MEDLINE search retrieval issues: A longitudinal query analysis of five vendor platforms.

This study compared the results of data collected from a longitudinal query analysis of the MEDLINE database hosted on multiple platforms that include PubMed, EBSCOHost, Ovid, ProQuest, and Web of Science. The goal was to identify variations among the search results on the platforms after controlling for search query syntax. We devised twenty-nine cases of search queries comprised of five semantically equivalent queries per case to search against the five MEDLINE database platforms. We ran our queries monthly for a year and collected search result count data to observe changes. We found that search results varied considerably depending on MEDLINE platform. Reasons for variations were due to trends in scholarly publication such as publishing individual papers online first versus complete issues. Some other reasons were metadata differences in bibliographic records; differences in the levels of specificity of search fields provided by the platforms and large fluctuations in monthly search results based on the same query. Database integrity and currency issues were observed as each platform updated its MEDLINE data throughout the year. Specific biomedical bibliographic databases are used to inform clinical decision-making, create systematic reviews, and construct knowledge bases for clinical decision support systems. They serve as essential information retrieval and discovery tools to help identify and collect research data and are used in a broad range of fields and as the basis of multiple research designs. This study should help clinicians, researchers, librarians, informationists, and others understand how these platforms differ and inform future work in their standardization.

Clinical presentation of patients with prior coronary artery bypass grafting and suspected acute myocardial infarction.

AIMS: Diagnosis of acute myocardial infarction (AMI) can be challenging in patients with prior coronary artery bypass grafting (CABG). METHODS AND RESULTS: Final diagnoses were adjudicated by two independent cardiologists using the universal definition of AMI among patients presenting to the emergency department (ED) with suspected AMI. Diagnostic accuracy of 34 chest pain characteristics (CPCs) and four electrocardiogram (ECG) signatures stratified according to the presence or absence of prior CABG were prospectively quantified. Among 4015 patients (no prior CABG: n = 3686; prior CABG: n = 329), prevalence of AMI and unstable angina were higher in patients with prior CABG (35% vs. 18%; 26% vs. 8%; both P < 0.001). Three CPCs (9%) and two electrocardiographic findings (50%) showed a different diagnostic performance (interaction P < 0.05) with loss of diagnostic value in patients with prior CABG. The diagnostic accuracy as quantified by the area under the curve (AUC) of the integrated clinical judgement was moderate to good in patients with prior CABG, and significantly lower compared to patients without prior CABG [AUC 0.80 (95% confidence interval (CI) 0.75-0.84) vs. AUC 0.87 (95% CI 0.86-0.89); P = 0.004]. Time to discharge from the ED was significantly longer in patients with prior CABG [359 (215-525) min vs. 300 (192-435) min; P < 0.001]. Key findings were confirmed in a large independent external validation cohort (n = 13 653). CONCLUSIONS: Patients with prior CABG presenting with suspected AMI have a high prevalence of AMI and unstable angina and lower diagnostic accuracy of CPCs and the ECG, possibly justifying liberal use of early coronary angiography in these vulnerable patients. CLINICALTRIALS.GOV REGISTRY: Number NCT00470587.

Search results outliers among MEDLINE platforms.

OBJECTIVE: Hypothetically, content in MEDLINE records is consistent across multiple platforms. Though platforms have different interfaces and requirements for query syntax, results should be similar when the syntax is controlled for across the platforms. The authors investigated how search result counts varied when searching records among five MEDLINE platforms. METHODS: We created 29 sets of search queries targeting various metadata fields and operators. Within search sets, we adapted 5 distinct, compatible queries to search 5 MEDLINE platforms (PubMed, ProQuest, EBSCOhost, Web of Science, and Ovid), totaling 145 final queries. The 5 queries were designed to be logically and semantically equivalent and were modified only to match platform syntax requirements. We analyzed the result counts and compared PubMed's MEDLINE result counts to result counts from the other platforms. We identified outliers by measuring the result count deviations using modified z-scores centered around PubMed's MEDLINE results. RESULTS: Web of Science and ProQuest searches were the most likely to deviate from the equivalent PubMed searches. EBSCOhost and Ovid were less likely to deviate from PubMed searches. Ovid's results were the most consistent with PubMed's but appeared to apply an indexing algorithm that resulted in lower retrieval sets among equivalent searches in PubMed. Web of Science exhibited problems with exploding or not exploding Medical Subject Headings (MeSH) terms. CONCLUSION: Platform enhancements among interfaces affect record retrieval and challenge the expectation that MEDLINE platforms should, by default, be treated as MEDLINE. Substantial inconsistencies in search result counts, as demonstrated here, should raise concerns about the impact of platform-specific influences on search results.

Characteristics of personal health information management groups: findings from an online survey using Amazon's mTurk.

OBJECTIVE: The study characterized three groups with different levels of familiarity with personal health information management (PHIM) in terms of their demographics, health knowledge, technological competency, and information sources and barriers. In addition, the authors examined differences among PHIM groups in subjective self-ratings and objective test scores for health literacy. METHODS: A total of 202 survey participants were recruited using Amazon's Mechanical Turk (mTurk) service, a crowdsourcing Internet service. Using K-means clustering, three groups with differing levels of familiarity with PHIM were formed: Advanced, Intermediate, and Basic. RESULTS: The Advanced group was the youngest, and the Basic group contained the highest proportion of males, whereas the Intermediate group was the oldest and contained the fewest males. The Advanced group was significantly more likely to engage in provider- or hospital-initiated PHIM activities such as emailing with providers, viewing test results online, and receiving summaries of hospital visits via email or websites than the other groups. The Basic group had significantly lower information management skills and Internet use than the other groups. Advanced and Basic groups reported significant differences in several information barriers. While the Advanced group self-reported the highest general literacy, they scored lowest on an objective health literacy test. CONCLUSIONS: For effective personal health records management, it is critical to understand individual differences in PHIM using a comprehensive measure designed to assess personal health records-specific activities. Because they are trained to perform an array of information management activities, medical librarians or patient educators are well positioned to promote the effective use of personal health records by health consumers.

Examining care navigation: librarian participation in a team-based approach?

OBJECTIVE: This study investigated responsibilities, skill sets, degrees, and certifications required of health care navigators in order to identify areas of potential overlap with health sciences librarianship. METHOD: The authors conducted a content analysis of health care navigator position announcements and developed and assigned forty-eight category terms to represent the sample's responsibilities and skill sets. RESULTS: Coordination of patient care and a bachelor's degree were the most common responsibility and degree requirements, respectively. Results also suggest that managing and providing health information resources is an area of overlap between health care navigators and health sciences librarians, and that librarians are well suited to serve on navigation teams. CONCLUSION: Such overlap may provide an avenue for collaboration between navigators and health sciences librarians.

Enhancing the care navigation model: potential roles for health sciences librarians.

This study analyzed the overlap between roles and activities that health care navigators perform and competencies identified by the Medical Library Association's (MLA's) educational policy statement.Roles and activities that health care navigators perform were gleaned from published literature. Once common roles and activities that health care navigators perform were identified, MLA competencies were mapped against those roles and activities to identify areas of overlap. The greatest extent of correspondence occurred in patient empowerment and support. Further research is warranted to determine the extent to which health sciences librarians might assume responsibility for roles and activities that health care navigators perform

Outreach impact study: the case of the Greater Midwest Region.

OBJECTIVES: The purpose of the study was to assess the impact that funding from the National Network of Libraries of Medicine (NN/LM), Greater Midwest Region (GMR), has on member institutions' ability to conduct outreach on behalf of NN/LM. METHODS: The study employed both content analysis and survey methodologies. The final reports from select GMR-funded outreach projects (n = 20) were analyzed based on a set of evaluation criteria. Project principal investigators (n = 13) were then surveyed using the same evaluation criteria. RESULTS: Results indicated that outreach projects supported by GMR funding improved access to biomedical information for professionals and the general public. Barriers to conducting outreach projects included time constraints or commitments, staffing, scheduling and absenteeism, inadequate space, and issues associated with technology (e.g., hardware and software, Internet connectivity and firewall issues, and creation and use of new technologies). CONCLUSIONS: The majority of project principal investigators indicated that their attempts to conduct outreach were successful. Moreover, most noted that outreach had a positive impact on professionals as well as the general public. In general, it seems that negative outcomes, as with most barriers to conducting outreach, can be mitigated by more thorough planning.

The effect of patients' race on provider treatment choices in coronary care: a literature review for model development.

This selective literature review provides insight into the depth and breadth of the problem of unequal medical treatment of Blacks compared with Whites, with particular focus on coronary heart disease. Poor health outcomes among Blacks, when compared with Whites, are well documented, and these disparities are linked to lower quality of and less aggressive medical treatment. It is not clear why these disparities in treatment occur. This review provides theoretical frameworks that attempt to explain the effect of race on treatment and presents an analysis of the quality and strength of existing evidence of racial disparity related to coronary care. Based on the review, implications for policy makers and providers are identified.

"Partnering with Seniors for Better Health": computer use and Internet health information retrieval among older adults in a low socioeconomic community.

PURPOSE: This health communication project measured the psychosocial influences of computer anxiety, computer confidence, and computer self-efficacy in older adults at six meal congregate sites. The adults completed a five-week education intervention, based on Bandura's self-efficacy model, designed to assist older adults in retrieving and evaluating health information resources on the Internet. METHODS: One hundred thirty-seven participants, ages sixty-five and older, were randomized in a controlled, two-group, pre-post, repeated measures design. Participants in the intervention group received a two-hour training session, once a week for five weeks. The Computer Confidence Subscale and Computer Anxiety Subscale of the Computer Attitude Scale and the Computer Self-Efficacy Measure were administered to both groups at three time intervals: at baseline, completion of the five-week intervention, and six weeks after completion of the intervention. Data were analyzed using repeated measures analysis of variance. RESULTS: Findings showed a reduction in computer anxiety and increases in computer confidence and computer self-efficacy in retrieving and evaluating online health information (P<0.001). DISCUSSION: The study suggests an array of possibilities to engage older adults in the use of Internet health information resources to better contribute to their health, independence, safety, and wellness.

Working in an eICU unit: life in the box.

This ethnographic study of the VISICU eICU (VSISCU, Inc., Baltimore, MD) work environment in a large midwestern health care system describes everyday life working in a telemedicine intensive care. Data were gathered through 60 hours of observation and formal interviews of eICU clinician team members. Working in the remote telemedicine center, often referred to as the "Box", is like working in an air traffic control center. Remote oversight and effective communication ensure the best possible outcomes to support the bedside intensive care unit team.

Camp for all connection: a community health information outreach project.

PURPOSE: The purpose of the Camp For All Connection project is to facilitate access to electronic health information resources at the Camp For All facility. SETTING/PARTICIPANTS/RESOURCES: Camp For All is a barrier-free camp working in partnership with organizations to enrich the lives of children and adults with chronic illnesses and disabilities and their families by providing camping and retreat experiences. The camp facility is located on 206 acres in Burton, Texas. The project partners are Texas Woman's University, Houston Academy of Medicine-Texas Medical Center Library, and Camp For All. BRIEF DESCRIPTION: The Camp For All Connection project placed Internet-connected workstations at the camp's health center in the main lodge and provided training in the use of electronic health information resources. A train-the-trainer approach was used to provide training to Camp For All staff. RESULTS/OUTCOME: Project workstations are being used by health care providers and camp staff for communication purposes and to make better informed health care decisions for Camp For All campers. EVALUATION METHOD: A post-training evaluation was administered at the end of the train-the-trainer session. In addition, a series of site visits and interviews was conducted with camp staff members involved in the project. The site visits and interviews allowed for ongoing dialog between project staff and project participants.

Introduction to Reference Sources in the Health Sciences: an interview with Jo Anne Boorkman, Jeffrey T. Huber and Fred W. Roper. Interview by Elizabeth Connor.

Few works serve as solid a framework for the field of health sciences librarianship or provide as many insights and detailed knowledge as Introduction to Reference Sources in the Health Sciences. Now in its fourth edition, the book's editors and contributors represent an impressive range of experience, expertise, and subject knowledge appreciated by practicing librarians in a variety of settings and by students of health sciences librarianship. Jo Anne Boorkman, Jeffrey T. Huber, and Fred W. Roper answered a series of questions about the latest edition of this seminal work, and offered opinions about reference works, services, and librarians.

Woman to Woman: Community Health Information Project.

The Woman to Woman: Community Health Information Project facilitates information access at selected community-based women's health agencies in Houston, Texas. The community partners were selected based on objectives outlined in Healthy People 2010. A variety of institutions and disciplines contributed to the planning and implementation of the project. Internet-connected workstations were placed at each participating agency site for staff use. A comprehensive compendium of local health resources for women was developed and posted on a dedicated Website. In addition, training in accessing electronic health information resources was provided for staff at each participating site. Trainees provided evaluative data at the end of the training session as well as one month later so that project members could determine the need for additional training. Site visits and structured interviews were also conducted at each participating agency to monitor progress and further evaluate the program. A final focus group was conducted with representatives from each participating agency to assess the project's success. Evaluative findings indicate that academic and community-based organizations can collaborate effectively to increase women's access to electronic health information.

Complementary and alternative medicine as represented in the HIV/AIDS body of knowledge: a bibliometric analysis.

Although the HIV/AIDS epidemic began more than twenty years ago, there still is no cure for the disease and no vaccine to prevent infection. As with the general population, individuals with HIV/AIDS have sought care using a variety of traditional and nontraditional approaches. The popularity of complementary and alternative interventions among the HIV/AIDS community continues. To understand better the distribution of the HIV/AIDS body of knowledge concerning complementary and alternative medicine (CAM), this study sought to (1) examine the literature specific to the use of complementary and alternative medicine where HIV/AIDS is concerned to determine publication patterns; (2) determine the degree of overlap among bibliographic citation databases that index the literature concerning the use of CAM practices in treating HIV/AIDS; and (3) facilitate access to this body of literature.

Facilitating access to consumer health information: a collaborative approach employing applied research.

Responsibility for the provision of consumer health information typically lies within the public library domain or the health sciences library arena. In many communities, both types of libraries provide support for consumer health information services, often with varying levels of expertise. Public library employees may or may not be trained in the use of health and biomedical information resources. Conversely, health sciences library staff may or may not be familiar with information needs of the lay public within their community. To offset these potential differences, a model was developed to assess the health information needs of community members and to provide training for public library staff regarding use of relevant electronic consumer health information resources.