The Search Principle blog

Speaking to the Association of American Publishers, the University of Michigan President, Mary Sue Coleman suggests that Google knows about the value of books. And she wants the University of Michigan library – among the largest research libraries in the world – to let the search giant digitize its entire collection.

“Google Book Search is the most revolutionary enterprise I’ve ever experienced” says the Prez. “It has the potential to [preserve] and transform the flow of knowledge, and there is no greater gesture a university can make”. Dr. Coleman, a PhD biochemist, has done groundbreaking medical research, worked with the brightest minds, Pulitzer Prize winners and Nobel laureates. Here is a vodcast of her talk.

Digitizing collections faces roadblocks, especially copyright issues, and legal challenges by publishers. (Yes, that’s one of those book scanners to your left.)

Dean Giustini
UBC Google scholar blogger

I gave my first class of LIBR2195 – medical reference for library technicians – at Langara College in Vancouver BC tonight. I met 24 eager library technicians-in-training, and established a dialogue about the political, social and economic contexts for providing reference services in medical libraries. Of course, it included the challenges of doing so in an era of open access, Google and other access issues including universal health care.

Teaching library school students and library technicians to do reference is one of the great joys of my profession. My class tonight was extremely attentive, willing to participate and quick to catch on. I look forward to my future classes on searching in complementary and alternative medicine, and their special hands-on search projects.

Students: if you have any comments or suggestions, please share them with me. What did you think of searching PubMed? What did you think of the ready reference sources and the discussion of wikipedia? Let me know. What was the most memorable thing you learned about searching in class tonight? See you next week.

Dean Giustini
UBC Google scholar blogger

Doggydiagnosing has been in the news. According to the March 2006 Integrative Cancer Therapies journal, dogs can be trained to sniff out biochemical markers in the breath of cancer patients, even before traditional diagnostic tests can detect cancers. The article Diagnostic Accuracy of Canine Scent Detection in Early and Late Stage Lung and Breast Cancers suggests that regular domestic dogs can be trained to sniff out volatile cancer compounds released in human breath, than would normally be expected by chance alone.

I was curious to know what evidence I could sniff out on this subject from Cochrane (nothing), PubMed, EMBASE, Google Scholar, Google and Scirus. The result? A few “proof of principle” studies; and a fascinating tale of a sniffer dog in a skin clinic who was so bothered by melanomas that he’d want to bite them off (while benign moles went unnoticed)! Here are some search results from Healthline and Kosmix.

Though the evidence-base is minimal, doggydiagnosing does have its charms.

Dean Giustini
UBC Google scholar blogger

As Iain Chalmers has said, the United States has given the world two great gifts: jazz and MEDLINE. (Most of us in hospital libraries would add DOCLINE and the MLA). My admiration for MEDLINE is one of the primary reasons I became a hospital librarian. Its structure – supported by human indexing and the venerated medical subject heading (MeSH) – is a marvel of organization. But, like the waning importance of AACR2R to the centrality of library cataloguing, librarianship’s core values are under siege. Librarians need to take notice and adapt – or, we stand to lose our users.

Physicians are becoming increasingly comfortable with and accustomed to easy access to medical information. Is this Google’s fault? Certainly, it’s one reason why we face raised expectations from users; more than ever before, physicians want to be able to search multiple files simultaneously, extract the best evidence from worldwide repositories, and occasionally go beyond to new forms of scholarly communication on wikis and blogs. For most users, is MEDLINE still the gold standard?

For literature reviews, MEDLINE is still the gold standard. In fact, I still fill MEDLINE workshops at Vancouver hospital as readily as those on Google Scholar. But searching MEDLINE is difficult to do well unless one practices daily. Before 1995, physicians relied on medical librarians to perform exhaustive literature searches (remember Elhill and Internet Grateful Med?). Then, our lives changed forever when PubMed was announced to the world. Since then, librarians have continued to teach health professionals how to search the literature for themselves.

But we need to be prepared for what lies ahead. We need to have a discussion about what the new information landscape will look like, and how we can protect the core values we hold so dear, while meeting the emerging needs of users.

Dean Giustini
UBC Google scholar blogger

Venture capitalists take note: medical search on the Web is an untapped market, both on the consumer and physician side of the equation. We are still waiting for that next great thing. However, recent developments – and less enthusiasm for Google due to censorship and privacy issues – suggest that three new interfaces may be winter’s antidote.

Healthline, a relatively-new consumer health search engine, is up first. According to the New York Times, Healthline secured a whopping $14 million dollars in backing from Reed Elsevier, one of the giants in publishing. As far as content goes, will Elsevier move Healthline beyond its self-limiting content to more evidence in tools like MDConsult (which also has patient information)? In any case, it’s a smart move to work with the best content providers in business, legal and educational spheres.

Next up – Kosmix, which brands itself the ultimate health search. What’s cool is Kosmix has $7.5 million in backing and founders – Anand and Venky – know Google’s Sergey and Larry from their days together at Stanford. Unlike other consumer health or physician-oriented portals, Kosmix wants to index the entire web and has come up with its own page-rank technology to list results by clustered categories (hey, can you say library classification?), which is novel as visual guidance is rarely provided in medical search (MEDLINEplus does it). Librarians will appreciate the breakdown for clinical trials, blogs, basic and expert information in the Kosmix results display.

Finally, meta-search Mamma.com has launched a free desktop search application. My first thought was “yawn” not another over-hyped application. However, for so-called deep web health content, try Mammahealth.com (reviewed here before) which clearly lists its sources now like MEDLINEplus, eMedicine, and NHSDirect out of the UK. What, no Canadian content? For shame!

Dean Giustini
UBC Google Scholar blogger

The National Library of Medicine is retooling its PubMed search engine….according to an article in today’s Bio-IT World PubMed getting a makeover. David Lipman, Director of the National Center for Biotechnology Information (NCBI), says that he has consulted search engines MSN Search, A9 Search and Google.

I told the reporter that any and all improvements to PubMed are welcome; but three important search issues in medicine need to be addressed if we want to make PubMed more user-friendly: 1) address users’ demands for easier navigability (represented by Google and Google scholar); 2) provide better interoperability within citations to NCBI genome data (which Google cannot do); and 3) link to full-text outside of the NIH to items in open access repositories and in the deep web.

Dean Giustini
UBC Google scholar blogger

Open access to high-quality, digitized versions of the most influential medical books in history is improving, all the time. The National Library of Medicine’s History of Medicine Division and the British Library have notable digitization projects worth exploring. NLM’s amazing historical collections examine various facets of medical history, and include Islamic manuscripts, searchable images and even the Vesalius
De humani corporis fabrica. The NLM version of the anatomy classic includes audio commentary, and online magnifying and “page turning” technology.

Google’s Book Search is typical of current digitization efforts – it’s very much a work in progress. The great medical texts of history – such as Harvey’s Circulation of the Blood – are not yet digitized but others mention Harvey’s landmark book or are translations. Text versions are available on Bartleby’s as are writings by Lister and even Pasteur. Try an advanced search on the Web for specific digital versions.

Googling for medical texts in the digital atheneum is getting easier. But first, if you can, browse specific portals such as MLA’s and the AAHM. Two of Canada’s best collections in the history of medicine are located at the UBC Woodward Library and McGill’s Osler Library of the History of Medicine. Sir William Osler was a bibliofile and gave a collection of 8,000 medical books to McGill.

It will take time to view Osler’s complete collection online. Digitization is hard on books, and some texts will likely never be digitized. At present, however, search for static images using Google’s Image search, view progress at the Gutenberg project and the Internet Archive. For a good starting point, browse sites selected by McGill’s librarians and search for history papers on PubMed, the IndexCat or Google scholar.

Dean Giustini
UBC Google scholar blogger

Evidence-based practice begins and ends with the patient. Often, patients can benefit from salient and appropriate information explaining lab tests, drugs and disease prognoses. In oncology, where some patients face a terminal diagnosis, reliable information provides succour and comfort at a very difficult, uncertain time.

Due to confidentiality, information professionals do not disclose details of their interactions with patients. However, imagine a hypothetical situation where a young, single mother of two growing children, living in a remote area of Canada, learns of a recurrence of her cancer. In extremis, she makes a phonecall to a hospital librarian.

This is an extreme and graphic example of the importance of open access to evidence-based information. Imagine how this problem is compounded by the challenges of waiting lists and poor health care coverage! Fortunately, there are a number of excellent consumer information tools and websites – view them directly or search for them using a search engine – that will help this female patient. Any patients interested in participating in the Cochrane Collaboration can provide feedback via the Cochrane Consumer Network.

Finally, it must be stressed, that health librarians are important allies for physicians in providing evidence-based care. We are trained to lead the patient to the most pertinent information based on our knowledge of sources and our ability to interpret the patient’s clinical question. When at a distance, easy open access to information is humane.

Dean Giustini
UBC Google scholar blogger

Google‘s refusal to release a week’s worth of search queries to the U.S. DOJ has been the topic of debate among search experts this week. As physicians, should you be concerned about this potential intrusion into your search habits?

That depends. According to this week’s PC World, 56% surveyed said that they didn’t believe Google would hand over its records (unlike Yahoo and MSN, which did). However, 41% say they’d stop googling if Google releases its records to the feds.

How does Google track your searching, you ask? When using Google, a cookie is installed onto your computer and thereafter tracks what you search for. This is not as nefarious as it sounds. It is common practice at websites such as Medscape and Amazon, and is useful because you can see what you’ve searched for in previous visits. (In PubMed, you need to enable cookies for full interactivity.)

To avoid problems in the long run, try the following: 1) Every few weeks, delete cookies from your desktop. (It is still possible that a website will download an old cookie when you return to it). 2) Always use clinical terms (MeSH) in medical searching, first to improve the precision of your results, but also to avoid “adult” content. (Anatomical words like these will help you avoid adult sites). If you are worried about privacy, you can install a tool called an anonymizer.

The free-wheeling, open web brings a concomitant loss of privacy. Be careful about what you browse online. A good rule of thumb is to remember how open the web is, and steer clear of obvious problems.

I’ll try to keep you up-to-date on Google’s next move regarding the Department of Justice subpoena.

Dean Giustini
UBC Google scholar blogger

Unnecessary lab tests, medical error, long waiting lists, lack of time for patients – the list of what ails our medical system is as long as your arm. Today’s Globe and Mail highlights Testing, testing: more is not better, MDs say and the ordering of unnecessary diagnostic tests which costs .5 billion dollars a year in Canada.

Is it far-fetched to suggest that better access to information would ameliorate some of the system’s problems? Health librarians in Canada work closely with physicians and other health providers to ensure that they have access to the best information. But providing information services is money well-spent. Perhaps Health Canada should not have let their health librarians go, after all.

A special thanks to Maureen Bennie, Director, Autism Awareness Centre in Calgary, Alberta for bringing this important matter to my attention.

UBC Google scholar blogger
Dean Giustini