MEDLINEplus andConsumer Health Initiatives

at NLM/NIH

October 20, 2000

Annual Meeting, Mid-Atlantic Chapter

of the Medical Library Association

Adam Glazer, Reference Librarian

National Library of Medicine

Overview• MEDLINEplus

• NLM Gateway

• ClinicalTrials.gov

• AgePage

• Electronic Health Information Projects

• HEALTHINFOQUEST

• Consumer Health: An Online Manual

• The Public Library and Consumer Health: Meeting Community Needs Through Resource Identification and Collaboration

MEDLINEplus

• History and development• Components and technology• Content arrangement, selection guidelines• Evaluation and feedback• Future plans

What is MEDLINEplus?http://medlineplus.gov

• Service to organize health information on the Internet

• From the National Library of Medicine/ National Institutes of Health

Why MEDLINEplus?

• General public searching MEDLINE

• NLM’s main Web site– 90% of searches for medical terms– Diseases, drugs, conditions

• Customer service questions– Health reference

October 22, 1998

• Public Library pilot project • 22 health topics• Where did the topics come from?

– MeSH– Planetree– Consumer health Web sites– User searches

• 116,000 hits first month

October 22, 1998 - September 21, 1999

September 22, 1999 - August 23, 2000

August 24, 2000 - present

MEDLINEplus Today

• Comprehensive health resource– 414 topics (diseases, wellness issues)– Links to organizations, libraries, directories– Drug information– Encyclopedia

• Over 2.5 million page hits/month

Statistics

Major Components

• Health Topic pages– Links - full text on NIH and other sites – Prepackaged MEDLINE searches– ClinicalTrials.gov links

• Drug information via USP DI®

• Medical encyclopedia via adam.com

Technology• Database of records (Oracle)

– Includes information on sites and contacts– Over 13,000 records

• Web-based input system (Cold Fusion)– Remote access

• Authorities and rules• Review and approval process• HTML generated nightly for Web

MEDLINEplus W eb sitemedlineplus.gov

Oracle databasefor input andmaintenance

Input system(Cold Fusion)

Selectors/Maintainersw ith W eb brow ser

Static HTML files

Nightlyprocess

creates staticHTML files

Health Consumersw ith W eb brow ser

MEDLINEplus System

Quality Checks

• Broken links fixed nightly

• Individual records reviewed before approved

• Pages reviewed before release to public

• Pages reviewed after release

MEDLINEplus Strengths• User-driven topics • User-driven design• NIH collaborations• Authoritative information• Private• Semi-annual topic evaluation• Nightly link checking

• Selective, not comprehensive resource

User-Driven Topics• Customer driven

– NLM Web page usage and search log evaluation• NLM Web medical topic searches >90%

– Pilot project with public libraries

• Builds on NLM strengths – Selecting and organizing information – MEDLINE

• Created looking at several vocabularies– NLM’s Medical Subject Headings (MeSH)– Planetree Classification– Other consumer health Web sites– What users are searching

Content Arrangement

• Multiple access points (A-Z, categories) • Related categories; related topics• Topic pages have table of contents

arrangement; point to full text information• Prepackaged MEDLINE searches

using PubMed• Links to ClinicalTrials.gov

Selection Issues

• Abundant health information on the Web– Not always authoritative– Often with agenda

• Nature of Web sites: constant change

Selection Guidelines

• Linked from “About MEDLINEplus”

• Emphasis on resources from government health organizations, especially NIH Institutes

• Collaborate with NIH Institutes on content development and review

Selection Guidelines (2)

• Must be authoritative, accurate and well maintained

• Educational, not selling product• NLM contacts organizations about

– displaying advisory boards– technical issues (frames)

NIH Collaboration

• Focus on NIH information • Information Officers and staff

– Organizations– Sites– Topics and arrangement

• Institute staff reviewing topic page

30 Most RequestedSeptember 2000 (1-15)

• Diabetes

• Shingles

• Fibromyalgia

• AIDS

• Skin Diseases

• Breast Cancer

• Foot/ankle Injuries

• Thyroid Diseases

• Multiple Sclerosis

• Parkinson’s Disease

• Back Pain

• Knee Injuries & Disorders

• Gallbladder & Bile Duct Diseases

• Sexually Transmitted Diseases

• Sleep Disorders

30 Most RequestedSeptember 2000 (16-30)

• Arthritis

• Depression

• Heart Diseases

• Anemia

• About Your Medications

• Spinal Stenosis

• Mouth & Throat Disorders

• Cancer (general)

• High Blood Pressure

• Insect Bites & Stings

• Sinusitis

• Bipolar Disorder

• Stroke

• Nutrition

• Lymphoma

MEDLINE Searches

• “Canned” searches created by NLM Reference Staff

• Tailored for the consumer– Current, English, clinical– 20-70 references– Cover selected aspects of topic

• Search PubMed each time

Canned PubMed Search

Consumer Health Titles Subsetconsumerj[sb]

• Alternative Medicine Review

• Breastfeeding Review• FDA Consumer• Harvard Health Letter• Harvard Heart Letter• Harvard Men's Health

Watch

• Harvard Mental Health Letter• Harvard Women's Health

Watch• Health News• Johns Hopkins Medical

Letter, Health After 50• Medscape Women's Health• Mayo Clinic Health Letter

ClinicalTrials.gov Links

• Introduced - February 2000

• Mutual links through MeSH

MEDLINEplus MeSH ClinicalTrials.gov

Online TourReleased September 13th

Frequently Asked QuestionsReleased September 13th

Feedback and Evaluation

• Customer Service (phone, E-mail)

• Comment link on every page

Comments - Jan - Sep 2000N=1195

Link requests21%

Suggestions 16%

Health information

41%

Compliments7%

Miscellaneous9%

Technical6%

Recent Comments

“I am very impressed with your website. The layout is very clear and easy to navigate... Now that I have visited, I will surely return. Many thanks to you and your staff for the creation of a truly worthwhile site.” (9/21/00)

Recent Comments

“Your information has been very helpful to my wife and I and we want you to know we greatly appreciate it. Thank You!!!” (9/18/00)

Recent Comments

“I wanted to tell you what a wonderful web site you have created and continue to develop. You have helped me, my students and our patients/families more than you might know… I wish there was a way to better thank you.” (9/3/00)

Experience to Date

• Over 13,000 records in system

• Over 1000 organizations– over 400 for display

• Over 100 organizations contacted

• Sites change

• Hard to keep up

Future• Health news• Patient education

modules• AgePage (National

Institute on Aging)• Additional drug

information• Share links with local /

regional Web sites

• Terminology server to improve searching

• Spanish language• Consumer health

libraries from DOCUSER

• Cooperation: sharing health resources

Coming Soon - Health News

Full News Story

Topic with News

Summarizing MEDLINEplus...

MEDLINEplus is:

• Selective

• Highly reviewed

• Private

• Responsive

• Growing

NLM Gatewayhttp://gateway.nlm.nih.gov/

• Launched October 16th

• A single Web interface that searches multiple NLM retrieval systems

• Includes limits for consumer health (MEDLINEplus)

ClinicalTrials.govhttp://clinicaltrials.gov/

• Provides patients, family members, health care professionals, and members of the public easy access to information on clinical trials for a wide range of diseases and conditions

• Collaborative effort between NLM, other NIH institutes and the Food and Drug Administration (FDA)

AgePage

• Cooperative effort between the National Library of Medicine and the National Institute on Aging

• Reflects NLM’s efforts of reaching out to special populations

Electronic Health Information Projects

• Announced in January 2000• Projects will run from 12 to 18 months• More than $1 million invested• Projects target people who lack access to

computers and computer skills• Originally involved 49 projects; four more

were recently added

http://www.nlm.nih.gov/news/press_releases/ehip.html

http://www.nlm.nih.gov/nno/hipprojects.html

http://www.nlm.nih.gov/news/hipprojects2.html

JAMA 2000 Apr 5;283(13):1675-6.

HEALTHINFOQUESThttp://www.nnlm.nlm.nih.gov/healthinfoquest/

• Series of pathfinders primarily for public librarians and health educators

• Joint effort of– King County Library System (Bellvue, WA)– NN/LM Pacific Northwest Region (University of

Washington Health Sciences Library and Information Center)

Consumer Health: An Online Manualhttp://www.nnlm.nlm.nih.gov/scr/conhlth/manualidx.htm

• Includes information about– Planning a consumer health library– Evaluating consumer health Web sites– Consumer health materials in Spanish

• Coordinated by the NN/LM South Central Region (Houston Academy of Medicine--Texas Medical Center Library)

The Public Library and Consumer Health:Meeting Community Needs Through

Resource Identification and Collaborationhttp://www.pla.org/consumerhealth.html

• January 10-11, 2001 at the Hyatt Regency, Washington, DC

• Presented by the Public Library Association (PLA), NLM and MLA

• Provides library staff with an introduction to health information resources, collection development and searching health and medical information databases

• Examples of collaborative projects that public libraries can model will be presented

• Special tours of NLM will be offered

• Get the word out to your local public libraries!

For more information...