses frequently encounter time and work-related constraints that can interfere with the provision of patient education. They are challenged to educate patients in an environment of rapidly expanding and innovative computer technology. Barriers that hinder nurses in integrating educational Internet resources into patient care include lack of training, time constraints, and inadequate administrative support. Advantages of Internet use for patient education and support include wide-ranging and current information, a variety of teaching formats, patient empowerment, new communication options, and support 24 hours a day, seven days a week. Pitfalls associated with Internet use for patients with cancer include inaccurate information, lack of access, poor quality of online resources, and security and privacy issues. Nurses routinely use computer technology in the workplace and follow rigorous security and privacy standards to protect patient information. Those skills can provide the foundation for the use of online sources for patient teaching. Nurses play an important role in helping patients evaluate the veracity of online information and introducing them to reliable Internet resources.
PMID: 18258575

Anglophonic Canadians seeking healthcare info online:

Health Informatics J. 2008 Mar;14(1):17-28.
Use of health-related information from the Internet by English-speaking patients.
Khechine H, Pascot D, Prémont P.
Departement of Information Systems, Faculté des sciences de l’administration, Université Laval, Quebec, Canada G1K 7P4. hager.khechine@sio.ulaval.ca.
The aim of this research is to determine the kinds of health-related information that patients seek more often from websites written in English, and at which stages of the healthcare decisional process they use this information more intensively. A quantitative study was performed. Canadian English-speaking patients who have long-term diseases and who use the Internet completed an 18-item questionnaire online. Respondents were questioned about the categories of health-related websites they visit the most (scientific, general, commercial websites, or discussion groups) and the stages of the medical decisional process during which they use the information obtained (identification of possible treatments, treatment choice, and treatment application or follow-up). Results show that respondents use Internet information displayed in English mostly at the stages of identification of possible treatments (94.2%) and treatment application or follow-up (86%). At these two stages, patients look more often for information from scientific websites.
PMID: 18258672

You’ve probably already heard about this one- but just in case you haven’t…

Cancer. 2008 Feb 11
Commonly cited website quality criteria are not effective at identifying inaccurate online information about breast cancer.
Bernstam EV, Walji MF, Sagaram S, Sagaram D, Johnson CW, Meric-Bernstam F.
School of Health Information Sciences, University of Texas Health Science Center at Houston, Houston, Texas.
BACKGROUND: Consumers increasingly consult the Internet for breast cancer information. Concerned about accuracy, multiple organizations developed quality criteria for online content. However, the effectiveness of these tools is unknown. The authors determined whether existing quality criteria can identify inaccurate breast cancer information online. METHODS: The authors identified 343 unique webpages by using 15 breast cancer-related queries on 5 popular web search-engines. Each page was assessed for 15 quality criteria and 3 website characteristics, link type (sponsored or not), search engine used to find the page, and domain extension. Two clinician-reviewers independently assessed accuracy and topics covered. The authors then determined whether quality criteria, website characteristics, and topics were associated with the presence of inaccurate statements. RESULTS: The authors found 41 inaccurate statements on 18 webpages (5.2%). No quality criteria or website characteristic, singly or in combination, reliably identified inaccurate information. The total number of quality criteria met by a website accounted for a small fraction of the variability in the presence of inaccuracies (point biserial r = -0.128; df = 341; P = .018; r(2) = 0.016). However, webpages containing information on complementary and alternative medicine (CAM) were significantly more likely to contain inaccuracies compared with pages without CAM information (odds ratio [OR], 15.6; P < .001). CONCLUSIONS: Most breast cancer information that consumers are likely to encounter online is accurate. However, commonly cited quality criteria do not identify inaccurate information. Webpages that contain information about CAM are relatively likely to contain inaccurate statements. Consumers searching for health information online should still consult a clinician before taking action. Cancer 2008. (c) 2008 American Cancer Society.
PMID: 18266210

More details: NLM Browser Toolbar

I posted earlier this month about a browser toolbar built to make use of NLM resources.

At the time I was impressed with Guus van den Brekel for having discovered it. It turns out that I have better reason to be impressed. Guus built it.

I finally got around to trying it…and I like it. I’m not sure that the “Other PubMeds” feature is really worth the real estate it takes up (I’d rather it linked directly to particularly useful 3rd-party PubMed Tools rather than to sites about them), but that’s a fairly minor complaint.

Conduit appears to have a good reputation and I absolutely trust Guus- so I’d say it is worth trying whether or not it has been endorsed by the NLM. If you have suggestions about how it could be improved, please share them with Guus.

Searching BioMedical Literature (slides)

Oh, I downloaded a copy of this right away for the next time I need to teach about this topic.

A Bioinformatics 800.6 Module A lecture given on February 5, 2008 on the topic of biomedical web-based literature searching tools.

LibWorm is an “Awesome Beta Research Tool”

CollegeDegree.com lists LibWorm as one of its “25 Awesome Beta Research Tools from Libraries Around the World.”

24. LibWorm: This beta helps you “search the biblioblogosphere and beyond.” When you want to start your search on the Internet but only want to find library-related material, this tool can help. By pulling information from over 1500 RSS feeds in categories like academic libraries, government libraries, law libraries, podcasts: librarianship, medical libraries and more.

Thanks to Paul Pival for the heads-up!

RSS Feed for New PMC Journals

Guus van den Brekel used Feed43 and the tutorial I wrote to create an RSS feed for journals recently added to PubMed Central.

Here’s the feed’s URL:
http://feeds.feedburner.com/PmcJournalListnew

A preview:

Great idea, Guus!

Troubled Tuesday (Reactions to Marcus Monday)

Dean Giustini likes Marcus’ idea about replacing LIS journals with blogs (see yesterday’s post), but also has concerns:

…my only reservation is when research methods are used such as randomization and the articles would need to go through peer-review.

T. Scott (former editor of the JMLA and one of my favorite contrarians) explains some of his reservations about the idea:

I’m not one who is terribly impressed by the “wisdom of crowds” (a concept that seems to be especially dubious during the US election season). I’ve rarely seen anything approaching substantive discussion and analysis take place in a comment thread, and the longer the thread, the more worthless it typically is. Rather than providing vibrant post-publication review, I’m afraid that posting unedited articles for comment would result in much good work being buried and ignored.

[...snip...]

Marcus is pushing the right questions, and everyone involved in scholarly publishing, at whatever level, should be thinking creatively about how to make the communication and discussion of projects and ideas more effective.

I’ve noticed my neck often aches after reading T. Scott’s blog. After some investigation, I’ve finally figured out that this is because I can’t seem to stop nodding my head while I read him.

I especially like this last bit of his post:

But it isn’t a matter of journals vs blogs. The most effective modes of communication that we develop over the next decade will adopt features that we associate with each, but will be fundamentally different from either.

I couldn’t agree more. I don’t think that blogs or wikis are going to revolutionize medicine, education, or publishing- but some applications of their descendent technologies might.

Since LIS News and LibraryStuff both posted about it, I’m betting there’ll be more interesting opinions to enjoy soon.

Medical Vocabulary Test

This short quiz from the University of South Carolina was a fun way to waste 5 minutes.

I got 24 out of 25 and am kicking myself for the one I missed.

[via]

Marcus Monday: Replace LIS Journals with Blogs

Marcus Banks is having quite a Monday.

First, he makes an argument for why LIS journals should be replaced by LIS blogs.

“…the traditional journal model is antiquated for sharing research and knowledge among librarians. A better course is to develop and nurture excellent blogs, with multimedia capabilities and guaranteed preservation of the postings. This could be an entirely new blog that starts from scratch, or an established journal that evolves into a blog.”

On peer review for this model:

“Peer review should be a post-publication process, rather than a pre-publication process that sometimes drags out for many months. If physicists can post pre-prints that get discussions flowing quickly, why can’t librarians?

The argument for pre-publication peer review is that it filters out poor research. This is a legitimate concern when the research in question is about a new and potentially deadly medical intervention. Library research is not like this; peer review can occur via community conversation.”

Interesting stuff that I’ll be thinking about for a good while.

Second, Marcus has posted the slides from his paper on MedLib Blogs via slideshare…but I can’t get slideshare to load. Dagnabbit.

Marcus kindly let me upload his slides to Google Docs so I could embed them here:

Presentation on Health Information in Second Life (SLHealthy Wiki)

Patricia Anderson has posted the slides for her presentation on the SLHealthy Wiki.

JANE (Journal/Author Name Estimator)

Have you recently written a paper, but you’re not sure to which journal you should submit it? Or are you an editor, and do you need to find reviewers for a particular paper? Jane can help!

Just enter the title and/or abstract of the paper in the box, and click on ‘Find journals’ or ‘Find authors’. Jane will then compare your document to millions of documents in Medline to find the best matching journals or authors.

http://biosemantics.org/jane/

More info:
Martijn J. Schuemie and Jan A. Kors, Jane: Suggesting Journals, Finding Experts, Bioinformatics, January 28, 2008.

[via]

Other posts about third-party PubMed/MEDLINE tools

Web Geekery in Recent Literature – 2/6/2008 (1337speak in Pu8M3d!)

Geekiest Article Title in PubMed to Date!

J Exp Psychol Hum Percept Perform. 2008 Feb;34(1):237-41.
R34d1ng w0rd5 w1th numb3r5.
Perea M, Duñabeitia JA, Carreiras M.
Departamento de Metodologia, Facultad de Psicologia.
Letter identities and number identities are usually thought to imply different cortical mechanisms. Specifically, the left fusiform gyrus responds more to letters than to digits (T. A. Polk et al., 2002). However, a widely circulated statement on the internet illustrates that it is possible to use numbers (leet digits) as parts of words, 4ND TH3 R35ULT1NG S3NT3NC3 C4N B3 R34D W1TH0UT GR34T 3FF0RT. Two masked priming lexical decision experiments were conducted to determine whether leet digits produce (automatic) lexical activation. Results showed that words are identified substantially faster when they are preceded by a masked leet word (M4T3R14L-MATERIAL) than when they are preceded by a control condition with other letters or digits. In addition, there was only a negligible advantage of the identity condition over the related leet condition. This leet-priming effect is not specific to numbers: A prime in which leet digits are replaced by letter-like symbols (MDeltaTeuroR!DeltaL-MATERIAL) facilitates word processing to the same degree as an identity prime. Therefore, the cognitive system regularizes the shape of the leet digits and letter-like symbols embedded in words with very little cost. (PsycINFO Database Record (c) 2008 APA, all rights reserved).
PMID: 18248151

Actually interested in this subculture? Check out Wikipedia’s entry on Leetspeak.

_____________

Suggested alternate title: “Comparison tools are okay if they’re what’s called-for. Meh.”

J Med Internet Res. 2008 Jan 22;10(1):e3.
What do evaluation instruments tell us about the quality of complementary medicine information on the internet?
Breckons M, Jones R, Morris J, Richardson J.
School of Nursing and Community Studies, University of Plymouth, Faculty of Health and Social Work, Plymouth, United Kingdom.
BACKGROUND: Developers of health information websites aimed at consumers need methods to assess whether their website is of “high quality.” Due to the nature of complementary medicine, website information is diverse and may be of poor quality. Various methods have been used to assess the quality of websites, the two main approaches being (1) to compare the content against some gold standard, and (2) to rate various aspects of the site using an assessment tool. OBJECTIVE: We aimed to review available evaluation instruments to assess their performance when used by a researcher to evaluate websites containing information on complementary medicine and breast cancer. In particular, we wanted to see if instruments used the same criteria, agreed on the ranking of websites, were easy to use by a researcher, and if use of a single tool was sufficient to assess website quality. METHODS: Bibliographic databases, search engines, and citation searches were used to identify evaluation instruments. Instruments were included that enabled users with no subject knowledge to make an objective assessment of a website containing health information. The elements of each instrument were compared to nine main criteria defined by a previous study. Google was used to search for complementary medicine and breast cancer sites. The first six results and a purposive six from different origins (charities, sponsored, commercial) were chosen. Each website was assessed using each tool, and the percentage of criteria successfully met was recorded. The ranking of the websites by each tool was compared. The use of the instruments by others was estimated by citation analysis and Google searching. RESULTS: A total of 39 instruments were identified, 12 of which met the inclusion criteria; the instruments contained between 4 and 43 questions. When applied to 12 websites, there was agreement of the rank order of the sites with 10 of the instruments. Instruments varied in the range of criteria they assessed and in their ease of use. CONCLUSIONS: Comparing the content of websites against a gold standard is time consuming and only feasible for very specific advice. Evaluation instruments offer gateway providers a method to assess websites. The checklist approach has face validity when results are compared to the actual content of “good” and “bad” websites. Although instruments differed in the range of items assessed, there was fair agreement between most available instruments. Some were easier to use than others, but these were not necessarily the instruments most widely used to date. Combining some of the better features of instruments to provide fewer, easy-to-use methods would be beneficial to gateway providers.
Publication Types:
Research Support, Non-U.S. Gov’t
PMID: 18244894

_____________

Article about Isabel (video demo available here).

J Gen Intern Med. 2008 Jan;23 Suppl 1:37-40.
Comment in:
J Gen Intern Med. 2008 Jan;23 Suppl 1:85-7.
Performance of a web-based clinical diagnosis support system for internists.
Graber ML, Mathew A.
Medical Service-111, VA Medical Center, Northport, NY 11768, USA. mark.graber@va.gov
BACKGROUND: Clinical decision support systems can improve medical diagnosis and reduce diagnostic errors. Older systems, however, were cumbersome to use and had limited success in identifying the correct diagnosis in complicated cases. OBJECTIVE: To measure the sensitivity and speed of “Isabel” (Isabel Healthcare Inc., USA), a new web-based clinical decision support system designed to suggest the correct diagnosis in complex medical cases involving adults. METHODS: We tested 50 consecutive Internal Medicine case records published in the New England Journal of Medicine. We first either manually entered 3 to 6 key clinical findings from the case (recommended approach) or pasted in the entire case history. The investigator entering key words was aware of the correct diagnosis. We then determined how often the correct diagnosis was suggested in the list of 30 differential diagnoses generated by the clinical decision support system. We also evaluated the speed of data entry and results recovery. RESULTS: The clinical decision support system suggested the correct diagnosis in 48 of 50 cases (96%) with key findings entry, and in 37 of the 50 cases (74%) if the entire case history was pasted in. Pasting took seconds, manual entry less than a minute, and results were provided within 2-3 seconds with either approach. CONCLUSIONS: The Isabel clinical decision support system quickly suggested the correct diagnosis in almost all of these complex cases, particularly with key finding entry. The system performed well in this experimental setting and merits evaluation in more natural settings and clinical practice.
Publication Types:
Research Support, Non-U.S. Gov’t
PMID: 18095042

Free full text: [PDF] [HTML]

Google Books – Admitting Usefulness

I hadn’t spent much time playing with Google Book Search, but I was intrigued by this recent post from Dr. Joshua Schwimmer describing a moment in which it was very useful:

Several months ago, a group of medical students, residents and I were in the emergency department examining a patient who might have had necrotizing fasciitis. This condition, also known as “the flesh eating bacteria,” is as evil as it sounds. It must be diagnosed and treated quickly — often with extensive surgical debridement — or the patient will die. Atul Gawande, one of my favorite medical authors, had written about a patient with necrotizing fasciitis in his book Complications, which I’d recently read. It’s a great book, it contains a perfect description of the disease, and at that moment, I wished I had it in front of me. So I punched “gawande necrotizing fasciitis” into Google Book Search, and instantly the exact passage was on the screen.

It got me thinking. How many potential opportunities for teaching are lost because the original text isn’t available, short of taking a trip to the nearest medical library? How much knowledge lies dormant because no one can find it?

Having recently read this post by Dr. Schwimmer, Google Books was on my mind the other day when a library patron put to me a question about how commas should appropriately be used. Wishing that I had my home copy of Strunk and White’s Elements of Style with me, I wondered if I could look it up via Google Books. I went to Google Books and searched for “elements of style” comma after each term. The first search result was exactly what I wanted.

Huh.

I’m not sure I have a solid grasp of the issues surrounding the anxiety/fear/loathing that some librarians seem to have for Google Books. If anyone would like to recommend a good article or essay on the topic, I’d be grateful.

WorldPharmaNews.net (Digg for Pharma News)

Another Pligg-powered communal news service based on the Digg model- this one is for Pharma news.

From the press release:

“We know that it is a very ambitious initiative but we trust in the power and in the flexibility of the coming Web 2.0 pharmaceutical solutions/interfaces, we sincerely hope that in the nearest future the term ‘Pharma 2.0′ will sound as well appropriate as the terms Web 2.0 or Health 2.0″, assumed World Pharma News .net administrator.

“Pharma 2.0″? Oy. Another meaningless application of the “2.0″ suffix.

Also, what’s so ambitious about setting up a free, open-source content management system that hundreds have previously used successfully?

Related Posts

Scinversations: Aggregating Online Conversation About an Article

I think Jon Udell started it.

Jon noted that science stories get released online and bookmarked, commented upon, and blogged about all over the Web.

It’s all happening on the web, but it’s happening in isolated ghettoes with few points of actual contact. How could we bring those worlds into closer contact?

Jon also suggests how this might best be done.

Here’s one approach that could help. When the citation engines in the blogosphere find references in blog entries to scientific articles on the web, they could resolve those to their most canonical forms: DOIs, PubMed records. And they could make equivalences among those forms. That way, conversation in the blogosophere about a scientific article, and scientific conversation about the same article, would tend to hang together and would be discoverable in the same contexts.

Alf Eaton seemed to think this was a good idea and built a tool at Scintilla to do this. Go give Scintilla Conversations a try.

There’s also a Scinversations bookmarklet you can drag and drop on to your browser’s toolbar: Scinversations

Peter Suber points out a perfect PubMed Central article with which you can take the Scinversations bookmarklet to a test drive.

Nicely done, Alf!

NLM Browser Toolbar

http://nlm.ourtoolbar.com/

This appears to be a Conduit toolbar…but I see no proof that the NLM is actually behind it.

If you install it and use it, leave a comment to let me know what you think of it?

[Via Guus van den Brekel]

Google’s Social Graph API

The new Social Graph API from Google might prove really interesting.

I added a bunch of XFN ‘rel’ attributes to this blog’s links so I can do a little more playing (if you’re using WordPress, you can do this quickly and easily).

Someday I’ll get around to writing about microformats here- but not today.

For more on why this new API is interesting, see this item from Tim O’Reilly.

Crohn’s & Me

A stack of flyers for this online community was seen in the examination room of a gastroenterologist and passed on to me by an acquaintance.

Interesting. Seems that the site is a product of UBC Inc.

UBC makes Dipentum (Olsalazine) for the treatment of Ulcerative Colitis and Cimzia (Certolizumab Pegol) for the treatment of Crohn’s disease.

I don’t trust a pharmaceutical manufacturer to offer unbiased information to healthcare consumers and I can’t figure out why a physician would put these in his office.

Are there other portals that are run by drug companies? If you’ve checked them out, what do you think of the information or services they offer?

I’d feel a lot better about a social network for patients with Crohn’s or Colitis if it was run by the CCFA…wouldn’t you?

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