Searching for Health Information Online (Part 4)

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 3)

In part 1, I introduced ways of searching for health information online and discussed Healthline's approach and the use of HealthMaps. In part 2, I discussed MedlinePlus and the individual web pages of physicians. In this part, I'll compare three other methods of searching for health information: UpToDate (a "top-down" approach), Google Search (a "bottom-up" approach), and Google Co-op (a "hybrid" approach).

UpToDate is a popular, frequently updated, online textbook of medicine for health care providers. It's unparalleled at giving a quick, high-level overview of many frequently encountered clinical situations and is widely used by physicians. UpToDate also offers a section of information designed for patients (which is less well-known). This information for patients on UpToDate is typically written by the same experts that write the reviews on the main site for health care providers. You might consider this a "top-down" approach to providing health information -- the site itself provides reviews of topics written by respected experts.

For example, our patient in part 1 with a kidney stone might navigate to UpToDate's "Table of contents for patient-level information," choose "kidney disease," then choose the section on "kidney stones." The reviews for patients on UpToDate are detailed and written at a high-level (which some people might find appealing and others might dislike), which reflects the main focus of UpToDate as a source of information for health care providers.

In contrast to the "top-down" approach of UpToDate, the search engine Google provides a "bottom-up" approach. Rather than producing it's own content, Google provides a list of links chosen based upon an automated method which provides a ranking of quality. If the patient with a kidney stone in part 1 searches for "kidney stones" in Google, the first link provided is a review from the National Institutes of Health. The second is the review from Wikipedia (a public encyclopedia to which anyone can contribute).
While Google typically provides relevant, high-quality results, the links provided are not necessarily the most authoritative (take Wikipedia, for example) or safe (see McAfee Siteadvisor's analysis of the Safety of Internet Search Engines).

Google Co-op, a "hybrid" approach, is an attempt to address these concerns. Google Co-op combines the "bottom-up" search results from Google with the "top-down" expertise of various organizations and individuals. For example, the Google Co-op Health Section lists contributors such as the Centers for Disease Control, the National Library of Medicine, and the Cleveland Clinic. When searching for various health topics, the "labels" from these contributors are included as part of the search under the "Refine results" section. Searching for "kidney stones" on Google, for example, displays the following additional links:


Clicking "From medical authorities" provides only links that have been labeled by the contributors as being from reputable medical authorities. This is one way of combining the expertise of health care organizations with the results from Google's search engine.

In part 4, I'll conclude with a look at searching for more detailed health information using Google Scholar and PubMed.

Labels: google, google co-op, health information, healthline, medlineplus, uptodate, wikipedia

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Searching for Health Information Online (Part 2)

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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