Understanding search failures in consumer health information systems.
We examined queries that led to search failures on two National Library of Medicine Web-based consumer health sites, ClincialTrials.gov and MEDLINEplus. The purpose of the study was to analyze and categorize queries resulting that led to no results with the ultimate goal of developing interventions to assist users in recovering from those failures. We first analyzed over 2,700 queries, iteratively developing a coding scheme. We subsequently applied the codes to an additional set of 2,000 queries. We found that most of the queries were in scope, relevant to the system being searched, and did not exhibit so-called consumer language. As the final step, we developed a taxonomy based on whether the search failures were due primarily to content issues, to problems in query formulation, or to limitations of the search system. The results reported here have informed the further development of our own systems, and they may be helpful to others as they seek to improve consumer access to health information. (+info
Perception of quality and trustworthiness of Internet resources by personal health information seekers.
OBJECTIVES: This paper focuses on one dimension of personal health information seeking: perception of quality and trustworthiness of information sources. DESIGN: Intensive interviews were conducted using a conversational, unstructured, exploratory interview style. SETTING: Interviews were conducted at 3 publicly accessible library sites in Arizona, Hawaii and Nevada. PARTICIPANTS: Thirty-eight non-experts were interviewed. RESULTS: Three separate and distinct methods used to identify credible health information resources were identified. Consumers may have strong opinions about what they mistrust; use fairly rigorous evaluation protocols; or filter information based on intuition or common sense, eye appeal or an authoritative sounding sponsor or title. CONCLUSIONS: Many people use a mix of rational and/or intuitive criteria to assess the health information they use. (+info
Interpreting hypernymic propositions in an online medical encyclopedia.
Interpretation of semantic propositions from bio-medical texts documents would provide valuable support to natural language processing (NLP) applications. We are developing a methodology to interpret a kind of semantic proposition, the hypernymic proposition, in MEDLINE abstracts. In this paper, we expanded the system to identify these structures in a different discourse domain: the Medical Encyclopedia from the National Library of Medi-cine's MEDLINEplus Website. (+info
The Genetics Home Reference: a new NLM consumer health resource.
The Genetics Home Reference (GHR) is a new information resource developed to be part of the National Library of Medicine's (NLM's) consumer health initiatives. The GHR's guiding principle is to make the health implications of the Human Genome Project accessible to the public. The GHR accomplishes this by providing a bridge between the NLM's consumer health systems MEDLINEplus and ClinicalTrials.gov on the one hand and the multiple resources emanating from the Human Genome Project on the other. The initial focus is on single gene conditions that are main topics in MEDLINEplus. (+info
Design of Genetics Home Reference: a new NLM consumer health resource.
The authors have developed the Genetics Home Reference, a consumer resource that addresses the health implications of the Human Genome Project. The research results made possible by the Human Genome Project are being made available increasingly in scientific databases on the Internet, but, because of the often highly technical nature of these databases, they are not readily accessible to the lay public. The authors' goal is to provide a bridge between the clinical questions of the public and the richness of the data emanating from the Human Genome Project. The Genetics Home Reference currently focuses on single gene or polygenic conditions that are also topics on MEDLINEplus, the National Library of Medicine's primary consumer health site. As knowledge of genetics expands, the interrelationships between genes and diseases will continue to unfold, and the site will reflect these developments. (+info
Reformulation of consumer health queries with professional terminology: a pilot study.
BACKGROUND: The Internet is becoming an increasingly important resource for health-information seekers. However, consumers often do not use effective search strategies. Query reformulation is one potential intervention to improve the effectiveness of consumer searches. OBJECTIVE: We endeavored to answer the research question: "Does reformulating original consumer queries with preferred terminology from the Unified Medical Language System (UMLS) Metathesaurus lead to better search returns?" METHODS: Consumer-generated queries with known goals (n=16) that could be mapped to UMLS Metathesaurus terminology were used as test samples. Reformulated queries were generated by replacing user terms with Metathesaurus-preferred synonyms (n=18). Searches (n=36) were performed using both a consumer information site and a general search engine. Top 30 precision was used as a performance indicator to compare the performance of the original and reformulated queries. RESULTS: Forty-two percent of the searches utilizing reformulated queries yielded better search returns than their associated original queries, 19% yielded worse results, and the results for the remaining 39% did not change. We identified ambiguous lay terms, expansion of acronyms, and arcane professional terms as causes for changes in performance. CONCLUSIONS: We noted a trend towards increased precision when providing substitutions for lay terms, abbreviations, and acronyms. We have found qualitative evidence that reformulating queries with professional terminology may be a promising strategy to improve consumer health-information searches, although we caution that automated reformulation could in fact worsen search performance when the terminology is ill-fitted or arcane. (+info
High school peer tutors teach MedlinePlus: a model for Hispanic outreach.
OBJECTIVES: The objective was to introduce the MedlinePlus Website to the predominantly Hispanic residents of the Lower Rio Grande Valley region of Texas by partnering with a health professions magnet high school (known as Med High). METHODS: Community assessment was used in the planning stages and included pre-project focus groups with students and teachers. Outreach methods included peer tutor selection, train-the-trainer sessions, school and community outreach, and pre- and posttests of MedlinePlus training sessions. Evaluation methods included Web statistics; end-of-project interviews; focus groups with students, faculty, and librarians; and end-of-project surveys of students and faculty. RESULTS: Four peer tutors reached more than 2,000 people during the project year. Students and faculty found MedlinePlus to be a useful resource. Faculty and librarians developed new or revised teaching methods incorporating MedlinePlus. The project enhanced the role of school librarians as agents of change at Med High. The project continues on a self-sustaining basis. CONCLUSIONS: Using peer tutors is an effective way to educate high school students about health information resources and, through the students, to reach families and community members. (+info
The MedlinePlus public user interface: studies of design challenges and opportunities.
QUESTION: What are the challenges involved in designing, modifying, and improving a major health information portal that serves over sixty million page views a month? SETTING: MedlinePlus, the National Library of Medicine's (NLM's) consumer health Website, is examined. METHOD: Challenges are presented as six "studies," which describe selected design issues and how NLM staff resolved them. MAIN RESULT: Improving MedlinePlus is an iterative process. Changes in the public user interface are ongoing, reflecting Web design trends, usability testing recommendations, user survey results, new technical requirements, and the need to grow the site in an orderly way. CONCLUSION: Testing and analysis should accompany Website design modifications. New technologies may enhance a site but also introduce problems. Further modifications to MedlinePlus will be informed by the experiences described here. (+info