Searching for Health Information Online (Part 4)
Monday, April 30, 2007
Joshua Schwimmer, MD, FACP, FASN
The last three parts of this series reviewed searching for online health information designed for patients. In
part 1, I discussed Healthline's approach and the use of HealthMaps. In
part 2, I discussed MedlinePlus and the individual web pages of physicians. In
part 3, I compared UpToDate, Google Search, and Google Co-op. In this part, I'll look at two other ways of searching for more detailed, professional-level health information: PubMed and Google Scholar.
PubMed is a service of the National Library of Medicine. It is a search engine of the MEDLINE database, which covers over 5,000 biomedical journals dating back to the 1950's. Searching PubMed allows access to the primary medical literature for healthcare professionals and patients interested in recently updated, technical information.
PubMed has many advantages. It's more frequently updated than many other databases (citations can even be found that are "
in process" and haven't yet been formally added); and it's
powerful and customizable. However, for the busy clinician with little formal training in searching the medical literature, PubMed can be difficult to use, and therefore its powerful features are often wasted. And if professionals have a difficult time using it, then non-professionals and patients will also likely have a tough time.
Google Scholar is an attempt to preserve the power of PubMed, add additional features, and present the search interface simply. The advantages include:
- Papers are listed not in order of publication, but in order of relevance, which is determined by PageRank, the same system used in regular Google searches.
- Next to each publication is a link to other publications that cite it. This allows you to immediately determine whether a paper is influential and who it has influenced.
- Scholar also includes searches of publications that don't make it to Medline, like books, small journals, and private collections.
- Scholar uses the familiar uncluttered Google interface.
To use an example: our hypothetical patient with kidney stones from part 1 has heard that drinking lemonade may help prevent kidney stones and is interested in reading the original research. First he searches for ["kidney stones" AND lemonade] in PubMed:

PubMed initially only provides
one link. After clicking on "show related searches," it expands the search and provides 100 entries in no obvious order.
Next, he searches Google Scholar for ["kidney stones" AND lemonade]:

While Google Scholar only provides 73 results, the results are listed in order of importance, and it's easy to see at a glance how many times each paper is cited by other papers.
This is a critical feature. First, it instantly introduces you to some of the most important papers in the field. Second, it allows you to follow the web of citations in the medical literature. Almost without exception, every published physician and scientist I've seen encounter Google Scholar for the first time has immediately "Scholared" themselves to see who is citing and reading their work.
Of course, as useful as Google Scholar is, it's not perfect. For an overview of the advantages and disadvantages of using Google Scholar see
this discussion from the McMaster Health Sciences Library. And for more discussion of Google Scholar and searching the medical literature, see Dean Giustini's
Google Scholar Blog.
Lastly, if you have access to a medical library, I encourage you to take advantage of it and learn from the people who work there.
Labels: google scholar, healthline, medical informatics, medlineplus, pubmed
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Searching for Health Information Online (Part 2)
Thursday, April 19, 2007
Joshua Schwimmer, MD, FACP, FASN
In
part 1, I introduced ways of searching for health information online and discussed Healthline's approach and its innovative use of
HealthMaps. In this post I'll discuss MedlinePlus.
MedlinePlus.gov is a service of the National Library of Medicine, part of the National Institutes of Health. From the website:
MedlinePlus will direct you to information to help answer health questions. MedlinePlus brings together authoritative information from NLM, the National Institutes of Health (NIH), and other government agencies and health-related organizations. Preformulated MEDLINE [medical literature] searches are included in MedlinePlus and give easy access to medical journal articles. MedlinePlus also has extensive information about drugs, an illustrated medical encyclopedia, interactive patient tutorials, and latest health news.
To use an example, having returned from the emergency department after having a kidney stone, our hypothetical patient from part 1 would see the following after searching for "kidney stones" on MedlinePlus:

The search results are divided into topics, including kidney stones, bladder diseases, and other diseases of the kidney. The section on "kidney stones" has a large amount of information (which some patients might find overwhelming). Links include patient information from the National Institutes of Diabetes & Digestive & Kidney Diseases, the American Medical Association, the American Urological Association, and many other sources.
Also included is a link to
Clinicaltrials.gov -- this site, created by the National Library of Medicine, is a search engine for federally and privately supported clinical trials, and is the best place to go to answer the question, "What research trials are being done on this particular disease?" (At some time in the future, I'll write a post on Clinicaltrials.gov; it's a useful and underutilized resource.)
Finally, another possible source for medical information is the web pages of individual physicians. Services like
Google Page Creator now make it easy for health care providers (or anyone, for that matter) to create simple websites inexpensively or for free, no programming knowledge required. For example, on my website, I've created a page linking to
information on kidney disease. This links to another page which lists
types of kidney diseases, which includes information on kidney stones and
this link that I've chosen from the National Institutes of Health. Dr. Ves Dimov talks further about
using Google Page Creator on the Clinical Cases and Images blog.
Part 3 will look at more useful sources of health information online.
Labels: clinical trials, healthline, medical informatics, medicine, medlineplus
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Searching for Health Information Online (Part 1)
Tuesday, April 17, 2007
Joshua Schwimmer, MD, FACP, FASN
Unexpectedly, I was recently quoted in this year's
Google Annual Report (page 3) on searching the medical literature. The quote was based on an interview I gave to the
Google Scholar Blog where I mused about the ease of finding health information on the Internet using Google Scholar and other tools.
Also recently, a patient remarked that "On the Internet, you're always a few clicks away from certain death." He had searched online for his diagnosis and found a wealth of information, but he quickly realized that much of it was irrelevant, unduly alarming, or just plain wrong.
So I've been thinking a lot lately about health information on the Net. This series of posts will examine various ways that both patients and physicians can find reputable medical information online. To be clear: I'm not a medical librarian or a professional researcher, and this review will not be comprehensive, but it will touch upon some of my favorite methods of finding health information on the Internet.
Take kidney stones as an example. You're a patient, you've just spent most of the day in the emergency department in excruciating pain with your first kidney stone, and you come home and sit in front of your computer looking for more information. Where do you look?
A number of sites offer customized search engines which link to other websites carefully chosen to have reliable medical information. Healthline is one example of these specialized medical search engines and is certainly one of the best. (Full disclosure: I proudly blog here and consult for them.) Typing "kidney stones" in the search box on Healthline, our hypothetical patient receives a list of resources on kidney stones including
an article on kidney stones reviewed by a physician,
an entry on kidney stones in a medical encyclopedia, as well as information on kidney stones from outside sources including the
Mayo Clinic.

In addition, glancing at the top of the page reveals "Search Ideas" -- these options include ways of broadening and refining the search, and also include a feature unique to Healthline called "HealthMaps."
A HealthMap, as I mentioned in a previous post on
the value of mapping, is a visual representations of the epidemiology, diagnosis, and treatment of disease -- a "disease at a glance." Clicking on any of the components further refines the search to focus on that aspect of the disease. Clicking on "uric acid stones," for example, would automatically direct the patient to further information about that type of kidney stone.

More on searching for health information online in
part 2.
Labels: healthline, medical informatics
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