The Search Principle blog

Open medical content vs. locked. Publishing the EBM resources handout resulted in several e-mailed questions about the top EBM sources; here is my attempt at listing the Top 20 (or so) evidence-based medicine sources of information – some content is open (free), some closed (fee). Have I missed any top sources in either handout? One omission: EMBASE in part two. Shouldn’t the entire corpus in medicine, across all disciplines and all time periods, be open access and web searchable?

Dean Giustini
UBC Google scholar blogger

Sir Iain Chalmers – On cumulating the evidence (pdf version)
by Dean Giustini, UBC Google scholar blogger

Sir Iain Chalmers is one of the founders of the worldwide Cochrane Collaboration. (What is Cochrane?) For many years, he has lobbied for cumulating the evidence in medical research. He received a knighthood for his contributions in 2000.

These days, as editor of the online James Lind Library, Dr. Chalmers says that many of the same guiding principles of cumulating the evidence continue to occupy his thinking. “Patients and professionals want decisions in health care to be informed by as high a proportion as possible of all the reliable evidence relevant to particular questions. [But] researchers and journals don’t always serve us well in this respect”.

“The results of new studies are not presented and interpreted within the context of systematic integration of other research. As a result, patients have suffered and died unnecessarily and resources have been wasted.” (The scandalous failure of science to cumulate the evidence scientifically. Clinical Trials, 2005) [2005 & ICML9 ppts]

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Another of Dr. Chalmers’ areas of interest is the ways that the ideas of testing have evolved over several hundred years. The James Lind Library is dedicated to shedding light on these contributions.

“The James Lind Library has been created to help people understand fair tests of treatments in health care by illustrating how they have developed over the centuries” he says. “At its core, the Library provides online access to key passages and images from books and journal articles, and essays explaining the principles of fair tests. Much of the core is accompanied by commentaries, biographies, portraits, and other relevant historical material.”

From a librarian’s perspective, the James Lind Library website is easily searchable and rates very highly in its presentation of historic medical materials. Here are its contributors.

Dr. Chalmers ends our conversation by discussing the ethics of clinical trial under-reporting and the influence of the drug industry. “Biased under-reporting of clinical trials is unscientific and unethical. Physicians who acquiesce in this ignore their responsibilities to patients, sometimes because they are colluding with industry, which has primary responsibilities to the interests of shareholders.

After Eliot Spitzer, the Attorney General of New York State, charged GlaxoSmithKline with suppression of information about drug side effects, the International Committee of Medical Journal Editors (ICMJE) took a stand on the issue of clinical trial registration, which had been written about years ago (Chalmers I. Under-reporting research is scientific misconduct. JAMA 1990;263:1405-1408.). The public has become more aware of this commercial and professional misconduct, and public trust has been eroded (House of Commons Health Committee. The Influence of the Pharmaceutical Industry. London: Stationery Office, 2005).”

“It is clear that industry and the medical profession need to clean up their acts and outlaw biased under-reporting of research to deserve public trust” says Chalmers.

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James Lind Library – be sure to view:

Open medicine vs. subscription only (locked down) content is designed for physicians who want an overview to evidence-based databases and websites on the Internet. If sources are missing from the EBM list, let me know and I will add them.

Note to Google Scholar: is open access content crawl-able for easy searchability?

Dean Giustini
UBC Google Scholar blogger

Thanks to Ves Dimov at Clinical Cases and Images Blog who alerted me to the Medscape videocast Are Traditional Peer-Reviewed Medical Articles Obsolete? [Registration (free) required.] Medscape founder Peter Frishauf says that “a variant of Wikipedia for medicine is the future for peer review in medicine”.

On 29 December 2005, I wrote about wikis in the context of Internet search here as a possible solution to freeing up “locked down” medical content, which seems more and more likely in an era of open access. Collaborative social technologies like blogging and wikipedias for medicine have an undeniable appeal – will they be short-lived or revolutionize the way physicians communicate best evidence?

Dean Giustini
UBC Google Scholar blogger

Many of you may be familiar with Rita Vine and her astute observations about searching in medicine. After a long hiatus, she revived her blog this week, and published a review of Google Scholar in the JMLA (open access in PMC).

I have prepared a few comments in response to her well-reasoned articles here.

Dean Giustini
UBC Google Scholar blog

According to fellow librarian Search Engine Watch’s Gary Price, Google Scholar is poised to announce new language preferences (Chinese, Portuguese) and interfaces for Denmark, Finland, Norway and Sweden. It remains to be seen what medical citations are unique to each subsection. I will be running some search tests on medical topics later in the week.

Dean Giustini
UBC Google Scholar blogger

Vancouver pediatrician Dr. Jane Hailey – host of CBC 690am’s Medical Almanac – will discuss Google’s influence in medicine on Tuesday Jan. 10th at 12:20pm PST. The British Medical Journal editorial How Google is Changing Medicine is among the topics. Outside of B.C.? You can (in fact) listen to the program over the Internet here.

It will be worth tuning into to hear a physician’s take on Google.

Dean Giustini
UBC Google Scholar blogger

Blogging has been good to me this week, bringing attention to UBC and the work of medical librarians. The U.S. media, CBC and Search Engine Watch have given me a forum to discuss a major concern of mine: access to information for developing countries. For that, I am grateful.

In 2006, watch for bloggers’ influence in public discourse to increase. Consequently, the media will dissect what we say and, in medicine, some of our secrets will be revealed. Blogging is anti-hierarchical and anti-paternalistic; as such, it is one of the more powerful, grassroot tools of communication in the Internet age. Blogs have the potential to change the way medical professionals are perceived; expect both positive and negative repercussions should you decide to blog about your own work.

Following How Google is changing medicine, the media and blog buzz have put my ideas under a microscope. Was I prepared for media questions? Yes, thanks to almost a year of blogging. Did it help that I could direct the media to my blog for further information? Absolutely. Several times, the media asked me “What’s next”? Will Google call for my opinion? Will I continue to write about Google?

I encourage you to set up the RSS feed on this blog (upper left, orange icons) or check back regularly to find out.

Dean Giustini
UBC Google Scholar blogger

UBC’s medical program started its evidence-based theme weeks today. After framing a clinical question, finding the best evidence is the next step in EBM; therefore, we librarians were asked to discuss search strategies with fourth-year medical students.

Here are three highlights from the workshops:

1. Formulating the clinical question – One student said that “recasting” the case as a question felt awkward. However, I said that good clinical questions give thrust and forward direction to step 2 of EBM – information retrieval.

2. Retrieval of evidence – students of medicine do understand basic searching. However, many complain that we provide too many sources. PubMed is frustrating; using clinical queries is quirky; though OVID is easiest to use (a proxy was needed).

3. Googling your sources – much debate about “how”. Could we find articles from UptoDate? I showed them how to Google for an osteoarthritis patient and to get best evidence. In Google scholar, this free item appeared from BMJ clinical evidence.

Shortcuts like these are invaluable. Googling your treatment should not induce guilt for librarians or doctors, as long as you search specific tools with precision.

Dean Giustini
UBC Google Scholar blog

CBC Radio in Vancouver broadcast a story about Google Medicine this morning. Steve Lus, the CBC reporter, did an excellent job of synthesizing information I gave him for a one minute story. Talk about evidence-based reporting. Meanwhile, U.S. based Health ITWorld ran Neil Versel’s article Google Has a Future in Medicine and the New England Journal of Medicine published more proof of Google’s impact in accessing medical literature. McMaster University, arguably the birthplace of evidence-based practice, has now published this fact sheet on Google Scholar.

Dean Giustini
UBC Google Scholar blogger