NASA STI Program Seminar · NASA STI Program Seminar September 29, ... Gary Marchionini ... Willis...

NASA Technical Memorandum 109928

NASA STI ProgramSeminar

September 29, 1994

Electronic Documents

National Aeronautics and Space AdministrationScientific and Technical Information ProgramWashington, DC 1994

https://ntrs.nasa.gov/search.jsp?R=19950005970 2018-07-13T19:48:45+00:00Z

This publication was prepared by the NASA Center for AeroSpace Information,

800 Elkridge Landing Road, Linthicum Heights, MD 21090-2934, (301) 621-0390.

TABLE OF CONTENTS

Speakers .......................................................... i

Welcome and Introductions ............................................. 1

Terese Ohnsorg

Electronic Documents Management at the CASI .............................. 1

Roy Stiltner

The Impact of Electronic Publishing on User Expectations and Searching ............ 15

Gary Marchionini

Image Record Management ............................................ 27Don Willis

Secondary Publisher Considerations for Electronic Journal Literature ............... 63Andrea DiDonato

The Technical Manual Publishing On Demand System ......................... 95Steve Sherman

NASA STI PROGRAMNASA STI PROGRAM SEMINAR

Electronic Documents

September 29, 1994

10:30 a.m. - 4:00 p.m.

NASA Headquarters

Welcome and IntroductionsTerese Ohnsorg

NASA STI Program

Electronic Documents Management at the CASIRoy Stiltner

NASA Center for AeroSpace Information

The Impact of Electronic Publishing on User Expectations andSearching

Gary Marchionini

College of Library and Information Services

University of Maryland

Image Record ManagementDon Willis

I-NET

Secondary Publisher Considerations for Electronic JournalLiterature

Andrea DiDonato

BIOSIS

The Technical Manual Publishing On Demand SystemSteve Sherman

Defense Printing Service

ii

Welcome and Introductions

Terese Ohnsorg

NASA STI Program

Washington, DC

Electronic Documents Management at theCASI

Roy StiltnerNASA Center for AeroSpace Information (CASI)

Linthicum Heights, MD

Roy Stiltner provided a comprehensive look at the multifaceted program

underway at the CASI to implement electronic documents management -- where

it is and where it's going. Stiltner emphasized that CASI efforts extend far

beyond simply modernizing automatic data processing (ADP) capabilities and, in

fact, include technological and workflow upgrades at the infrastructure level. All

of these initiatives complement other modernization efforts underway at the

facility.

The program's objectives include improving NASA researcher access to STI,

minimizing waste and trimming costs, and eliminating or at least drastically

reducing environmental hazards caused by the use of processing chemicals andrelated materials.

All of these efforts are unfolding in conjunction with similar activities at NASA

Centers and across a broad range of NASA STI exchange partners.

Stiltner's presentation included a discussion of steps in capturing information for

a bibliographic record in paper and microfiche (current and proposed), and both

a general and a detailed conceptual look at electronic documents management at

the CASI in terms of STI acquisition, processing, and dissemination. Closing

visuals highlighted the NASA STI Program's ongoing migration to an electronic

document management system rooted in state-of-the-art communications

technology.

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The Impact of Electronic Publishing on User

Expectations and Searching

Gary MarchioniniCollege of Library and Information Services

University of Maryland

Gary Marchionini offered a look at the world of electronic documents. He

recounted trends in electronic publishing, especially the tremendous growth in

end users and such related developments as listservs and news groups; electronic

journals; such for profit services as America Online, Opus Global, and Dialog;

and the delivery of government data via the Internet.

After examining an array of interfaces for electronic text and the special

challenges and opportunities of electronic publishing (including the as yet

unresolved issue of how to handle chargebacks for copyrighted material),

Marchionini suggested new roles information specialists must adopt to survive in

this brave new world of the information age.

His envisioned roles require that information specialists develop greater facility

with a range of specialized skills; enlarge their roles as teachers, information

consultants, evaluators, and validators; and hone their expertise as entrepreneurs

for new information products and services.

He suggested that the forte of information specialists is services, not products.

In the coming years, Marchionini predicted an as yet unrecognized array of new

markets that will likely emerge for these services.

Marchionini then focused on the capabilities offered by one particular search

engine, the Wide Area Information Server (WAIS). He alluded to research he

and several colleagues have conducted which identified both WAIS advantages

and disadvantages.

Marchionini concluded, perhaps providentially, that this is the golden age of

opportunity for information specialists. If the current opportunities are handled

properly, information specialists will flourish in the coming decades. If not, they

will disappear.

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Image Record Management

Don WillisI-NET

Don Willis offered a wide-ranging look at image databases and online document

delivery. He noted that the explosion of information has created a need for tools

to facilitate the access and processing of these exponentially increasing levels of

information. Similarly, there is a need for electronic document delivery through

a variety of means.

After looking at document delivery today, tomorrow, and further into the future,

Willis focused on the image component of the document delivery system, saying

there simply is no other technology available now, or in the near future, that can

provide this capability as cost-effectively. Imaging, for instance, can represent

chemical and mathematical formulas and symbols, graphics and line drawings,

halftone pictures, foreign languages, and built-in editorial intelligence.

Willis said that putting the image database on CD-ROM, with its wide array of

capabilities, is a logical outgrowth of this reality. A detailed look at the many

facets of CD-ROM technology and its potential followed, proceeding from this

premise: CD-ROMs are an emerging technology that can support the creation,

storage, and network dissemination of large volumes of digital data ... a

capability that is essential for the successful implementation of information and

imaging distribution management concepts.

Willis referred to the tremendous storage capacity of digitized page images on

CD-ROMs. For instance, a one-year stack of all the journals indexed by

medicine would rise to more than 800 ft, compared with a dramatically smaller

pile of only 960 CD-ROMs holding the same quantity of information. From

another perspective, CD-ROM strengths are reflected in their improved economy

(stated in cost per megabyte) compared with a variety of media, including

removable hard disk, paper, floppy disk, and mag tape.

Looking to the future, Willis discussed such diverse storage possibilities as

three-dimensional storage, storage at the atomic level, and optical computing.

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Secondary Publisher Considerations forElectronic Journal Literature

Andrea DiDonatoBIOSIS

As access to networks by end users increases, more and more information,

including journals, is being published in electronic form.

Andrea DiDonato examined key considerations for secondary publishers in this

modern publishing environment.

Offering a case study from BIOSIS dealing with the Online Journal of Current

Clinical Trials, DiDonato recounted her organization's experience with this

online literature as its initial venture with the secondary publishing of electronic

journal literature. BIOSIS soon discovered the tremendous unevenness of this

medium, offering as it does quick access -- but unsteady availability -- to

information.

DiDonato provided a variety of relevant issues for secondary publishers of

electronic journals to consider, including inconsistency in format and delivery.

She also noted the need to standardize the processing system and address

questions of copyright and liability.

DiDonato concluded that electronic journals are becoming commonplace and,

therefore, important sources of information that responsible secondary publishers

cannot ignore.

63

BIOSIS"• -¢.-..c._..:.....-_....,_ .............. _......... :._.._c_¢_.:,_,_...._ ....... _"_'_""":'" ========================================================================:: " .'.: _,'.:_:_:_.'.'_:!_ .': :! .'."_ ff:__""." _ ff :i

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Secondary PublisherConsiderations forElectronic JournalLiterature

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_iii_'ii_ili_,_,_!_!_ii_iii_iiiiiiiiiiiiiiiiiii!iii!iiiiiiiii!ili!i_,,__i_,,_,_._ii__ii_!!ii_i_iiii!i!i!i!iiiiiii!i!iiiiii!!i!iiiii!iiiii!i!iiiii_....

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Secondary Publisher Considerationsfor Electronic Journal Literature

I. "Online Journal of Current ClinicalTrials" (OJCCT)

--BIOSIS experience

I!. Future Coverage of ElectronicJournals

--issues to be aware of

--generalizations

II!. Summary of Issues

--quality

--processing

--copyright

65

I. "Online Journal of Current ClinicalTrials" (OJCCT)

Selection I Coverage Considerations

Post-Selection Processing Considerations

Processing Considerations

--BIOSlS experience--vehicle for discussing :broader issues

--elementary example--not the future mechanism

--adapted to BIOSlS requirements

" 66

Selection I Covera e Considerations

1. Selection & Retrieval

-OCLC direct hookup via Guidon software

-monitor output--daily

-download & print out appropriate articles

-selectively cover contents: original research

-don't cover: articles of editorial orphilosophical nature; letters; articles fromMorbidity & Mortality WeeklyReports (MMWR) (cover original)

-dual publication of some articles in Lancet

67

Selection ICovera e Considerations

B Bibliographic Citation

-based on National Library of Medicine form

-adapted for our processing and productrequirements

-some Information unique to electronicpublications

-cross-reference to Lancet abridged version

-standards only in Infancy

68

BIBLO

&UTH8ADDR

WORDS

CODES

TEXT

MEDIA

ISSN

PROD

97095917 V97 PR II0 MAR PR009 GE001 ON33040 ZOV

OJCTE / ONLINE JOURNAL OF CURRENT CLINICAL TRIALS 0

(JAN. 14). 1994. DOC NO 113, ii0 PARAGRAPHS, 7906WORDS. * EN *

Silagy C/ Mant D/ Fowler G/ Lodge M/DEP. GENERAL PRACTICE, FLINDE_S UNIV. SOUTH AUSTRALIA,

SCH. MED., GPO BOX 2100, ADELAIDE, SA 5001, AUL.

THE EFFECTIVENESS OF NICOTINE REPLACEMENT TEERAPIE8 IN

SMOKING CESSATION ABRIDGED VERSION OF THIS PAPER

PUBLISHED IN LANCET 343 8889 1994 PAGE 139-142/META-ANALYSIS SERIAL ONLINE HUMAN NICOTINEANTIADDICTIVE-DRUG GUM TRANSDERMAL PATCH INTRANASAL

SPRAY INHALED PREPARATION EFFICACY

C21004" C07004- C10060 C12512- C14001- C16001-C18501-C22005- C22024- C22026- C22100- C22501- S86215ABST

PRINT

1059-2725

BA

69

10895917 BIOSIS Number: 97095917

The effectiveness of nicotine replacement therapies in smoking

cessation:(Abridged version of this paper published in Lancet 343

(8889): 1994 page139-142)

Silagy C; Mant D; Fowler G; Lodge M

Dep. General Practice, Flinders Univ. South Australia, Sch. Med.,GPO Box2100, Adelaide, SA 5001, AUL

Online Journal of Current Clinical Trials 0 (JAN. 14). 1994.

NO 113,110 PARAGRAPHS, 7906 WORDS.

DOC

Full Journal Title: Online Journal of Current Clinical Trials

ISSN: 1059-2725

Language: ENGLISH

Print Number: Biological Abstracts Vol. 097 Iss. 005 Ref. 063422

To determine the effectiveness of nicotine replacement

therapies (NRTs)(including gum, transdermal patch,

intranasal spray, and inhaledpreparations) in facilltatingsmoking cessation, and to determine whetherthe effect was

influenced by the clinical setting in which the smoker

wasrecruited and treated, the level of nicotine dependency, the

dosage of NRTused, or the intensity of additional advice andsupport offered to thesmoker. Data Sources: Published trials

of NRT were identified by asystematic search of 7electronic databases, published reviews, reference llsts from

clinical trials, conference abstracts, smoking and

healthbulletins, and a bibliography on smoking and health.

Unpublished trialswere identified by approaching manufactures

of NRT. Study Selections: A total of 53 trials (42 gum, 9patch, 1 intranasal spray, and i inhaler),with data from 17,703

patients, were included An the analyses. Only trialsthatassessed abstinence at least 6 months after the

commencement of therapy were included. Data Extraction: Data

were extracted from the trial reports by 2 authors

independently. Where the methodology was unclear or the resultswere not expressed in a form which allowed extraction of key

data we wrote to the investigators for the required

information. Data Synthesis: Use of NRT increased the oddsratio (OR) of abstinence of 1.71 (95% confidence interval

(CI), 1.56 to 1.87) compared with those who had been allocated tothe control interventions. The OR for the different forms of NRT

were 1.61 for nicotine gum (95% CI, 1.46 to 1.78), 2.07 (95%

CI,1.62 to 2.62) for transdermal patch, 2.92 (95% CI, 1.49 to

5.74) for nasal spray, and 3.05 for inhaled nicotine (95% CI,

1.42 to 6.57). These odds were not significantly higher in

patients with higher levels of nicotine

7O

dependence (Fagerstrom score gtoe 7; -0.06), but they

were largely independent of the intensity of additional support

provided or the setting in which the NRT was offered.

Conclusion: We conclude that the currently available forms of _RT

are effective therapies to aid smoking cessation.Descriptors/Keywords: META-ANALYSIS; SERIAL ONLINE; HUMAN;NICOTINE; ANTIADDICTIVE-DRUG; GUM; TRANSDERMAL PATCH; INTRANASAL

SPRAY; INHALED PREPARATION; EFFICACY

Concept Codes:*07004 Behavioral Biology-Human Behavior

*12512 Pathology, General and Miscellaneous-Therapy (1971-)*14001 Digestive System-General; Methods

*16001 Respiratory System-General; Methods

*18501 Integumentary System-General; Methods

*21004 Psychiatry-Addiction-Alcohol, Drugs, Smoking, etc

*22005 Pharmacology-Clinical Pharmacology (1972-)

*22024 Pharmacology-Neuropharmacology

*22026 Pharmacology-Psychopharmacology*22100 Routes of Immunization, Infection and Therapy

*22501 Toxicology-General; Methods and Experimental10060 Biochemical Studies-General

Biosystematic Codes:86215 Hominidae

Super Taxa:

Animals; Chordates; Vertebrates; Mammals; Primates; Humans

?I

10928907 BIOSIS Number: 97128907

Meta-analysis on efficacy of nicotine replacement therapies in

smoking cessation (Full version of this paper publishedelectronically in Online Journal of Current C1inlcal Trials

(January 14): 1994 Doctunent No. 113.}

Silagy C; Mant D; Fowler G; Lodge M

Dep. Gen. Practice, Flinders Univ. South Aust., Sch. Med., GPOBox 2100, Adelaide, SA 5001, AUL

Lancet (North American Edition) 343 (8890). 1994. 139-142.

Full Journal Title: Lancet (North American Edition}

ISSN: 0099-5355

Language: ENGLISH

Print Number: Biological Abstracts Vol. 097 Iss. 006 Ref. 078768

Nicotine-replacement therapy (NRT| by g_un, transdermal patch,

intranasal spray, or inhalation is expensive but how effectiveis it? We have done a meta-analysis of controlled trials to see

how effects on abstinence rates are influenced by the clinical

setting, the level of nicotine dependency, the dosage of NRT,

and the intensity of addltional advice and support offered.Published or unpublished randomized controlled trials of NRT thathave assessed abstinence at least 6 months after the start

of NRT were identified and 53 trials (42 gum, 9 patch, 1

intranasal spray, 1 inhaler}, with data from 17 703 subjects,were included in the analyses. Use of NRT increased the oddsratio (OR) of abstinence to 1.71 (95% confidence interval

1.56-1.87) compared with those allocated to the controlinterventions. The ORs for the different forms of NRT were

1.61 for gum, 2.07 for transdermal patch, 2.92 for nasal

spray, and 3.05 for inhaled nicotine. These odds were

non-significantly higher in subjects with higher levels ofnicotine dependence but they were largely independent of the

intensity of additional support provided or the setting in

which NRT was offered. We conclude that the currently

available forms of NRT are effective therapies to aid smokingcessation.

Descriptors/Keywords: META-ANALYSIS; HUMAN; NICOTINE DEPENDENCY;THERAPEUTIC METHOD; METHOD EFFICACY

Concept Codes:*07004 Behavioral Biology-Human Behavior

*20506 Nervous System-Pathology

*21004 Psychiatry-Addiction-Alcohol, Drugs,

*22024 Pharmacology-Neuropharmacology

Smoking, etc

72

10060 Biochemical Studies-General12512 Pathology, General and Miscellaneous-Therapy (1971-)

Biosystematic Codes:86215 Hominidae

Super Taxa:Animals; Chordates; Vertebrates; Mammals; Primates; Humans

73

Post-Selection ProcessinConsiderations

I

• Log-In/Receipt History

.adapted to system designed for routineprocessing of print Journals

-log-in of downloaded paper copy

-each article Included in receipt history

-each download receives "accession #" andlabel

74

VIEW LOG-IN HISTORY (HISTORY)

TITLE: ONLINE Journal of CURRent CLINical TRIALS

CODEN: OJCTEI JCODE: ON33040

GEO: 001 UNITED STATES

PROC: 009 WHITE

FREQ: IFISSN: 1059-2725

C M R ACC NO MAILDT D VOLUME ISSUE PUBYR

15588P 060794 0 JUNE 4

15868U 060994 0 JUNE 9

16240R 061494 0 JUNE 14

16380D 061594 0 JUNE 1517318B 062394 0 JUNE 23

17920P 062994 0 JUNE 29

18144B 070194 0 JULY 1

19434N 071594 0 JULY 15

1994

1994

1994

19941994

1994

1994

1994

VIEW LOG-IN HISTORY (HISTORY)

TITLE: ONLINE Journal of CURRent CLINical TRIAL8CODEN: OJCTEI JCODE: ON33040

GEO: 001 UNITED STATES

PROC: 009 WHITE

FREQ: IFISSN: 1059-2725

C M R ACC NO MAILDT D VOLUME ISSUE PUBYR

10540A 041994 011064X 042594 0

11456K 042894 0

11745R 050294 0

11455J 042894 0

12285N 050594 014047J 052394 0

15221J 060294 0

APRIL 16

APRIL 23

APRIL 27

APRIL 26

APRIL 28

MAY 5MAY 21

MAY 27

1994

1994

1994

1994

1994

1994

19941994

75

Post-Selection ProcessinConsiderations cont.

2. Coverage Statistics

-tracks coverage "profile" for the journal

-also adapted to journal processing system

-the"number available" - Includes allappropriate articles Including: orig. research& MMWR articles

-the "number taken" Includes productdestination

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78

Processing Considerations

1. Format of Article

-downloaded verston processed after log.in:cite/text Input, indexing

-must "clean-up" the abstract before dataentry: headings, numbering, OCLCconventions

-arrangement of article is specialized:abstract, introduction, objective, materials,methods, results, discussion, conclusion,appendices, references, tables

-CORRECTIONS -. OJCCT has published--notcovered by us since didn't affect our material

79

<article><front><cite>Silagy C, Mant D, Fowler G, Lodge M. Theeffectiveness

of nicotine replacement therapies in smoking cessation [article].Online J

Curr Clln Trials [serial online] 1994 Jan

14;<voln>1994</voln>(Doc No

<docn>l13</docn>):[7906 words; 110 paragraphs]. 5 figures; 8tables.</cite>

<ti>THE EFFECTIVENESS OF NICOTINE REPLACEMENT THERAPIES IN

SMOKINGCESSATION</ti>

<aublk><au><fnm>Christopher</fnm> <snm>Silagy</snm>, </au>

<au><fnm>David</fnm> <snm>Mant</snm>, </au>

<au><fnm>Godfrey</fnm><snm>Fowler</snm>, </au> <au><fnm>Mark</fnm>

<snm>Lodge</snm></au>

<all>Department of Public Health and Primary Care, Radcliffe

Infirmary,

Oxford University, Oxford OX2 6HE, United Kingdom</aff> </aublk><class>Metaanalysis</class>

<keyword><phrase>metaanalysis</phrase>,<phrase>nicotine</phrase>,

<phrase>smoking cessation</phrase><dcode>MET</dcode></keyword><pubdate>19940114</pubdate> </front>

<sec><pid>l</pid> Parallel Publication: The abridgedversion of

this paper appeared as follows: Silagy C, Mant D, Fowler G, LodgeM,

Meta-analysis on efficacy of nicotine replacement therapies insmoking

cessation. Lancet 1994 Jan 15:343(8889):139-142.</sec><abstract> <st>ABSTRACT</st>

<pid>2</pid> Objective: To determine the effectivenessof nicotine

replacement therapies (NRTs) (including gum, transdermal patch,intranasal

spray, and inhaled preparations) in facilitating smokingcessation, and to

determine whether the effect was influenced by the clinicalsetting in which

the smoker was recruited and treated, the level of nicotine

dependency, the

dosage of NRT used, or the intensity of additional advice andsupport

offered to the smoker.

<pid>3</pid> Data Sources:Published trials of NRT wereidentified

by a systematic search of 7 electronic databases, publishedreviews,

reference lists from clinical trials, conference abstracts,

smoking and

health bulletins, and a bibliography on smoking and health.

8O

Silagy C, Ment D, Fowler G, Lndgo M. The effectiveness of nicotinereplacement _orapiss in smoking cessation [a,licis]. Online J Curt C|n Trials [sedal online] 1994 Jan14;1994(Doc No 113):[7906 words; 110 paragraphs]. S Igures; 8 tables.

THE EFFECTIVENESS OF NICOTINE REPLACEMENT THERAPIES IN SMOKING CESSATION

Christopher Siisgy, David Mant, Godfrey Fowler, Mark Lodge Department of Pubic Haa_ andPrimary Care, Radcliffe Infirmary, Oxford University, Oxford OX2 6HE, Un_ed KIngdom

Metunalysismetaanalys_s, nicotine, smoking cessationMET

1g940114(1) -Parallel Publication:" The abridged version of this paper appeared as follows: 81isgy C,Mant D, Fowler G, Lodge M, Meta4nalyeis on efficacy of nicotine replacement therapies insmoking cessation. Lancet 1994 Jan 16:343(8889):139-142.

ABSTRACT

(2) "Objective:" To determine the effectiveness of nicotine repiscement therapies (NRTs) (includinggum, tram;dermal patch, intranacal spray, and inhaled preparations) in facilteting smoking coasal_on,and to determine whether the effect was influenced by the clinical seffing in which the tmoker w_recruited end treated, the level of nicotine depandanry, the dotage of NRT used, or the interm_ ofadd_onel advice and support offered to the smoker.

(3) "Data Sourcas:"Pubished tdale of NRT were iden_ed by •systematic search of 7 electronic databases, pubished reviews, reference lists from clnical trials,conference abstracts, smoking end health bulletins, and a bibliography on smoking and health.Unpublished _ale were identified by approaching manufacturers of NRT.

(4) -Study Selection:" A total of 53 _ale (42 gum, 9 latch, 1 inlbranacalsway, and 1 Inhaler), withdata kom 17,703 patients, were included in the analyses. Only t_le that assessed abstinence st bast 6months offer the commencement of therapy were included.

($) "Data Extra.on:" Data were extracted tram the trial reports by 2 authors independently. Wherethe methodology was unclear or the results were not expressed in a form which allowed a_ ofkey data we wrote to the investigators for the required information.

(6) "DAM Synthesis:" Usa of NRT Increased the odds ratio (OR) of abstinence to 1.71 (95%confidence intenlal [CI], 1.56 to 1.87) compared with those who had been olk)cated

8!

to the control interventions. The OR for the Qfferent forms of NRT were 1.81 for nicotine gum (95% CI,1.46 to 1.78), 2.07 (95% CI, 1.62 to 2.62) for tranedarmai patch, 2.92 (95% el, 1.49 to 5.74) for nasalspray, and 3.05 for inhaled nicotine (95% CI, 1.42 to 6.57). These odds were not signiflcanUy higher inpa_ents with higher levels of nicene dependence (Fagerstrom score Oto+ 7; --P- - 0.06), butthey were largely Independent of the intemdty of additional support wovided or the seWng in which theNRT was offered.

(7) "Con_:" We conclude that the currently available fon_ of NRT are effectivo thoraples to_d smoking cessation.

INTRODUCTION

(8) Nicotine replacement therapy (NRT) is frequentb used Is an Important component of smokingceseeUon strategies. It minimizes many of the physk)lngloal end pm/chornotor withdrawal symptomsusual/experienced following smoking coesation and, therefore, may Inuem the Ikelhood ofremaining abstinent. 1

(9) The 1at type of NRT to become widely available was chewing gum. The nicotine resin complex ispresented in • buffered chewing gum base to enable the nicotine to be absorbed directly through thebuccll rnucosl, resulting in plasma concentmUons which am aplxoximately half that produced bysmoking a cigarette. 2 Nicotine chewing gum is available either as 1 2 mo or 4 mo preparation, and inmany countries the lower dose is sold over-the-counter, without a prescription from a medicalpractitioner. Several factors imit the usefuL-tessof nicotine chewing gum in some smokers, incimlingoral and gastric side effects, 3 impaired absorption when taken with coffee or eddicbeverages, 4 and a nsk that some smokers may transfer their dependency from clgaratles to the gum.4

(10) More recently, other forms of NRT, aimed to Ivoid maw of the problems associated with nicotinegum, have bean developed, Including trsnsdermal nicotine patches, intmnesal nicotine spray, andnicotine inhaler devices. The last 2 are stll undergoing research and have not been Icensad for generalclinical use.

(11) Transdermal patches were aplxoved for use as an saidto smoking cessation by the Food and DrugAdminLstm_on in tho United States in 1992. Available in moral different sizes, the patches deivorbetween 7 mg and 22 rng of nicotine over a 24..hour period and resuR in plasma levels similar to thetrough levels seen in heavy smokers. 5

(12) The introdu_on of transdermal patches has been accompanied by strong marketing campaignsover the past 12 months in a number of countries,

$2

targetedbothst smokers and phyaiclans, encouraging use of the patch as • "Woven and effective"smoking caasation strategy. 6 This has caused much debate about the role of NRT in smokingcessation; including wNch group(s)of smokers should be offered NRT, which preparations should be used, in what dose regimen, endwhether NRT le offso_ve when used alone or only together with some form of sddl_onal supportstrategy.

(13) There have been several previous attempts to systematically review the effectiveness of nicotinegum 7-8 and tmnedormai patches. 6, g In 1987, a motaanalys_ of 14 trials of nicotine chewing gumconcluded that this formof NRT was most offecINa when used in specidzed smoking-caasation cinica, and was of questionablevalue when used in general medical prac_ca. 8 These findings were reinforced in a more recent reviewofpharmacological aids to Smokingcessation. 1 However, since both of these reviews, them have beenover 20 new mndomlzed controlled Mab examining the effect of nicotine gum In MdltaUng smoldngcessation.

(14) Two systematic reviews of randomized controlled trials of tmnsdermal nicotine patches werepublished in 1992. 5, 9 The results suggest that this form of NRT is also highly effecUve but neither ofthe reviews used comprehensive methods to identify all the relevant published and unpublished trials,nor did they use quantilative techniques to synthesize the data and test for homogeneity or sta_Istical_niflcanca.

(15) Since NRT is widely available and costly, It is Important to establish the offeclivonass of thedifferent forms of NRT when offered to smokers who have varying levels of dependency and moSvationto quit, in a range of clinical settings, and with or without additional support progmrns.

OBJECTIVE

(16) To determine the effec_eness of NRT (including gum, tmnsdermal patch, intranasal spray, andinhaled preparations) in achieving long-term smoldng cessation, we wished to test the fogowinghypotheses (see AppendixA):

(17) 1. use of NRT is more effective than placebo or "no NRT" intervention in promoting smokingcessation (Comparison 1);

(18) 2. NRT is more effecUve when offered to smokers who am motivated to quit and will, lherefom, bemore effective in clinical seffings which selectively recruit moUvated smokers (Comparison 2);

(19) 3. NRT is more effective in highly dependent smokers compared with those who m onlymoderately dependent (Comparison 3); lind

83

(20)4. theprovleionof high-inteneitysupport,Inadditionto theuseof NRT,willbemoreeffecUve inIxoclu_o abstinence tiwn eckgtlonoflow-intensity Suplpa_ programs (Comparison 4).

MATERIALS

Critode for Coneidodng Trials for This Review

Types of Intervention

(21) bullet All rmxlonVzed controlled compedsons of NRT (Including nicotine chewing gum, tnmederrnalnicotine petches, nicotine nasal spray,end nicotine Inhalers) versus placebo or no NRT control

(22) bullet Randomized trials of different doses of NRT.

Types of Patients

(23) Smokers of either gender wore Inc_lnd irrespeclNo of the uffing from which they wore recruitedend/or their initial level of nicotine

dependency. Studies which randomized therapists, rather then smokers, to offer NRT or • control wereincluded providing that the specific aim of the study was to examine the effect of NRT on smokingcessation. Tdals which randomized physidene or other therapists to receive an educMIonei Intervention,which included encouraging their patients to use NRT, were not Included but ere being handled as pertof a separate review.

Types of Outcome Measures

(24) We confined the review to a comparison of the effects of NRT versus control on smokingcessation, rather then withdrawal symptoms. Trials in which foBow.4Jpwas of short duretion (less then 6months), or which did not include measurement of smokiog ceasdon, were idBoexcluded. Tdals forwhich no data were available were excluded (Table 1).

(25) In each study the strictest available cdtede to define abstinence were used. For example, instudies where biochemical vddation of cessation was xvldleble, only those pertidpentz who met thecriteria for biochemicelly confirmed abstinence were regarded as being mbetlnent.

VVhereverpossible• sust1.,inedceesmtionfete,ratherthanpointIxevelence,M.m used.Intrialswhere

patients were lost to fogow-up they were regarded is being continuing smokem.

Search Strategy for Identification of Trials

(26) A computerized literature search w_ conducted wlth DxtaStar

84

Elwood M, Cox B, Richardson A. The effectiveness of breast cancer screening by

mammography in younger women: Correction petter]. Online J Curr Clin Trials [serialonline] 1994 Mar 31;3(Doc No 121)[385 words; 4 paragraphs] 5 tables.

THE EFFECTIVENESS OF BREAST CANCER SCREENING BY MAMMOGRAPHY IN

YOUNGER WOMEN: CORRECTION

age factors, breast neoplasms, mammogrephy, mass screening, oncology,radiography, randomized trialsERR

19940331

(1) When updating the analysis in the original article 1, we detected a small error inTable 10, in the line referring to Malmo. As a result of the correction of that error, thelast line (Total) of the table also changed. Corrections to Table 10 appear in boldface.

(2) Associated alterations of the text occur in paragraph 62, quoted below. Thecorrections appear in boldface.

.

Corrected Paragraph 62, Doc No 32

(3) The breast cancer mortality experience of older women was analyzed identically

to that of younger women. Table 10 presents the effect of screening older womenfrom 5 of the 6 published studies at 7 years of follow-up. -Overall, a reduction inbreast cancer mortality of 31% was achieved, with 95% Cl, from a 17% to a 42%reduction.** The reductions ranged from 20% in Edinburgh to 43% in Stockholm,

being significant overall and in the HIP and $2C trials. Inclusion of the results of theCanadian study produced little change in the effect and only resulted in a slightincrease in the --overall relative risk to 0.72 (95% Cl, 0.61 to 0.82)', although it maynot be entirely appropriate to add the Canadian data as that trial compares 2 differentmodalities of screening. Table 8a, Table 8b, and Table 8c show the ratio ofcumulative breast cancer mortality rates in the intervention compared to the controlgroups for older women in the RCTs. A small excess mortality is seen in the 1st year,but a sustained reduction in mortality occurred from the 2nd year of follow-up whichwas confirmed by the mortality rate ratios for the individual years of follow-up (Table11). The mortality rate ratios did not vary significantly, and showed no evidence of atrend, with increasing years of follow-up. This pattem of relative risk with successiveyears of follow-up is different from that seen among younger women.

(4) These changes do not alter the conclusions reached in the article.Mark Elwood Brian Cox Ann Richardson Hugh Adam Cancer Epidemiology Unit,

85

Processin Considerations cont.

1 Indexing

-like any other article for database

-use downloaded copy

-add keyword: "serial.online"(hyphenated for retrieval)

• 86

Processin Considerations cont.

e Document Delivery

-available for document delivery fromdownloaded version (articles are usuallylong)

-store articles from single release together--like any other issue of journal (sometimesonly one)

-OJCCT available on Internet: could probablydownload--no need for document delivery

87

II. Future Coverage of ElectronicJournals

-coverage of individual electronic Journals aproblem: variation in formats, deliverymechanisms, etc. for each

-most likely scenario: from large publisher totransmit a number of journals

-trial proposal of tapes in SGML format

-feasibility greater now: either tape or electronictransmission

88

_o Future Coverage of Electronicurnals (cont.)

-drawbacks Identified in study still true:

-hard copy of article

-critical mass to be cost-effective

-inconsistencies & variations in content

-dual processing (most of material processedis still print journal form

-variation with multiple providers

-"header" information more cost-effective

-several publishers now offering

89

II. Future Coverage of ElectronicJournals (cont.)

.most considerations faced with OJCCT but on

larger scale:

-qualityiconsistency of distribution & content

-selection: e.g., select parts of the Journal,unless taking everything

-log-in/acquisitions/receipt history (for bothelectronic & hard copy subscriptions)

-variable receipt timing

-coverage statistics

9O

I!. Future coverage of ElectronicJournals (cont.)

-possible system adaptation:

.streaming of data into system-content for Iog-inlreceipt files ??-serials control for Journal information (title,

editor, profile changes, etc.) ??-procedures for coping with format variation

(particular procedures in A&rs based onproducts: e.g., tags, special sections,

special issues, meetings)-uploading for citation and abstract Input(clean up data for format compatibility)-uploading for indexing ??

-esp. for material with only abstracts(meetings)-esp. if parallel processing desirable

-uploading for translations ??-possible "mini-system": selection, cite &abstract Input, Indexing)

-uploading for post-processing analysis ??-for special products/projects done aftermainline processing

91

II!. Summary of Issues

-quality; resources; standards; property rights

Inconsistenc in formats

-experimental formats..meant to be "moremeaningfur'

-variety of formats: individual publications; largepublishers

Inconsistenc in delive

-large publishers dependable; still coordinatehard copy and electronic

-individual publications bigger problem:-predicting volume: affects resources,

production planning

III. Summary of Issues (cont.)

Ada tin rocessin s stem

-irregularity in schedules, content, formats-large effort for system development & dataprocessing

-dual processin¢!-rely on few publishers-critical mass-need hard copy for indexina, post Production-lack of standards

-formats & delivery mechanisms

Co ri ht / Liabilit

-copyright problems for infrequent publications-agreement with large publishers-probable encoding to assure notice ofownership-storage of electronic full text -- A&I orpublisher?-yiabili_ issues much as are now

-more problematic for individual, trulyelectronic publications

93

The Technical Manual Publishing

On Demand System (TMPODS)

Steve ShermanDefense Printing Service (DPS)

Steve Sherman offered a description of the DPS, beginning with its

establishment in April 1992. As the former Navy Publishing and Printing

Service, DPS is the consolidated organization for printing and duplicating in the

Department of Defense.

Sherman described the DPS corporate structure, mission, advantages, and major

automation initiatives, including the Technical Manual Publishing On Demand

System (TMPODS).

The basic system design for TMPODS involves technical manual entry,

scanning, storage, order processing, data management, and production. Under

TMPODS, Navy technical manuals are stored in a digital database in a raster

format on CD-ROMS configured in "jukeboxes."

This new digital approach has reduced a variety of costs associated with Navy

technical manuals, including printing, dissemination, and, especially, storage

since the paper-based documents were eliminated. Sherman explained how these

documents are produced on demand at hundreds of DOD facilities throughout

the world m even aboard ships at sea.

Other benefits of TMPODS include the delivery of fully updated technical

manuals, rapid order turnaround, delivery in either hardcopy or digital format,

the capability to bundle technical manual collections, and greatly reduced

distribution costs.

95

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REPORT DOCUMENTATION PAGE

1. AGENCY USE ONLY (leave blank) 2. REPORT DATE

October 1994

4, TITLE AND SUBTITLE

NASA STI Program Seminar: Electronic Documents

6. AUTHOR(S)

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NASA Headquarters

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Form Approved OMB No. 0704-0188

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Technical Memorandum

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11. SUPPLEMENTARY NOTES

12a. DISTRIBUTION I AVAILABILITY STATEMENT

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12b. DISTRIBUTION CODE

13.ABSTRACT

The theme of this NASA Scientific and Technical Information Program Seminar was electronic

documents. Topics covered included Electronic Documents Management at the CASI, the Impact of

Electronic Publishing on User Expectations and Searching, Image Record Management, Secondary

Publisher Considerations for Electronic Journal Literature, and the Technical Manual Publishing OnDemand System (TMPODS).

14. SUBJECT TERMS

CD-ROM, conferences, electronic documents, electronic publishing, images,

information management

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