Which literature retrieval method is most effective for GPs?
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BACKGROUND: Evidence-based medicine requires new skills of physicians, including literature searching. OBJECTIVE: To determine which literature retrieving method is most effective for GPs: the printed Index Medicus; Medline through Grateful Med; or Medline on CD-ROM. METHODS: The design was a randomized comparative study. In a continuing medical education course, three groups of health care professionals (87 GPs and 16 other health care professionals) used one of the literature retrieval methods to retrieve citations on four search topics related to general practice. For the analysis in pairs, we used the search results of the 75 participants who completed all four assignments. As outcome measures, we used precision, recall and an overall search quality score; we also had a post-course questionnaire on personal characteristics, experience with computers, handling medical literature and satisfaction with course instruction and search results. RESULTS: The recall and overall search quality scores in the Index Medicus groups (n = 32) were higher (P = <0.001) than those in the CD-ROM groups (n = 31). In addition, the search quality scores in the Grateful Med groups (n = 12) were higher (P < 0.003) than those in the CD-ROM groups. There were no differences in precision. CONCLUSION: In the period 1994-1997, the printed Index Medicus was the most effective literature retrieval method for GPs. For inexperienced GPs, there is a need for training in electronic literature retrieval methods. (+info)
The evolution of rural outreach from Package Library to Grateful Med: introduction to the symposium.
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Outreach is now a prevailing activity in health sciences libraries. As an introduction to a series of papers on current library outreach to rural communities, this paper traces the evolution of such activities by proponents in health sciences libraries from 1924 to 1992. Definitions of rural and outreach are followed by a consideration of the expanding audience groups. The evolution in approaches covers the package library and enhancements in extension service, library development, circuit librarianship, and self-service arrangements made possible by such programs as the Georgia Interactive Network (GaIN) and Grateful Med. (+info)
A "Digital Divide" in information and technological literacy exists in Utah between small hospitals and clinics in rural areas and the larger health care institutions in the major urban area of the state. The goals of the outreach program of the Spencer S. Eccles Health Sciences Library at the University of Utah address solutions to this disparity in partnership with the National Network of Libraries of Medicine-- Midcontinental Region, the Utah Department of Health, and the Utah Area Health Education Centers. In a circuit-rider approach, an outreach librarian offers classes and demonstrations throughout the state that teach information-access skills to health professionals. Provision of traditional library services to unaffiliated health professionals is integrated into the library's daily workload as a component of the outreach program. The paper describes the history, methodology, administration, funding, impact, and results of the program. (+info)
Web-based Loansome Doc, librarians, and end users: results from a survey of the Southeast Region.
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OBJECTIVES: The study examines how Loansome Doc services are implemented and used by libraries in the Southeast Region and describe end users' experiences with and attitudes toward Loansome Doc. METHODS: 251 active DOCLINE libraries and 867 Loansome Doc users were surveyed. RESULTS: Roughly one half of the libraries offered Loansome Doc services. Of those that did not, most indicated no plans to offer it in the future. The majority had a small number of end users and experienced minimal increases in interlibrary loan activity. Problems were relatively rare. Satisfaction with Loansome Doc was high among all types of libraries. End users were usually physicians or other health care professionals who requested articles for research and patient care. Most learned about Loansome Doc through PubMed or Internet Grateful Med. End users appeared to be largely self-taught or received informal instruction in Loansome Doc. Loansome Doc filled document requests in a timely manner, and end users reported being satisfied with the service. CONCLUSIONS: Greater promotion of what Loansome Doc is and how it can benefit libraries can increase the number of participating libraries. While satisfaction of Loansome Doc end users is high, satisfaction could be increased with more help on the PubMed screen, more library training, and faster delivery methods. (+info)
Using BITNET to access the National Library of Medicine databases.
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An ongoing developmental project is described that uses the National Library of Medicine (NLM) GRATEFUL MED software on the BITNET network to access the NLM databases. The objective of the project is to improve biomedical communication capabilities to support health professionals in countries where international telecommunication services are limited. After a successful demonstration of the concept, the system was assembled and tested by the University of Chile and NLM. The full impact of this project will be measured at a later time. This paper describes the concept and testing of the system in Latin American countries. (+info)
Grateful Med on an institutional local area network.
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Grateful Med version 6.0 provides new features very desirable to network users. These include: a single copy of the application resident on a server providing access to many users; a new communications architecture which provides access to Medline via the Internet or local network modems; additional scripting capabilities allowing local customization. These new features reduce the overhead in installing and maintaining Grateful Med (GM), allow much quicker downloading of citations and abstracts from Medline, and remove the requirement of a local modem for each PC accessing Medline. (+info)
From patient reports to bibliographic retrieval: a Meta-1 front-end.
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A software front-end has been programmed to help construct Medline query expressions from selected text in clinical records. The user "clicks" to choose pertinent words or phrases from the text with a pointing device and the words are translated into Medical Subject Headings (MeSH). The National Library of Medicine's Unified Medical Language System Meta-1 Thesaurus is used to look up the words selected by the user. The software traces through chains of synonyms to assemble a small set of MeSH indexing terms. The user then makes the final selection from among the MeSH terms and combines chosen terms using logical connectives to form a Medline query which is passed on to Grateful Med. This approach provides the clinical user with a natural starting point, the text of a patient report with no need to know the MeSH terminology. The software handles the translation that otherwise would necessitate looking up terms in MeSH guidebooks, as well as handling the added drudgery of checking out different synonyms. Preliminary evaluation of this approach with clinical trainees indicated that they find the front-end a straightforward way to search for literature relevant to a clinical case. Having a tool for immediate translation from clinical terminology to indexing terminology seems to be an important factor. Apparently minor issues in interface design, such as keeping the clinical report displayed simultaneously along with the search under construction, and keeping both visible during the search itself seem to help orient the user. (+info)
A study to enhance clinical end-user MEDLINE search skills: design and baseline findings.
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OBJECTIVE: To determine if a preceptor and timely, individualized feedback improves the performance of physicians in searching MEDLINE using GRATEFUL MED in clinical settings. DESIGN: Randomized controlled trial. SETTING: A 300 bed primary to tertiary care teaching hospital. Computers were installed in wards and clinics of 6 major clinical services, and the emergency room, intensive care and neonatal intensive care units. SUBJECTS: All physicians and physicians-in-training from the departments of Medicine, Family Medicine, Surgery, Psychiatry, Pediatrics, and Obstetrics and Gynecology were included if they made patient care decisions for at least 8 weeks during the study period. INTERVENTION: All participants were given a 1-hour training class and 1 hour of individualized searching with 1 of the 2 study librarians. After training, participants were randomized to a control group who received no further intervention or to an intervention group in which each person chose a clinical preceptor experienced in MEDLINE searching and received individualized feedback by a study librarian on their first 10 searches, indicating search quality and providing suggestions for improvement. Feedback was mailed the first week day after the search was done. MAIN MEASURES: Baseline characteristics by study group, department and level of training, study participation rates, and searching rates. MAIN RESULTS: 308 of 392 eligible physicians joined the study. Participation was almost 80% with some variation by department and level of training. Excellent balance in the baseline characteristics was achieved for the 2 groups, as well as for the number who did first searches. Intervention group participants searched MEDLINE more often than did controls (3.5 searches per month vs 2.5 per month for controls, P = 0.046). The recall and precision for first searches for both groups was significantly less than that of librarians. The analysis of study data will be completed by September 1991. CONCLUSIONS: Clinicians are willing to do self-service searching of MEDLINE in clinical settings but their precision and recall are less than a trained librarian at baseline. Search skills enhancements are needed and the effect of feedback and preceptors is being tested. SOURCE OF FUNDING: U.S. National Library of Medicine and Ontario Ministry of Health. (+info)