The Search Principle blog

This four-part look at medical bloggers started with Dr. Ves Dimov, and now moves to Stanford medical school student, Graham Walker, whose edgy, intelligent blog Over!My!Med!Body! is one-part insider med school confessional; one part medical muse – which takes in Graham’s photography, interest in biblio-art and serious medpolitik.

1. Graham, you wrote an amusing Jan 2006 post entitled Googlediagnosing, which was the first time I read your blog. How important/ unimportant are search engines for you as a med student?

Stanford Medical Student, Graham Walker: “I use Google all the time – and I’d say 75% of my attendings and 100% of my residents and interns do, too. If you just want to find a quick answer, it’s much faster to go through Google than hunting for a textbook, or using UpToDate, or anything else. One of the sites I’ve developed, mdcalc.com, was a response to frustration in not being able to easily find medical calculations and formulas online via Google. I’d say I use Google on an almost daily basis for my clinical work–and definitely used it everyday for my preclinical work. Have a mnemonic that you can’t fully remember? Just punch it into Google. Have a poorly-written syllabus and need a quick medical answer? Google to the rescue.

Google Scholar – I haven’t found it to be as helpful; I still prefer Pubmed because it will give me a more complete search that I can then limit quickly.”

2. What other sources of information do you find helpful?

Uhm, Yahoo? Seriously–another search engine. If not that, probably UpToDate or Lane Library’s Clinical Core search (http://lane.stanford.edu/clinician/index.html) — it searches 131 medical resources (including textbooks) for your search query.

3. How do you stay current? Do you know about RSS feeds, podcasting, e-alerts, and other “sharing” technologies?

I really like review articles, as well as the Annals of Internal Medicine highlighted articles, where every so often they will summarize important or interesting studies over the past 6 months or so. I definitely use RSS feeds, but I haven’t found them too useful for keeping up on specific medical areas. Same with podcasting.

4. Do you think your colleagues are opening up to these technologies? Or not?

They’ve already opened up to Google, UpToDate, and all the mainstream stuff. I think it will take some time for them to open up to RSS feeds, but with there being so much new information out there, RSS feeds give you quick access to it as well as help to organize it in your head.

5. Do you have access to a good medical librarian? If you could ask them to teach you something, what would it be?

Yes, I do! Stanford’s Lane Medical Library has *incredible* librarians, who are really friendly, helpful, and responsive. I think I’d ask them to teach me search strategies to help find the best keywords for my queries.

Graham’s BlogPicks

I love Maria’s Intueri.org. She’s a fantastic writer and has a great sense of humor:
http://www.intueri.org/

I’m also a big fan of Kate’s healthypolicy.typepad.com — she picks up a lot of the health policy I often miss.

Artiloop always has a lot of interesting and good takes on research: http://artiloop.blogspot.com/

And just for the entertainment value alone, Mimi Smartypants: http://smartypants.diaryland.com/

Medical blogging may yet prove to be the most controversial publishing medium in medical history. But, like many aspects of the dynamic Web, the 80/20 rule – the pareto principle seems to apply: 80% of high quality information in the blogosphere is created by only one fifth (20%) of medical bloggers.

A case in point is Clinical Cases and Images – Blog one of the most influential blogs in medicine, managed by Dr. Ves Dimov of the Cleveland Clinic. Dr. Dimov has received praise from mainstream media such as the British Medical Journal and Medscape. For me, a medical librarian with an interest in helping physicians stay informed, reading his blog helps me to stay current with hospital medicine (along with meeting my own UBC physicians here at Vancouver General Hospital.)

I’ve communicated with Dr. Dimov for a few months, but he was kind enough to answer some of my questions around how he looks for information these days, what are his favorite sources of information, and what he asks of his librarian colleagues at the Cleveland Clinic. Here’s a transcript of our interview:

1. Ves, you run one of the most popular blogs in medicine, and discuss how Google and Google scholar can help clinicians find the literature. How important are these tools and how often do you use them?

Dr. Ves Dimov: “Google search definitely changed the way I use the Internet. I do not type website addresses in the browser anymore; instead, I use Google to find them. This helps to avoid phishing due to misspelling since the top search result is usually the one that I want.

In addition, Google largely surpasses the searching provided by individual journals. Typing “NEJM, pneumoperitoneum” in a Google search box is often better and simpler than going to the NEJM website and searching for similar keywords. I use Google Scholar less than the regular Google search and find it is useful too. Its most valuable feature may be that the most reputable (& cited) source comes first.

PubMed is much more up-to-date than Google Scholar and therefore still feels more “professional” to me.

******************************

2. If Google went belly-up tomorrow – what would you find the second most helpful tool that you have access to?

No doubt Yahoo! Search is the second best player in town. Google has a simpler and cleaner interface and continues to provide the best search results but I am very happy that we have 3 players [search engines] in this market. What I refer to on my blog as the GYM – Google, Yahoo, Microsoft.

3. How do you keep up to the latest research in your specific area of medicine?

I regularly read the “What’s new” section of UpToDate and I follow the specific journals in my field of interest. Medscape subspecialty pages are also helpful. I also enjoy reading the blogs of physicians with similar professional interests to mine, e.g. hospital medicine, nephrology, medical education.

As a suggestion, I advise busy doctors to check out the “big five” journals on the day they are published online; NEJM and JAMA on Wednesdays, BMJ and Lancet on Fridays and to mark the articles they want to read later (on the weekend?). It helps that many journals now have audio summaries of contents that you can listen to when you commute to work or exercise — iPod/iTunes have made CME portable. (See Dr. Dimov’s post on this issue here.)

4. Do you know about RSS feeds, podcasting, e-alerts, and other “sharing” technologies like wikis, blikis, teaching portfolios?

I am very much aware of these new technologies and regularly write about them on my blog. In fact, I am in the middle of a lecture series called “Web 2.0 in Medicine. RSS, Blogs and Online Collaboration”. The talk was presented to the Cleveland Clinic hospitalists, medical residents and professional staff and now I have scheduled presentations at the other teaching hospitals in Cleveland.

I am gratified to see that leading researchers are incorporating RSS use in their daily search of medical literature as a direct consequence of my presentations.

The Cleveland Clinic embraces IT innovation in medicine and it is a leading provider of free CME. The Clinic was the first major health institution to start video podcasting. The IT team incorporated my idea of “RSS feeds for the Cleveland Clinic in the News” and it is now featured on the front page of ClevelandClinic.org.

******************************

5. Do you think your colleagues are opening up to these technologies? Or not?

Most physicians are curious by nature and they are willing to try new approaches if they can be useful and time-saving. After I introduced the concept of online word processing, Writely.com became the standard for article writing and collaboration at our section at the Cleveland Clinic.

6. Do you have access to a good medical librarian? If you could ask a medical librarian to teach you something, what would it be?

We have excellent medical librarians at the Cleveland Clinic but unfortunately I have been too busy to get to know them really well. However, my colleagues use the librarians’ expertise on a regular basis and they are very happy with them.

5. What are your favorite medical blogs?

KidneyNotes.com: Anything new in nephrology will be there. I like the fact that his blog is not limited to medicine only. Nothing beats columns like “Hilarious Journal Articles” and “Patient Quote of the Day”… 🙂

KevinMD.com/blog: He always finds something new. In fact, I am guest-blogging for Kevin right now and I find it very difficult to keep up with his high-output style.

GruntDoc.com : A very honest look at medicine from ED perspective.

Over!My!Med!Body: Graham is a medical student and a blogging star. I don’t always agree with him – but his opinions are very stimulating.

Krafty Librarian: A medical librarian since 1998 and currently the medical librarian for a hospital system in Ohio.

DB’s Medical Rants – features the commentary on medical news by Dr. Robert M. Centor, an academic hospitalist and the president of SGIM – http://www.sgim.org/

Notes from Dr. RW – a hospitalist in Northwest Arkansas writing about clinical topics.

There are many other medical bloggers that I follow in Bloglines but I will miss the ones above the most if they stop blogging one day.

A little more press for UBC Library and Academic Search – Google scholar.

Doug Payne, of The Scientist, has penned “Microsoft Launches Google Scholar Rival” – one of the best overview and announcement-type articles to come out since Windows Live Academic Search was released. My major points were captured and put into a helpful context for scientists in the life sciences. Thanks Doug.

Internet media and market researcher Nielsen//NetRatings is saying that Google and Yahoo searching grew 41% percent and 47% percent, respectively, in the last year. Both search engines outpaced the overall search growth rate of 36% percent.

Comparing the month of March in 2005 and 2006, Google’s searches increased from 2.1 billion to 2.9 billion; Yahoo’s searches increased from 907.8 million to 1.3 billion. MSN is still No. 3 with a 9% percent rise from 592.2 million to 643.8 million.

Sorry to sound like a broken record – but what about Google scholar? Do these figures include those numbers?

For years, the mother ship Google has outperformed other search engines due to its speed, size – 8 billion documents, at last count – and comprehensive coverage. Searchers vote with their keywords and keyboards – Google is still #1.

On the eve of its seventh anniversary last fall, Google curiously began to drop its homepage boast of being the largest index of/ to the Web. The idea seems to be that as the Web scales up in size, crawling unique documents from the dark, deep edges of the Web is what counts (above the boast of size & numbers). The size of the web indexed by Google is irrelevant, right?

Well, yes and no. From an information specialist’s perspective, the size of a general database conveys an important metric to searchers. Specialty medical databases like PubMed index the best content, and is a tightly controlled 16 million citations; Scirus, due to its broader scientific coverage of peer-reviewed journal literature and web content, comes in at 250 million documents.

Windows Live Academic Search beta was announced less than a month ago (with only a sliver of content in computer science, physics and electrical engineering):

“.. as of launch date, [Academic Search] has deep content … – with more than 6 million records from approximately 4300 journals and 2000 conferences.”

Take note, Google scholar. Size is important – and information retrieval experts like to have these facts made known to us. We estimate Google scholar weighs in at .5 billion documents and webpages, making it the largest scholarly index ever built.

500 million (1/2 billion) documents in Google scholar, searchable in seconds. Isn’t that worth boasting about?

Dean Giustini
UBC Search-Scholar blogger

Reference librarians in Canadian universities and colleges need to agitate for greater academic freedom, and more recognition for service we provide to the university. While we’re at it, the time has come for us to add academic ranks to our professional titles, just like our American counterparts. Without them, we’re viewed as glorified clerks by the academy.

Of notable Americans in search, Greg Notess at notess.com is an example that springs to mind. In addition to his speaking, writing and consulting, Greg is also a reference librarian who holds the title assistant professor. The closest Canadian counterpart (that I can think of) is Rita Vine at WorkingFaster who has been called “Canada’s best Internet trainer”. Vine is a librarian at the Gerstein Science Centre at the University of Toronto – but, unlike Notess, does not hold any academic rank.

Academic librarians can chose to participate fully in the new information economy – or, languish behind their desks waiting for reference questions. Invitations from Google, Microsoft and Yahoo offer reference librarians the opportunity to influence the direction of search.

It’s high time Canadian academic librarians were given the freedom to participate, if their writing and speaking invites that participation.

Google Scholar’s release of the “recent articles“ and “bibliography manager“ suggest they are watching Windows Live Academic Search closely regarding the UI (user-interface). Yesterday’s Google blog had this message – not nearly as revealing as this one by Anurag Acharya, chief engineer at Google scholar.

In the post, Anurag adds that when searching a “union catalog in your region, links will appear automatically in search results. You can also select links to specific union catalogs using the “Library Links” search box on the Scholar Preferences page.” This builds on the library link program that has been in place for a while.

I welcome recent articles – even if the feature is not a “sort by date”. But, I caution Anurag in that his explanation of what recent articles is is complicated. Scholars will find it confusing. Will the new feature be obvious to most academic end-users? Will they get recent articles, or miss them? More often than not, they’ll miss them.

“Recent articles” will not be easy to teach. A real sort by date should be considered. Windows Live has a better sort by – oldest and newest feature.

I will be testing the importing feature, later. EndNote, RefWorks, Refman and Bibtex provide a few options via Scholar Preferences page.

For a librarian critique of the new features, check out Gary Price at ResourceShelf.

Dean Giustini
UBC Search-Scholar blogger

A graphics-savvy friend at UBC sent me this graphic today; I got quite a kick out of it (but the fun turned to concern re: copyright). If this a way to write for the Dummies series, I’m available!!

Our Google scholar session to graduate students today went by in a flash; I outlined Google Scholar’s progress in the last sixteen months, comparing it to Google in terms of content, size, subject coverage, pluses and minuses. Hilde talked about the link between rising academic journal prices and how that led to open access models like Paul Ginsparg’s arXiv.org and PubMedCentral. We both showed arts and sciences examples.

A mere hour before the class started, Google e-mailed (did they see the teaching outline I posted?) and told me that they had implemented a “sorting” function. It is now possible to re-sort results by most recent articles. Smart move, Anurag. We want more sorting, though – particularly importing and e-mailing.

All for now. Hilde and I will be doing a post-test tomorrow of our Google scholar session, and we plan to share the grad students’ ideas with you.

Dean Giustini
UBC Search-Scholar blogger

Is search bullish? Oh, to the tune of ~ $10 billion a year by 2010.

Google Scholar and Windows Live Academic Search are “mum” on monetization. But think about it: would it be so bad if sponsored links were discreetly displayed to one side? The venerable British Medical Journal has sponsored links; a number of other medical tools plan to go that route, including the TRIP database.

Librarians and end-users don’t want academic search cluttered by ads. And we absolutely loathe pop-ups in our search space. Paid-for-placement is old media, Web 1.0 – ditch that old means of marketing, and getting attention.

Barbara Quint, whom I’ve spoken to over the phone, and a big name in search at InfoToday, has written her thoughts about Windows Live Academic Search.

Dean Giustini
UBC Search-Scholar blogger

“Man is a tool-using animal. Nowhere do you find him without tools; without tools he is nothing, with tools he is all.” – Thomas Carlyle

Ah, the wisdom of the 19th century. – Dean, UBC Search-Scholar blogger