Oct 03

The NNT

Just realized that I have not yet mentioned here that I don’t work in a medical library any longer.

A few months ago, I took a job as the geek (technologist-generalist?) for the Department of Emergency Medicine at SUNY Upstate. I love the job. Love it. The people are great and the work is both challenging and interesting.

While I have really enjoyed shifting more to the mechanics of health information than the content, I’ve found certain librarianish habits and interests haven’t faded.

For instance, TheNNT.com fascinates me.

http://www.thennt.com/

“There is a way of understanding how much modern medicine has to offer individual patients. It is a simple statistical concept called the “Number-Needed-to-Treat”, or for short the ‘NNT’. The NNT offers a measurement of the impact of a medicine or therapy by estimating the number of patients that need to be treated in order to have an impact on one person. The concept is statistical, but intuitive, for we know that not everyone is helped by a medicine or intervention — some benefit, some are harmed, and some are unaffected. The NNT tells us how many of each.”

Here’s a great example: Anticoagulation for Venous Thromboembolism

Or check out Mediterranean Diet for Secondary Prevention After Heart Attack.

Is it just me, or is this site crazy awesome? I’ve encountered a handful of physicians who like the site a lot, but I’ve heared next to nothing from medical librarians. Any thoughts?

Apr 06

Books I Would Very Much Like to Read/Review

New(ish) or upcoming books that I would really like to read and review here

The Information: A History, a Theory, a Flood
By James Gleick

Okay, I admit I’m already reading this one- and LOVING it.  Gleick (who also wrote a great biography of Richard Feynman), writes in a fascinating, engaging way about the history of information and of information technology.  This book wonderfully illuminates how we got where we are and provides hints at where we might be going.

I would like a stack of 20 copies, please, so I can give one to each of my favorite 20 technology-resistant librarians.

Check out these reviews.

________________________________

An Introduction to Research for Health Librarians
By Barbara Sen

This looks like one I’d love to read- and it is being released in May.

“This step-by-step guide provides encouragement, support, and direction for health librarians who may be new to research and evaluation or lacking in confidence or expertise. With a focus on practice-based research, evaluation, and small projects, it guides the reader through the research process, from starting to think about the research question, through to the completion of the research and dissemination of the results. It is designed to encourage quality research from library professionals and encourage them to add to the evidence base in this sector. This timely collection considers methods and approaches that are suitable in a health library context, making it a useful tool for health library professionals and students alike.”

________________________________

Evidence-Based Medicine: How to Practice and Teach it
By Sharon E. Straus MD, Paul Glasziou MRCGP FRACGP PhD, W. Scott Richardson MD, R. Brian Haynes MD

This one was released in December, but I haven’t gotten to it yet- and I’ve been instructed quite sternly to read everything Sharon Strauss writes.

“Evidence Based Medicine provides a clear explanation of the central questions: how to ask answerable clinical questions; how to translate them into effective searches for the best evidence; how to critically appraise that evidence for its validity and importance; and how to integrate it with patients’ values and preferences.”

________________________________

Without a Net: Librarians Bridging the Digital Divide
By Jessamyn C. West

Rachel Walden taught me what a “librarian crush” is, and I have had a librarian crush on Jessamyn since I saw these signs.

Teaching novice computer users, including seniors and individuals with disabilities such as low vision or motor skills, how to do what they want and need to do online is a formidable challenge for library staff. Part inspirational, part practical Without a/the Net: Librarians Bridging the Digital Divide is a summary of techniques, approaches, and skills that will help librarians meet this challenge.

Jessamyn C. West’s experience as a librarian is deeply immersed in technology culture, yet living in rural America makes her uniquely qualified to write this book. Taking a big-picture approach to the subject, she demystifies and simplifies tech training for the busy librarian, providing an easy-to-use handbook full of techniques that can be used with all of a library’s many populations. As an added bonus, she also examines the players in the library technology arena to offer firsthand reports on what works, what doesn’t, and what’s next.

________________________________

The Atlas of New Librarianship

Libraries have existed for millennia, but today the library field is searching for solid footing in an increasingly fragmented (and increasingly digital) information environment. What is librarianship when it is unmoored from cataloging, books, buildings, and committees? In The Atlas of New Librarianship, R. David Lankes offers a guide to this new landscape for practitioners. He describes a new librarianship based not on books and artifacts but on knowledge and learning; and he suggests a new mission for librarians: to improve society through facilitating knowledge creation in their communities.

The vision for a new librarianship must go beyond finding library-related uses for information technology and the Internet; it must provide a durable foundation for the field. Lankes recasts librarianship and library practice using the fundamental concept that knowledge is created though conversation. New librarians approach their work as facilitators of conversation; they seek to enrich, capture, store, and disseminate the conversations of their communities.

To help librarians navigate this new terrain, Lankes offers a map, a visual representation of the field that can guide explorations of it; more than 140 Agreements, statements about librarianship that range from relevant theories to examples of practice; and Threads, arrangements of Agreements to explain key ideas, covering such topics as conceptual foundations and skills and values. Agreement Supplements at the end of the book offer expanded discussions. Although it touches on theory as well as practice, the Atlas is meant to be a tool: textbook, conversation guide, platform for social networking, and call to action.

[More here]

________________________________

What new books are you reading or looking forward to?

Apr 04

SciPlore Combines Mind Maps with Reference and PDF Management

SciPlore is an interesting tool that I just started playing with.

“Are you using mind mapping tools such as MindManager, FreeMind or XMind? And reference management tools such as JabRef, Endnote, or Zotero? And do you sometimes even create bookmark in PDFs? Then you should have a look at SciPlore MindMapping.”

My need for PDF management tools is really pretty specific and infrequent. What about you academic folks? Is this something you could use?

Mar 18

Patient Handouts at the Point of Care

My Primary Care Physician is a good guy.  His practice implemented an EMR a few years ago- each time I see him, I ask him how that’s going and he lets me see how it looks on the tablet PC he carries into the exam room.

My last visit was for an annual checkup a few weeks ago and we were talking about point-of-care tools and integration with his EMR.  It turns out that their EMR has no useful functionality to help find or produce patient education handouts he can quickly sent to a printer

I told him it would not be difficult to make a tool that would enable him to find authoritative handouts quickly and easily from the paid resources his practice has available, and he expressed interest in that idea.

He hasn’t followed up, but I found the idea interesting, so I started thinking about what sort of tool could be built for this purpose that could be integrated into any EMR using only patient handouts that are available at no cost on the Web.

With that in mind, I came up with a Google Custom Search Engine for use by providers at our hospital, but I see no reason why it couldn’t be used by any institution or practice.

The idea behind this is that any search result is not only authoritative, but that it is within a click of a “print” button.

There are built-in refinements for large print, pediatrics, Spanish language, Seniors, and low literacy.

Please give it a try here.

Internists and medical libraryfolk: I’d be grateful for your feedback!

Dec 01

Social Media and the Medical Profession

“A guide to online professionalism for medical practitioners and medical students”

http://www.ama.com.au/socialmedia

The Australian Medical Association Council of Doctors-in-Training (AMACDT), the New Zealand Medical Association Doctors-in-Training Council (NZMADITC), the New Zealand Medical Students’ Association (NZMSA), and the Australian Medical Students’ Association (AMSA) are committed to upholding the principles of medical professionalism. As such, we have created some practical guidelines to assist doctors and medical students to continue to enjoy the online world, while maintaining professional standards.

Download PDF

Not a bad start. Not sufficient for the purposes of most, but not a bad start. Hope others will build on this.

UPDATE:
Ratcatcher’s comment below reminds me that I should also link to a similar attempt by the American Medical Association. I agree with Ratcatcher on the relative merits of these two efforts.

[via Ratcatcher]

Nov 30

Systematic Review Study

{Posted by request]

http://www.hsls.pitt.edu/services/reference/study

We are looking for volunteers to participate in a study to identify trends in conducting literature searches to support systematic reviews. Results will help systematic reviewers and information professionals to better plan resources to search and allow a more accurate estimation of time and effort required for the literature search portion of a systematic review. We hope to disseminate results of this study by presentation at a meeting and/or publication in a peer-reviewed journal.

The study is a survey designed to prospectively collect data and will include questions regarding participants’ background, systematic review topic, and specifics on search strategies such as names of resources utilized and time spent searching. The information will be collected at two different time points over the course of several months.

The maximum time required to complete the survey may be 45 minutes. However, most of the information we are collecting is routinely documented during the process of conducting a systematic review. Specific details on the systematic review projects will be kept confidential and survey results will be kept in safe storage. There are no foreseeable risks associated with this project. Your participation is voluntary, and you may withdraw from this project at any time.

Prerequisites: To participate in the study you must currently be involved in a systematic review, or plan to in the near future. However, searching should not have taken place prior to enrollment.

If you are interested in participating, please send an email to Ahlam Saleh at saleha@pitt.edu. Questions regarding this study should be directed to either Ahlam Saleh or Melissa Ratajeski:

Ahlam Saleh, MD, MLS
Reference Librarian
University of Pittsburgh, Health Sciences Library System
saleha@pitt.edu
412-648-2166

Melissa Ratajeski, MLIS, RLAT
Reference Librarian
University of Pittsburgh, Health Sciences Library System
mar@pitt.edu
412-648-1971

Oct 22

Melissa Rethlefsen’s Continued Awesomeness

I’d have given anything to see this presentation given. It may not interest you if you’re not a medlib person interested in publishing (or if you don’t know me or Melissa), but I grinned my way through the slides as they show the path to the creation of the book.

Then there’s this recent presentation of Melissa’s on mobile health tech for the Midwest Chapter of the Medical Library Association in Madison, WI in September that contains lots of consumer applications I know nothing about:

That’s especially timely, given Pew’s recent report.

Melissa is awesome. She even let me come to her wedding, where we took these photobooth shots:
David and Melissa
(Click for larger version)

Mar 20

Unsolicited Answers to Rhetorical Questions

From something I saw in Facebook recently:

facebook3rdpartypubmedmedline

Q: Will NextBio do away with PubMed?
A: Absolutely not. In order to even have a chance at making PubMed irrelevant, a 3rd-party tool would have to be free. I believe I have played with the vast majority of 3rd-party PubMed/MEDLINE tools available (see this post category for details).

Q: …will Pubget do away with PubMed?
A: In some libraries for some users, PubGet will be a the preferred option. Will it make PubMed irrelevant? Good lord, no.

K adds:

Suspect they use PubMed to get their lit content, esp since they say they include all the full text from PubMed Central.

K is absolutely right. Both PubGet and NextBio get their data through NCBI API tools.

Now, if GoPubMed (free) did LinkOut and/or made PDF retrieval as easy as PubGet (free) does and marketed it well…that could threaten to make PubMed irrelevant.

However, PubMed makes the index of the world’s medical literature available to millions and it used worldwide as an essential healthcare tool. Ask yourself: Do you want to trust a private corporation to take good and ethical care of such an important public good? I don’t. I’d rather trust the NLM.

Feb 21

How to: Add a Free Medical Dictionary to Word 2003/2007

Got an email from a friend the other day:

“I wonder if you have found a free add-on for Word 2003 that includes medical terms in the spell check feature and is secure enough for me to recommend to my users at the hospital?”

This is such a great question and something that has come up at my place of work previously. Out of the box, Microsoft Office Word doesn’t recognize a whole lot of the specialized medical vocabulary that people at our hospital use every day. The result of this is that Word frequently fails to recognize clinical terms and underlines them in red, essentially making them false positives for spelling errors.

Only one employee in my department has Stedman’s medical dictionary installed in her copy of Word 2003 because paying a license for each copy used in an entire hospital would add up to an unmanageable sum quite quickly.

Among the books made available to all employees through our hospital’s intranet is a medical dictionary- and that’s okay for the kinds of people who don’t mind stopping what they’re doing to look up a word, but it would be so much faster and easier for Word to be able to spell-check and correct spelling issues with medical terms.

So I promised the friend I’d think it over and come up with some recommendations.

In MS Word, a “dictionary” is just a list of words.

That’s all. Nothing on pronunciation, etymology, or definition.

A quick search reveals that these “dictionaries” (word lists) are stored as .dic files.

Microsoft even tells you how to MAKE a custom dictionary.

So, what we really need is a list of words to turn into a custom dictionary.

OpenMedSpel is pretty awesome.
Free, open source, and released under a GPL license, OpenMedSpel includes nearly 50,000 medical terms. This is all looks great, but while they have a plug-in for OpenOffice, there doesn’t seem to be one for MS Word.

No problem, though. I took apart a .dic file, and it is pretty much a .txt file with a word on each line, renamed with a “.dic” file extension. This means we can just download the .txt version (in the .zip fail available here) and rename it from OpenMedSpel 100.txt to OpenMedSpel 100.dic and save it to our computer.If you want to take a shortcut, you can download my .dic file here (right-click, Save As), but please note I don’t plan on keeping it updated as OpenSpelMed makes changes- so if you’re reading this more than a year after it was posted, I’d go get a fresh copy of the .txt file from OpenMedSpel. Firefox users: Firefox’s native spell-checking isn’t bad at all, but OpenMedSpel has a free Firefox plug-in you’ll probably want to check out.

To add this .dic file to Word (2003 or 2007), we just follow these instructions from Microsoft:

  1. Start Word.
  2. In Microsoft Office Word 2003 and in earlier versions of Word, click Options on the Tools menu.

    In Microsoft Office Word 2007, click the Microsoft Office Button, and then click Word Options.

  3. In Word 2003 and in earlier versions of Word, click Custom Dictionaries on the Spelling & Grammar tab.

    In Word 2007, click Proofing, and then click Custom Dictionaries under When correcting spelling in Microsoft Office programs.

  4. Click New to create a new custom dictionary.
  5. In the File name box, type a name for the
    new custom dictionary, and then click Save.

    The custom dictionary is added to the Dictionary list.

  6. In the Custom Dictionaries dialog box, click OK, and then click OK in the Options dialog box.

That’s it. You have medical term spell-checking in Word 2003 or Word 2007.

PLEASE NOTE: I would not hesitate to recommend this solution to my hospital’s CIO and could demonstrate to him why there is absolutely no security risk in adding this .dic file- but I wouldn’t go around setting it up on other employees’ computers without his go-ahead.

Want to go with a bigger word list?

The MTHerald blog has built on the OpenMedSpel list to one that contains almost 100,000 terms. I downloaded and checked it out and will recommend it as a harmless, malware-free .dic file- but as with any file I don’t host myself, I can’t promise that’ll be true tomorrow.

There are a number of other sources for lists of medical terms or abbreviations you can find online and add to your .dic file as suits you.

Know of any other especially good sources? Please advise in the comments.

Feb 13

Big Pharma in your iPhone and Nintendo

From The Independant: Medicines not working? There’s an app for that

(Is anyone else completely done with the “There’s an app for that” meme?)

Novartis, for example, signed a $24 million (£15.3 million) deal last month with US-based Proteus Biomedical to create “smart pills” that can transmit data from inside the body to monitor patients’ vital signs and check they have taken medicines as prescribed.

Bayer is connecting its glucometer for diabetic children to Nintendo’s video-gaming consoles to promote consistent blood sugar testing.

And Johnson & Johnson’s Lifescan unit has an iPhone application that lets users upload readings from their connected blood glucose monitors to their Apple phone.

Feb 10

Yet Another Reason to Love the NLM: Emergency Access Initiative

I just caught up and noticed this…and think it is brilliant.

http://eai.nlm.nih.gov/

The Emergency Access Initiative (EAI) is a partnership of the National Library of Medicine, the National Network of Libraries of Medicine, and the Professional/Scholarly Publishing Division of the Association of American Publishers. EAI provides free access to full text articles from major biomedicine titles to healthcare professionals, librarians, and the public in the United States affected by disasters.

Of course, I won’t be using this because I’m not doing anything related to the disaster in Haiti- but the NLM deserves all kinds of attention and praise for doing this, as do contributing publishers:

American Academy of Pediatrics, American Association for the Advancement of Science, American College of Physicians, American Society of Health-Systems Pharmacists, ASM Press, B.C. Decker, BMJ, Elsevier, FA Davis, Mary Ann Liebert, Massachusetts Medical Society, McGraw-Hill, Merck Publishing, Oxford University Press, People’s Medical Publishing House, Springer, University of Chicago Press, Wiley, and Wolters Kluwer.

Feb 09

USDA and Social Media

In my previous post about social media endeavors at the CDC and HHS, I should also have mentioned the United States Department of Agriculture.Full disclosure: My friend Craig Stoltz is working on USDA social media projects, and they’re very lucky to have him. There are a lot of social media “experts” who are not actually all that expert- but Craig really knows his stuff.

Are there other government agencies (related to health and/or healthcare) with social media projects I haven’t noticed yet? Please let me know in the comments?

Feb 08

CDC and HHS Guidelines/Policies on Social Media

Does it say something that these .gov agencies have formal social media operations and policies?

Centers for Disease Control
CDC Social Media Tools Guidelines & Best Practices

Front page for social media at the CDC:
http://www.cdc.gov/socialmedia/

Health and Human Services
The HHS Center for New Media, Standards and Policies

Front page for HHS Center for New Media:
http://www.newmedia.hhs.gov/

Brief “interview” from AdAge with Andrew P. Wilson, web manager for HHS:
http://adage.com/digital/article?article_id=134332

Excerpt:

Pblackshaw: So Andrew, does the Health and Human Services Department really have a social-media team?

AndrewPWilson: Yes. See http://tinyurl.com/accz97. The social-media outreach effort is being directed by the department’s new Social Media Center.

Pblackshaw: What does that mean — Social Media Center? Just you? A full team? A body of activity?

AndrewPWilson: People in the department have been working with social media for some time, e.g., http://tinyurl.com/bsrtt8 (and others). Now we’re starting broader initiatives.

Pblackshaw: But just you? What’s your role?

AndrewPWilson: It’s still evolving but much more than just me. To start, developing resources and expertise in the dept to help HHS understand and use new tools.

Feb 08

Atul Gawande on The Daily Show

Among the things I like: Patient safety, Jon Stewart, and Atul Gawande.

Gawande talks with Stewart about The Checklist Manifesto (video embedded below).

The Daily Show With Jon Stewart Mon – Thurs 11p / 10c
Atul Gawande
www.thedailyshow.com
Daily Show
Full Episodes
Political Humor Health Care Crisis

Steven Levitt calls this “…the best book I’ve read in ages.”

Dagnabbit. Now I need to read it.

Jan 29

MLGSCA/NCNMLG 2010 Slides (#jm2010az)

Perhaps I can write a bit more about my trip to Arizona soon, but for now I wanted to get the slides posted for those who attended.

It was lots of fun and a treat for me to get to leave Syracuse in January and gape at palm trees for a couple of days. :)