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Apomediation, Online Health Info and Baloney

A recent article in the Journal of Rheumatology:

“Trying to Measure the Quality of Health Information on the Internet: Is It Time to Move On?” [html] | [PDF]

Short answer:

Hell, no.

Longer answer:

Says the article:

“The natural assumption is to believe that there exists a link between the quality of information on the Internet and harm. However, a systematic review attempting to evaluate the number and characteristics of reported cases of harm in the peer-review literature determined that for a variety of reasons, there was little evidence to support this notion.”

It is impossible to quantify why people make bad decisions. For instance, say someone makes foolish financial decisions and loses everything they own: can it be determined if these bad decisions were made based on information they found online?

On the other hand, ask anyone you know who works in an Emergency Room if they’ve seen people who have done harm to themselves with a self-diagnosis or self-treatment based on something they read online. Every one of them will confirm they have. This isn’t necessarily the fault of the information found online, but knowing as we do that people increasingly make decisions about their health that are informed by information they find online, we don’t need evidence to assume, a priori and with confidence, that bad information can lead to harm. It is common sense for everyone in the health community to promote/produce good online information resources and discourage the existence/use of bad online information resources. Most importantly, we must help both health professionals and patients gain the information and health literacy skills to tell the good from the bad.

Authors Deshpande and Jadad argue that the evaluation tools for Web sites suffer…

“…from several limitations, which, in addition to those mentioned by the authors, include uncertain levels of usability, reliability, and validity.”

I won’t argue with that. I don’t think any single evaluation tool can let someone without information literacy skills determine the quality of information found online. I don’t think that even a vast arsenal of such evaluation tools will do the trick.

The authors have questions I’ll answer (I don’t care that the questions were intended to be rhetorical- they need to be answered):

“Will we ever develop an ideal tool that allows individuals to assess the quality of health information?”

Nope. We’ll also never invent a diagnostic tool that can replace a good physician’s experience and judgement- but that doesn’t mean we shouldn’t create tools that help new doctors build these skills or help more experienced doctors flesh out their differential.

What are the determinants of this quality?

That’s a pretty broad question, but the MLA has a good basic guide of where to start.

“Is it possible to assess or measure quality?”

Medical librarians assess the quality of information every single day. So…yeah, it is.

“Even if possible, is the formal assessment of quality even necessary?”

Necessity depends on who the user is and what his/her particular information needs are.

“Does it even matter?”

Kind, encouraging teachers throughout the world often say that there’s no such thing as a stupid question. These extraordinarily compassionate educators are lying. Yes, it matters.

I’m a Web enthusiast who sees a lot of value in lots of online collaborative efforts. There are absolutely places and uses for the wisdom of the crowd- but to hear some people talk about apomediation, you’d think the wisdom of the crowd could replace the judgement of experts.

“For example, Internet users could provide ratings or recommendations based on their own experiences to judge the quality and relevance of health information.”

Huh. So if we’re just gonna’ go with what a crowd of self-selecting amateurs agree upon, I guess we don’t need double blind trials any more, either? We’ll just ask a crowd their opinion. Who needs empiricism? Science, schmience. Why should we take this article more seriously because the authors have two MDs and dotorate between them? I’m not Andrew Keen¹, but neither am I an irrational technotopian.

“Analogous to the peer-review process, aggregation of ratings from many individuals (a form of crowdsourcing) allows “good” information to be highlighted prominently, while “not so good” information gets pushed to the bottom.”

That’s a terrible analogy. In the peer-review process, both the author(s) and the reviewer(s) are credentialed experts in their field. I would not ask a room full of neurologists for advice on my house’s plumbing and I would not ask a room full of plumbers about the treatment of peripheral neuropathy. For the “Digg” model to work at all for health information, the crowd should be very large and very knowledgeable. On the other hand, even widely agreed-upon practices have later been proven wrong by empirical testing and evidence…so shouldn’t we rely on evidence?

The problem with relying only on the wisdom of crowds is that, sometimes, the crowd shows an alarming lack of wisdom regarding health information. Huckster snake-oil salesman Kevin Trudeau’s Natural Cures ‘They’ Don’t Want You to Know About was a New York Times self-help Best Seller! (For more on why this is a great example of an unwise crowd, see this video.)

Let me illustrate with a real life example: When our infant son developed what appeared to be a tremor, we didn’t waste time asking a crowd. We first asked a local pediatric neurologist for his opinion. When he was unable to make a diagnosis, we asked Dr. Marc Patterson, a pediatric neurologist at the Mayo Clinic. Dr. Patterson’s unusual experience and education enabled him to make a diagnosis very quickly.²

I wonder: If Drs. Deshpande and Jadad have family members with worrying illnesses, do they consult the best available clinical expert, or go to the wisdom of the crowd?

But I’m getting off-track. Back to the article.

As seems to be typical for malinformed physician technotopians, these authors point at Wikipedia to support their perspective.

“The interplay of users to collaborate and deal with information overload has already been proven successful in other areas outside the health space. For example, Wikipedia not only allows users to submit content on various topics, but also provides the capability for users to edit the content of others. Although there is the potential for misuse, Wikipedia, which relies on anonymous, unpaid volunteers, seems to be as accurate in covering scientific information as the Encyclopedia Britannica.”

Well, yeah. And I’d trust Wikipedia as a source for health information about as much as I’d trust Britannica….which is to say not very much.³

“Since its inception in 1990 until the present day, the health system has grappled with how to manage potential harm associated with information available on the Internet. Research in this area, for the most part, continues to assume that techniques used to evaluate paper-based information can automatically be applied to online resources, ignoring the added complexity created by the multiple media formats, players, and channels that are brought together by the Internet.”

Someone please explain to me why peer review is less effective with texts distributed online than texts distributed on artifacts of dead trees. Text is text. Someone please explain to me why peer review would be less effective if this text is read aloud and recorded/played online as video or audio (downloadable or streamed in any format). The “added complexity” the authors mention impacts peer review in no way. Perhaps this is why they make such an assertion while providing utterly no support for it.

I like Web technology and have made a nice niche for myself by writing and talking about how it can be useful to health information professionals. I am sick to death, however, of people attempting to make names for themselves with inane prognostication and unsupported technotopianism. When these authors write that “…as the Web continues to evolve, we will likely gain new insights as to how this happens along with a better understanding of how to handle health information from any source…”, I want to beat my head against a wall. To me, this is no different from saying we should go ahead and build lots more nuclear reactors because we have faith that technology will work out a way to dispose of nuclear waste in a safe manner before we are harmed by our inability to dispose of it properly. Such things are too important to take on faith in the future.

“The time has likely come to end our Byzantine discussions about whether and how to measure the quality of online health information. The public has moved on. It is time to join them in what promises to be an exciting voyage of human fellowship, with new discoveries and exciting ways to achieve optimal levels of health.”

Such a perspective would have us ally ourselves with the Jenny McCarthys of the world. Jenny McCarthy believes and popularizes the idea that immunizations cause autism spectrum disorders, despite the fact that there is no scientific evidence correlating immunizations and ASDs.

Laypeople, even brilliant laypeople, do not generally have the information or health literacy skills to know where to find quality information and to know what to trust. My brother is an experienced Web programmer. He has topped out every IQ test he has ever taken. He is a brilliant man and as talented an autodidact as anyone I know. Still, when he needed a medical procedure, he was able to find more information and trust its authority by conferring with me- because I spend my days finding and evaluating health information.

Reliance on science and expertise is not Byzantine. Rationalism is not Byzantine. Empiricism is not Byzantine. Politicians should not make public policy decisions based on polls and clinicians should not make decisions based on the misinformed preferences of their patients. Clinicians have a duty to educate patients and help point them towards good information because the volume of shoddy information is growing at an alarming rate.

¹ Andrew Keen is a total jackass.

² It turns out that Simon had a benign shiver that has already almost gone away. We were, of course, deeply relieved and grateful to Dr. Patterson. We were also really impressed with the pediatrics center at Mayo. Wow.

³ Please see a number of previous posts on health information wikis.

Posted on January 20th, 2009 under Consumer Health Info, For Medical Libraryfolk, Information Literacy. Comments: 9

Physician Rating Sites (Guest post by PilgrimTinker)

The following is a guest post written by PilgrimTinker (a pseudonym for a consumer health information librarian who regularly blogs at Learn to Live.
___________________________

So, you need to see a doctor. Or, you have been seeing a doctor for some time and love her, or can’t stand her, or secretly suspect him of not paying appropriate attention to your complaints or wonder if he knows anything about geriatrics. Whatever the initial question, you decide to google him. And you discover that there are dozens of physician rating websites available, ready to help you dig up dirt or make a choice or trash a reputation.

Have you guessed yet that I am feeling ambivalent about these sites? I am. On one hand, it makes perfect sense to be able to research a physician or facility before you choose them for your health care. It’s responsible health care consumerism. On the other hand, doctors aren’t used cars and the complexity of medicine and the nature of the relationship between a patient and a physician cannot be portrayed with a simple matrix.

With these considerations aside, another difficulty in assessing physician rating websites is the large number and variety of choices. Here I offer a sampling, by no means exhaustive but more of a snapshot. I’ve looked at many more and chosen these as fairly representative.

First, there are physician directories, offered by government sources or various medical associations. These will verify an affiliation or specialty, board certifications, and contact information. They don’t offer much or anything in the way of user satisfaction but will verify professional credentials and provide a list of practitioners in a geographic area or at a particular facility. For a good start finding this kind of directory, try MedlinePlus GoLocal, the US Dept of Health and Human Service’s HospitalCompare or the AMA’s DoctorFinder.

Now for that more problematic category, the sites that encourage patients to publish their opinions and experiences and to surf what others have already posted. Let’s take a look at a few.

RateMDs.com makes posting ratings very easy- no need to sign in or create an account. The comments are completely anonymous, though they are read by the moderators and may be removed or edited. This is a fairly common policy on physician rating sites. The site uses a smiley face system, based on 2 questions: Is the doctor helpful and Is the doctor knowledgeable.

The downfall of this simplicity is that the faces become meaningless; as demonstrated by the comments for an obstetrician I saw in another city long, long ago. Several can be summed up by “he save my life, we wouldn’t be here if not for him” while others amounted to “he doesn’t answer questions, I would never recommend him, he is uncaring”. The only way I can imagine a site like useful is if there were thousands of comments per physician before they were displayed and the questions were more skillfully stated, allowing the number of responses to create a trend.

DrScore.com is also easy to use and invited me to rank my doctor on a scale of 0 to 10, with an option to post up to 40 words worth of commentary. They encourage raters to note “particularly good things you noticed about the visit” and that “Ratings and comments submitted to DrScore are designed to give feedback to physicians to help them enhance their medical practice.” This is a different and much more positive twist on the usual protect-yourself-by-digging-up-the-dirt approach to promoting physician rating venues. The process included more questions rated 0 to 10 such as time spent with the doctor, if and how well the doctor answered questions, treatment options offered, treatment success and ease of communication with the entire practice. The search works best for those checking ratings of an individual so it took several tries to get a list of physicians in one city to browse by score. The scores are divided into category and displayed on a 0-10 scale, providing a more nuanced profile than RateMD.com’s smilies.

Vitals also allows for consumer ratings of physicians but gathers information from medical boards, federal websites, hospitals, doctors, surveys, business alliances and third party affiliates. I found this search interface to be the easiest to use and the results display very slick. There are several interactive features that actually work, such as a compare box that displays choices side by side and an alert feature for changes to a profile.

Results are divided into sections including specialty, hospital affiliation, education and publications, with links and mapping features.

The rating feature asked only 7 questions with a final overall assessment; asking patients to respond from disagree strongly to agree strongly. This leads to the same limitations as the other sites data, but there are several reasons I like this site better. One is the 360 vitals view, diagrammed on the about us page. It is divided into thirds for empirical information, consumer ratings and peer reviews. The site encourages consumers to think more broadly about what makes a good physician. The search interface and results were much better than any others I’ve seen. Every feature I tried worked as I had hoped, never asking me to sign in, pay for a report or requiring me to use a series of those annoying drop down choice boxes.

But seriously, what about that elusive quality, hotness? Yes, there is a website for that particular aspect of a physician’s fitness to practice and I found it, thanks to an ad on WebMD. PharmaStats promises plenty, including a special icon to alert us when a hot physician has been identified. Unfortunately, the site didn’t deliver- results only included the most basic yellow pages contact information and the chance to “register for more results”

While we are on the subject of unfair or irresponsible ratings, I can’t quite classify The Healthcare Scoop.com. At first, I thought maybe I wasn’t on the home page but found that yes, it is simply a list of random posts with no format at all. Or, as they describe it, “Real, straight-forward information – written and shared by people just like you – about personal healthcare experiences.” Patients simply create an account and post a story, which is then immediately posted. The site also includes ads and a few search features (by doctor, by facility) but doesn’t organize the collected information in any other way.

There are several websites that charge fees for reports about individual physicians, including Angie’s List and HealthGrades, which wanted me to buy a report to see Disciplinary action, board certification, phone numbers and much more! These seem to be the least useful and most likely to prey on those easily frightened by contorted statistics in headlines.

What exactly do you need to know to intelligently choose a doctor? Their clinical proficiency? Quality of their office service? Bedside manner? Personal experiences and biases? What they learned from their first surgery experience and how they responded to their first death? How many journals they read and if they know about the latest advances in medical genomics? What about if they are willing to prescribe antibiotics over the phone for your niece? Will any of these sites allow you to determine if your physician is well educated, experienced and open minded, willing to listen and think and to use her hands to keep you as healthy as possible for as long as possible?

Surf all day if you like, but I’ll have to default to what is emerging as my personal take on the whole health 2.0 movement- thanks, it is nice and I’m glad to partake but there is nothing like the human touch. Give me my blink moment, when that young pup/pretty face/tanned golfer reveals with an indefinable gesture or prescient connection that they have heard me, and even better, that they have a plan for me. Medicine is practiced face to face, so ultimately, it is the face to face assessment that will convince me of a physician’s worth.

____________

Interested in writing a guest post while David is on paternity leave? Send your submission to:

Posted on July 21st, 2008 under "Social Software", Consumer Health Info, For Medical Libraryfolk, Guest Post, Medical Librarianship Blogs, Technology. Comments: 5

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?

Web Geekery in the Recent Literature – 12/9/2007

This article points us to RadiologyInfo.org, a consumer-oriented site for information about radiology.
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J Am Coll Radiol. 2007 Nov;4(11):809-15.
RadiologyInfo: reaching out to touch patients.
Ellenbogen PH, Tashjian JH.
[PubMed]

RadiologyInfo is a public information Web site created and maintained as an unprecedented joint collaborative effort of the Radiological Society of North America and the American College of Radiology. Conceived in 1997 and operating since 2000, the site has grown to become a leading medical information site, currently with more than 100 radiologic examinations and treatments described. Each month, well over half a million visitors connect to RadiologyInfo (660,000 visits in March 2007). The information is now also available in Spanish and French. New procedures, current topics, and additional images are added on an ongoing basis.
Haven’t gotten my hands on a copy of this one yet. Emphases in abstract below are mine:
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Postgrad Med J. 2007 Dec;83(986):759-62.
Web 2.0 technologies for undergraduate and postgraduate medical education: an online survey.
Sandars J, Schroter S.
[PubMed]

OBJECTIVES: To identify the current familiarity and use of Web 2.0 technologies by medical students and qualified medical practitioners, and to identify the barriers to its use for medical education. METHODS: A semi-structured online questionnaire survey of 3000 medical students and 3000 qualified medical practitioners (consultants, general practitioners and doctors in training) on the British Medical Association’s membership database. RESULTS: All groups had high familiarity, but low use, of podcasts. Ownership of digital media players was higher among medical students. There was high familiarity, but low use, of other Web 2.0 technologies except for high use of instant messaging and social networking by medical students. All groups stated that they were interested in using Web 2.0 technologies for education but there was lack of knowledge and skills in how to use these new technologies. CONCLUSIONS: There is an overall high awareness of a range of new Web 2.0 technologies by both medical students and qualified medical practitioners and high interest in its use for medical education. However, the potential of Web 2.0 technologies for undergraduate and postgraduate medical education will only be achieved if there is increased training in how to use this new approach.

Hmm…who could be providing the expertise, the knowledge and the skills to help medical students and practitioners use these tools?
This one mentions several tools I’ve posted about, like Healthmap, BioWizard and WhoIsSick.
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Nurs Educ Perspect. 2007 Sep-Oct;28(5):286-8.Links
Nursing education 2.0: are Mashups useful for nursing education?
Skiba DJ.
[PubMed]
Free full text: [PDF] [HTML]

Posted on December 9th, 2007 under For Medical Libraryfolk, Mashups, Technology, Web Geekery in Recent Literature. Comments Off

Poster: PubMed Alternative Interfaces

From the Wiki des Bibliothèques Universitaires de Médecine et Santé Publique – Lausanne, check out this great poster on Alternative interfaces for PubMed searches by Isabelle de Kaenel and Pablo Iriarte.

Thanks for pointing this out, Gaétan!

Elsevier’s Digg del.icio.us Clone

[Edit #1:Mr. Gunn is absolutely right. 2collab is more a Connotea or del.icio.us clone than a Digg clone. I've corrected the title of this post.]

[Edit #2: It turns out I'm not alone in my current view of 2collab]

Science Library Pad has a post all about 2Collab, Elsevier’s ~~Digg~~ Connotea(/del.icio.us) clone.

what is 2collab?

2collab is a social bookmarking site where you can store and organize your favorite internet resources – such as blogs, websites, research articles, and more. Then, in private or public groups you can decide to share your bookmarks with others – stimulating debate and discussion. Members of groups can evaluate these resources (by rating bookmarks, tagging and adding comments), or add their own bookmarks. You can browse public groups and bookmarks, but must register (your name and email address) to access the full functionality – such as creating groups, adding comments, and adding bookmarks.

I find myself again asking: Why use Elsevier’s tool when there are so many other, similar tools available that don’t benefit for-profit companies?

Posted on November 27th, 2007 under "Social Software", Online Social Networks, Technology. Comments: 4

Make Your Own YouTube Clone (FOSS)

Recently stumbled across Medical Videos (”Your Online Medical Video Tube”) and found it interesting. Interesting not because I expect it to turn into a useful resource (I sort of doubt it, actually), but because of how it was made.

About a month ago, I wrote:

…Tools like Pligg let anyone make a Digg clone, so I’m betting we’ll eventually see an open-source package for making YouTube clones…

Well, Medical Videos was made with PHPmotion.

PHPmotion is a free video sharing software application that will allow you to create and run your very own video sharing website. With very little knowledge required you can now have website just like youtube.com and dailymotion.com and best of all, its 100% free to download and use.

It is free, open source software.

It has been around for at least a few months, so I’m just a doofus for not having noticed it sooner.

Whaddaya’ think? Got any ideas for a niche video sharing site?

Posted on November 23rd, 2007 under "Social Software", Technology, Video. Comments Off

Health2.info (Digg for Medical Literature, Part XI)

What is health2.info?

health2.info is a Web 2.0 Health Information Platform. The objective is to provide information about Healthcare relevant stories found around the internet.

health2.info whishes to establish a social web (web 2.0) about Healthcare on different health interests groups (management, technology, public health, etc.), where there is a lot of knowledgement and big ideas but mostly of them are dispersed all around.

health2.info is NOT a scientifical magazine or publication; it’s simply a self generation content platform based on news and founds on the internet related to Healthcare.

health2.info is not responsible on the contents and opinions from the users that freely participate into the portal.

It’s an internet site that allows to move news that will be reviewed by all the community and rest of users and will be, or not, promoted to main page. When a user send a new or story, this will remain in a pendent queue until it gets enough votes (or prescriptions) to be moved to the home page.

Built on the Meneame platform (with what appears, given how much it looks like meneame.net, to be the default template), I don’t see a lot to differentiate this offering from the others I’ve previously noted (see below).

YouTube for [Fill in the Blank]

A whole lot of people like to write about the application of a popular “Web 2.0″ site’s model to a specialized interest, purpose, or population.

I’m as guilty of this as anyone else.

I’ve written (approximately) a bajillion posts about sites which seek to be “Digg for medical literature.”
I wrote a post called “Facebook for Scientists“
I even wrote posts with titles like NurseLinkUp: MySpace for Nurses and Sermo: Another “MySpace for Physicians”.

But I’m going to go a little off-topic because I want to point out a handful of the huge number of sites seeking to be YouTube for [Fill in the Blank].

Before we go completely off-topic, we’ll make a brief stop at SciVee.com, a site frequently described as “YouTube for Scientists.”

Of course, SciVee isn’t the only service seeking to apply the YouTube model to the needs of scientists- there’s also (the previously mentioned) Bioscreencast.com and SciTalks.

But that’s just scratching the surface of sites borrowing YouTube’s model!

There are two YouTube clones for Jews: JewTube and Yideoz.

Of course, Judaism isn’t the only religion with its own YouTube. F’rinstance, there’s IslamicTube (formerly IslamTube).

Not to be outdone by Jews and Muslims, Christian online video enthusiasts have their choice between GodTube and JesusClips.

Lest we be overwhelmed with Piety 2.0, remember that no technology exists which can’t be tasked to serve pornography. Witness if you will the example of PornoTube (I’ll refrain from linking to this obviously NSFW site). There are at least a couple of other sites like PornoTube.

A nice contrast to PornoTube is TeacherTube.

And look at the logos- they’re so stereotypically “2.0″ with their sans serif fonts, horizontal reflections and grey subtitles.

But I don’t have a problem with any of these. I think that a lot of libraryfolk spend a lot of time thinking over services like YouTube and wondering how their ideas might be leveraged to serve the needs of libraries, library patrons, and librarians. Tools like Pligg let anyone make a Digg clone, so I’m betting we’ll eventually see an open-source package for making YouTube clones- any bets on how long it’ll be before there is a YouTube clone intended for librar* purposes? Quick! Register the most intuitive and sensible domain names!

But before you do, ask yourself: does the world need another YouTube clone?

Posted on October 22nd, 2007 under "Social Software", Technology, Video. Comments: 2

Healia searches PubMed/Medline

Healia PubMed/Medline Search is a search engine specifically designed to help consumers find information in the PubMed/Medline dataset in a user-friendly way. Healia PubMed/Medline Search retrieves abstracts (published summaries) of journal articles.

Healia’s PubMed search (currently in beta) might be one of the best interfaces available for clinicians who don’t have the search skills to effectively search PubMed through its native interface.

Some notable features:

Automatic “AND”
By default, Healia inserts a boolean “AND” between all search terms (as Google does). While the expert searcher might find this unpleasantly limiting, it is a familiar behavior for many clinical searchers who view Google as their ideal, preferred search interface.

Sorting
Healia will allow the user to sort search results by date or by relevance. I’d love to know more about how Healia’s relevance sorting works- because it appears to work well (although a search for “ulcerative colitis” probiotics sorted by relevance at Healia is quite different from the same search sorted by relevance at ReleMed).

Filters and Limits
Healia’s interface is able to refine a search with most of the same facets as PubMed’s “Limits” tabwith Healia’s “Filters,” “Advanced Search,” and “Tabs” (see screen captures below).

Above: Healia Pubmed Filters

Above: Healia PubMed Advanced Search

Above: Healia PubMed Tabs

Acronym Expansions and Suggested Search Terms
Healia’s Acronym Expansion and Suggested Search Terms appear to work well. I’ve previously mentioned that PubMed doesn’t map “HRT” to anything (see this PubMed search), while ReleMed successfully maps “HRT” to (hormone replacement therapy) OR (hormone replacement therapies) OR hrt OR (hormone replacement rx). Healia expands “HRT” to “hormone replacement therapy” and suggests search terms of “hormone therapy” and “estrogen replacement therapy” (see this Healia search for details).

Other features of Healia’s PubMed search are detailed here.

Also worth checking out: Healia has a search interface for NIH Clinical Trials you can try here. Details about Healia Clinical Trials Search are available here.

PeerClip: Social Bookmarking for Physicians

From ConnectivHealth comes PeerClip, a social bookmarking tool for physicians.

From the press release:

PeerClip, a free service exclusively for physicians, physician assistants and nurse practitioners, allows members to add information from anywhere on the Web directly into PeerClip through a “research assistant” tool that subtly integrates in to the physician’s Web browser. As physicians add medical information to their PeerClip home page, they are provided at-a-glance information on any peer comments, ratings and keyword tags. Physicians also can add peers who have valuable perspectives into their network and track future comments and bookmarks from these members.

PeerClip’s other key feature is its ability to recommend other relevant content to each member. Essentially, PeerClip observes each member’s bookmarks and profile so that it can then recommend similar content from within the PeerClip community.

So, this sounds a lot like another “Digg for Medical Literature,” doesn’t it? Maybe it would be better to call it a “Digg/del.icio.us for Medical Literature.”

Can’t wait to try it.

Posted on September 25th, 2007 under "Social Software", For Medical Libraryfolk, Online Social Networks, Technology. Comments: 1

Two Medical Library RSS Services

I think it was a little over a year ago that I gave up on the idea of building my own portal for medical information RSS feeds because I had started chatting with Frankie Dolan (of MedWorm and LibWorm fame) and suggesting ideas to her instead. I still get most of my medical RSS feeds from MedWorm, but I’m enjoying seeing how others are building medical RSS portals.

Today I’m looking at the University of Wisconsin-Madison Ebling Library for Health Sciences RSS E-Journal Feeds by Subject and at the Harvey-Semester JournalBot.

I learned that UW-M libraries were up to good RSS-ish things from Ratcatcher’s post the other day that contained an abstract of an upcoming paper:

Developing and Marketing an RSS Journal Service for your Library
Authors: Erika L. Sevetson, MS, Christopher Hooper-Lane, MA, AHIP, Allan R. Barclay, MLIS, AHIP, Ebling Library, University of Wisconsin – Madison; Deborah Copperud, MA, School of Library and Information Science, University of Wisconsin – Madison
Abstract: More and more journals are making their tables of contents available via RSS feed; however, barriers still exist between the user and the content. A working group at a large, Midwestern academic health sciences library set out in Fall 2006 to “explore possibilities for developing an RSS current awareness service that would categorize health sciences RSS feeds and integrate them with SFX, document delivery, and RefWorks.” We developed a 4-phase plan, including overhauling our existing RSS journal feeds pages, developing bundled OPML packages for quick subscription to several journals, developing a shopping cart-like application for users to easily create customized collections, and developing instructional and promotional plans for staff and patrons. This panel will provide an overview of the project, focusing on work process, technology, marketing, and instruction and education. The panel discussion will include 15 minutes for audience discussion.

(Since I won’t be able to make it to this event, could someone please send me lots of detailed notes? Transcripts? Video recordings? Holograms?)

A little digging turned up this page at Ebling which lets the user select a subject, then see available RSS feeds for journals covering that subject (without reloading the page- a nice AJAXy touch). For example: Say we’ve got a hypothetical cardiologist: she could click “Cardiology” and get a nice list of TOC feeds for journals (through EZproxy) of interest to cardiologists.

Since the feed is retrieved through EZproxy, I’m guessing that these feeds will allow the user to click on an item in an aggregator and log in through EZproxy to get the full text. I also like that it offers an OPML file for ALL the feeds in the subject. Awesome. (Next, maybe they could add filtering functions to let our example hypothetical cardiologist user filter the journal feeds she selects for keywords she cares most about.)

The Harvey Semester JournalBot takes a sort of a “wizard” approach, guiding our hypothetical cardiologist through a process of creating a personalized feed (via PubMed API?) tailored for her specific needs and preferences.

First, the JournalBot asks the user to select a subject from a drop-down menu:

(The JournalBot can also let the user enter a MeSH term, but if the user had mastery of MeSH, she wouldn’t need the “wizard.”)

Next the JournalBot prompts the user to select a specific cardiovascular disorder:

Now JournalBot prompts the user to select from which journals she wants articles on this specific cardiovascular disorder…

…and asks the user to choose how many articles from each journal she wants and how old the articles can be:

Lastly, JournalBot offers the user a vanilla feed and a link to add the feed to Google Reader or iGoogle:

I love to see that academic medical libraries are developing services like these, and can’t wait to see what else is coming.

Posted on September 5th, 2007 under For Medical Libraryfolk, Interfaces, RSS/Feeds, Search, Technology. Comments: 4

CureHunter Visual Medical “Dictionary” (MeSH Browser)

Dangit!

I finished writing this post last night, but hadn’t posted it yet. Since Berci has beat me to it, I’ll go ahead and post it now.

————–

Curehunter.com has a “visual medical dictionary” that I’m having lots of fun playing with, even though I’m not sure that it is best described as a “dictionary.”

Really, it’s a nifty third-party PubMed/MEDLNE tool to visually browse MeSH (as an alternative to the NLM’s MeSH browser). As shown in the screen capture below, it gives the MeSH scope note for “colitis, ulcereative” as the definition for “ulcerative colitis.”

Then it grabs related terms from the MeSH Tree Structures and counts the number of citation hits for each:

Lastly, it gives you a visual, color-coded representation of related strongly related terms from the literature…

…and it does this all in three side-by-side frames:

Neat!

CiteMD (Digg for Medical Literature, Part X)

CiteMD is a community-based popularity website with an emphasis on science articles. It combines social medical bookmarking, blogging, and medical reference management with a form of non-hierarchical, democratic editorial control. News stories and websites are submitted by users, and then promoted to the front page through a user-based ranking system.

The features above aren’t anything new to anyone familiar with the seven similar tools that have previously been mentioned on this blog (see Related Posts below).

What sets CiteMD apart (for me, anyway) is that it will allow the user to “create a document from scratch, insert references and generate the footnotes automatically.” This sounds great as an idea, but when I created an account, logged in, ran a MEDLINE search and selected references to import, it didn’t import the references, telling me I was “not logged in” (when I clearly was)- so it appears to still be working out the kinks.

Also interesting: CiteMD appears to have been built on the Drupal open source CMS.

PubViz (3rd-party PubMed/MEDLINE Tool Prototype)

From the Microarray Lab, Department of Psychiatry / Molecular and Behavioral Neuroscience Institute at the University of Michigan comes PubViz, a powerfull, flexible prototype interface (built in Flash!) for MEDLINE information retrieval.

In short, PubViz is developed to provide the capability of utilizing external knowledge as well as interactive visual query functions for more efficient exploration of the Medline database. The current version has the ability to utilize protein-protein interaction data during Medline search and enable researchers to identify functionally related Medline records not retrievable in existing search engines. It can also utilize the structure relationship of different type of genetic markers including cytobands, microsatellite/STS markers, SNPs and genes derived from human genome assembly and HapMap data for deep search of genetically related Medline records. We include many visualization functions in PubViz, such as interactive PMID, MeSH, Gene views, the transition between different views, selection of node description display on network graph, as well as details of abstract and sorting/filtering functions. The combination of these novel capabilities will make PubViz a powerful tool for Medline exploration.

The site notes that PubViz currently searches only the sample corpus, but that they “plan to release full Medline search engine on 8/1/2007.”

Almost Everything About HubMed (Third-party PubMed Tool)

With tons of screen captures and good, simple descriptions of features, this seems like a really nice introduction to HubMed.

Previous posts about third-party PubMed tools

Posted on July 26th, 2007 under 3rd Party PubMed/MEDLINE Tools, For Medical Libraryfolk, Search, Technology. Comments: 2

Verbs in MEDLINE Searches & MEDIE (Third-Party PubMed Tool)

Created by the University of Tokyo’s Tsujii Laboratory, I was reminded of MEDIE by seeing the title of a recent article:

Bertaud, Valerie; Said, W.; Garcelon, Nicolas; Marin, Franck;
Duvauferrier, Regis. “The value of using verbs in Medline searches”
Medical Informatics & The Internet in Medicine 32.2 (2007). 05 Jun. 2007

MEDIE is an intelligent search engine to retrieve biomedical correlations from MEDLINE. You can find abstracts/sentences in MEDLINE by specifying semantics of correlations

http://www.informaworld.com/10.1080/14639230601140711

MEDIE formulates queries by offering the user three fields: Subject, Verb, and Object.

Examples:

"What does p53 activate?" (subject=”p53″, verb=”activate”)

"What induces MAPK1?" (verb=”induce”, object=”MAPK1″)

"What causes colon cancer?" (verb=”cause”, object=”colon cancer”)

"What interacts with CD4?" (verb=”interact with”, object=”CD4″)

"What does not cause cancer?" (verb=”cause”, object=”cancer”, modifier=”not”)

Previous posts about third-party PubMed tools

Posted on July 3rd, 2007 under 3rd Party PubMed/MEDLINE Tools, For Medical Libraryfolk, Search, Technology. Comments: 3

Social Search for Health Librarians [Edited]

It seems as if everything I’ve tried to write in the last couple of weeks is an exercise in contrariness. I apologize in advance.

Eugene Barsky and Allan Cho have an article in the current issue of the Journal of the Canadian Health Libraries Association, Introducing Web 2.0: social search for health librarians.

It’s great that Eugene and Allan gently introduce resources like YouTube and Flickr to Canadian health libraryfolk, but I find myself uncomfortable with their calling these resources “social search tools.”

I’ll attempt below to explain in simple terms what I understand a social search tool to be and offer some examples you can try.

So what’s “social search”?

Wikipedia has as good a definition as any:

A social search engine is a type of search engine that determines the relevance of search results by considering the interactions or contributions of users.

Get the idea? When Google returns your search results, these results are ordered by the PageRank algorithm¹, which notes (among other things) how many other Web pages link to each search result. The more Web pages link to a search result, the higher up the list of results it’ll appear. (Note to geeks: Yes, I know this is a dramatic oversimplification)

A social search engine puts this aside and asks itself: What have users liked when they searched for this topic? The more other users have indicted they liked the result, the higher up the list of results it’ll appear.

If YouTube and Flickr aren’t social search tools, what are they?

YouTube and Flickr are searchable collections of user-created content. In the case of Flickr, users upload and tag images that others can search. In the case of YouTube, users upload and tag video that others can search. Searching social content is not, in my thinking, the same thing as “social search.”

Is del.icio.us a social search engine?

You could call it that and not be wrong- but I don’t call it that. I haven’t been able to find any documentation on how del.icio.us sorts its search results, but Iit appears that the number of times a URL has been saved DOES figure into it…so it is accurate to say that searching del.icio.us is a kind of “social search,” but I wouldn’t call del.icio.us a “social search engine” because it is so much more than that. (I looooooooove del.icio.us.)

What about Google Custom Search Engines? Are they social search tools?

Some of ‘em are, but most of ‘em aren’t. Google Custom Search Engines are really pretty simple: Each uses Google’s engine, but its creator get to decide from which sites the CSE will return results. When I made the Consumer Health and Patient Education Information Search Engine I restricted it just to the sites that were recommended for consumer health information by the NLM or CAPHIS. Why don’t we call it a social search engine? Because there’s no social component. A single individual (me) plugged in which sites to include and set it out to be used. It sorts search results by Google’s PageRank, just like regular Google. Heck, even if I tweaked the way it sorts results, it still wouldn’t be social because I’d be the only one controlling it.

But a Google CSE could be social. When you create a CSE, you can invite others to add sites from which the CSE will return results or even place a form on its front page by which users can request access to add their input. In that sense, a Google CSE could be called social….

…but would I want to open up my CSE to be tweaked by anyone?

That depends on your goals and asks one of the most important questions about “social software.” Like a lot of social software, the value of social search is significantly impacted by who is participating. In the same way that AskDrWiki and Ganfyd have more value because they limit participation to licensed clinical professionals, some very specialized kinds of social search might similarly benefit from restricting participation to only expert contributors. If we take a look at the Google CSE that Alan and Eugene give as an example, we find out that (with good reason) it isn’t social at all and is maintained by one person:

There’s nothing wrong with a good CSE that is only created by one person- but it is mistaken to call it an example of social search.

So what are some good examples of social search engines?

Here are three:

URL.com

URL.com retrieves the top ten results for your search terms in Google, Yahoo and MSN, then lets the users rate how appropriately ranked they are.

Click thumbnail for larger screen capture

Sproose

Sproose is sort of a cross between Google and Digg. You run your search, then vote for the results which you think are best.

Phil Bradley on Sproose

Eurekster Swickis

A Swicki is sort of like a Google CSE, but a lot more social in that it learns how better to sort search results based on the activity of users, even if the users aren’t specifically seeking to tweak it.
FAQ

Is Social Search for Medical Libraries?

Sure. The library staff might make their own collaboratively-created Google CSE or Swicki of favorite, subject-specific sites (or have a CSE generated from a del.icio.us account’s links). Librarians should seek to be familiar with technologies for finding and organizing online information and social search is not likely going to go away as an idea any time soon.

My bottom line is that when it comes to health information for healthcare professionals, social models are only worthwhile if participation is restricted to those whose input is qualified. The Google Health Co-op, after all, is just a large-scale Google CSE where the invited 26 participating organizations are expert in healthcare information.

What am I missing?

Are there other ways social search tools can be used in medical libraries? Do you have any favorites? Please leave a comment and let me know.

[EDIT]
Further reading:

Melissa L. Rethlefsen looks at social search engines, where search is heading, and what it means for librarians

Melissa is a Web-savvy medical librarian and I read everything she publishes. This article gives a very nice overview of a few social search tools.
[/EDIT]

¹ Check out this excellent recent article for a long, complex, and good explanation of PageRank

Posted on June 26th, 2007 under "Social Software", CSEs, For Medical Libraryfolk, Search. Comments: 6

Admitt.com (Digg for Medical Literature, Part IX)

Created by Dr. Henry Wei, Admitt.com is another “Digg for Medical Literature” which, like Medinews, is built with the Pligg content management system.

Dr. Wei tells me via email that he’s hoping to cultivate a “digg-like irreverent attitude,” which sounds like it would be fun.

Search Results for "digg medical":

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