Find And Use On-Line Information and Learning Resources

Tools of the TradeSummer, 2009

Tools of the Trade – On-Line Resources 1

Your briefing of the Board went very well –until you mentioned that pregnant women were to be considered a high priority group for early vaccination against H1N1.

Mrs. Doubtfire, one of the citizen Board members, is currently six months pregnant. She rushes to be the first to ask you a question—and she appears a bit worked up about something. “Thanks for the briefing but you should know that I, for one, have no intention of getting a vaccination against this swine flu.” She continues, her voice rising, with members of the press eagerly taking notes and snapping photos, “I heard on TV that the vaccine can harm the developing fetus, and I refuse to do anything that might harm my baby! I don’t think any pregnant woman should get this vaccine!”

Tools of the Trade – On-Line Resources 2

You try to be reassuring, mentioning CDC and the ACIP, but Mrs. Doubtfire only responds, “I don’t know anyone on that Committee, and the feds assured us swine flu vaccines were safe in the past—and they were wrong!”

The energy in the room rapidly increases, until one of the Board members intervenes: “Perhaps it would be helpful if we asked the health department to research the evidence regarding vaccine safety for pregnant women, and let’s hold another briefing—say, in one week?” You are glad to agree to this, if for no other reason than to put an end to this unproductive turn of events.

Back in your office, you wonder, “Where should I begin? …

Search!

Exercise

Brain first, then Internet

• For every subject, there are subject matter experts (SMEs)

• Important questions are typically not simply matters of fact, but are often laden with emotion, underlying concerns, and matters of trust• Your strategy should address these dimensions

• Consider Facebook groups to ‘take the pulse’

• Look for intersection of who is likely to know the science and who (what organization) is credible to the person asking the question

Have an explicit search strategy

• Budget your time• Enlist allies in your search (e.g., other health

officials in your State)• Recruit allies for your planned briefing, esp.

insofar as they address underlying issues• Contact and communicate with the SMEs

• By telephone if possible, by e-mail if not

• Contact local, state, and federal agency SMEs

• Don’t forget key professional associations – local, state, and national

Organized lists of links

• There are official organizations and agencies (or agency divisions) associated with most public health issues

• In many cases, these agencies have developed well-organized, filtered sets of links to on-line resources

• See for example, the National Center for Immunization and Respiratory Diseases (http://www.cdc.gov/ncird/)

Brute-force Search Engines

• Can be amazingly useful

• Know that results are ranked not by relevance, but rather popularity and sometimes sponsorship

• Better engines allow very complex searches, can search newsgroups as well as WWW--worth your while to explore

• Different engines give different results

versus

Is H1N1 vaccine safe during pregnancy?

Caveats about Web searching

• Much of what is useful and on-line is not accessible via generic Web searches

• Real databases require specific queries (e.g., MedLine, CDC WONDER, Hazdat)

• Some database services require subscription and fees (e.g., ToxNet, Nexis)

• Much of what is useful and in print is not available on-line at all (e.g., most full-text, peer-reviewed articles)

Tips for weighing your “catch”

• Use common sense

• Use traditional means, e.g., from JAMA:• Authorship (names, affiliations, credentials)

• Attribution (for all references and sources)

• Disclosure (of Web site ownership, sponsorship, etc.)

• Currency (date that content was posted, updated)

• Use knowledge of URL anatomy

Biomedical Literature Search Tools

• Two great tools:• Medline Plus (http://medlineplus.gov/)

• PubMED(http://www.ncbi.nlm.nih.gov/pubmed/)

• Remember time lag: discovering writing publishing

For statistical data searches, consider

• US Census Bureau

• National Center for Health Statistics

• CDC WONDER• WISQARS

(for injury data, but broader applicability)

Tools of the Trade – Table Top Exercise

You have done a good analysis of the key players who will have to be on board to make this assignment work and you have successfully conveyed information about the project to key folks.  You’ve also allayed the technical concerns your Board has raised about patient safety.

Now you have to get much more specific about the content of the assignment – the tabletop exercise and engaging key officials in policy development.  You need to understand how tabletop exercises work, how they are designed, conducted and evaluated.  Time to find some tools to help you with these tasks.

Find And Use On-Line Information and Learning Resources

Tools of the TradeSummer, 2009