# Presentation: 721972

##  MEDLINEplus:Your Gateway to Consumer Health Information on the Web

-  MEDLINE*plus:**Your Gateway to Consumer Health Information on the Web*

## Objectives

- Understand criteria for evaluating web resources
- Identify quality resources for answering health questions
- Search MEDLINE*plus *for authoritative health information
- Learn about the content and features of other NLM databases
- Incorporate tips for effective training

**Notes:**
At the end of this class, participants will:
be familiar with criteria for high-quality health information web sites
be able to locate authoritative resources for health information
be able to search MEDLINEplus for answers to consumer health questions
be aware of other NLM databases that provide information on specific topics including AIDS, toxicology and environmental health
learn some tips for teaching the public about health information resources

## Consumer Health Information

- Any information that enables individuals to understand their health and make health-related decisions for themselves and their families
- Source: Patrick and Koss, CHI *White Paper, *1995

**Notes:**
I’d like to begin with a brief definition of consumer health information.

## CAPHIS Definition

- Information on health and medical topics provided in response to requests from the general public, including patients and their families.  In addition to information on the symptoms, diagnosis and treatment of disease, CHI encompasses information on health promotion, preventive medicine, the determinants of health and accessing the health care system.
- Source: *The Librarian’s Role in the Provision of Consumer Health Information and Patient Education - *CAPHIS, 1996

## Health Information on the Web

- Diseases & Conditions
- Medications
- Tests & Procedures
- Medical Research
- Health Care Providers
- Advocacy & Support Groups

**Notes:**
The Internet has greatly expanded the public’s ability to find health information 
Patients can now use computers and the Internet to: 
obtain information
analyze their own health care needs
make health decisions in consultation with their physicians
At the click of a mouse, consumers can
Find information about a disease or condition
Learn about medications
Understand tests and procedures
Keep up with the latest research
Locate information on a physician or hospital
Identify advocacy and support groups

## Quality Matters

- Accurate
- Current
- Relevant
- Evidence-based
- Free of bias
- Reliable
- Understandable

**Notes:**
How can I tell if I've found good information on the Internet?

Ask yourself if a Web site meets the following guidelines:
  1.  Information content is of good quality, authoritative, accurate, and current
  2.  Information provided is readable, well-organized and easy to use
  3.  Links are evaluated/reviewed/quality-filtered
  4.  The purpose of the site is educational, and is not selling a product or service
  5.  The site is available and maintained
		Source: NNLM/PSR   BeWell. Be Informed

Mention Savvy Health Surfing handout in packet..

## Slide 7

**Notes:**
I would like to introduce you to MEDLINEplus, a consumer health resource from the National Library of Medicine.
MEDLINEplus is a goldmine of up-to-date, quality health information written in lay terminology that, thanks to the Internet, is available to you at any time and from any location that has web access.

## MEDLINEplus Historical Overview

**October 1998**
- 22 health topics
- 116,000 hits

**October 2000**
- 418 health topics
- Drug information
- Clinical Trials
- MEDLINE searches
- Illustrated medical encyclopedia
- 2 million hits per month

## "We nearly decided not to bother listing any other sites after spending a few hours with the remarkably well-edited MEDLINEplus, a service of the National Library of Medicine.”

- 		Craig Stolz
- 		“Healthy Web Sites for Seniors"		**Washington Post** *Health* Section
- 		July 18, 2000

**Notes:**
In 1998 MEDLINEplus included 22 health topics and received 116,000 hits per month.
MEDLINEplus is now an extensive health resource.  It includes 400 health topics, information about clinical trials, drug information and an illustrated medical encyclopedia.  It includes pre-formatted MEDLINE searches. And it currently receives 2 million hits per month.
Articles frequently appear in the popular press highlighting MEDLINEplus as an authoritative site
NBC4 in Washington frames MEDLINEplus on its web site
And NLM is now engaged in a nationwide outreach program to alert consumers about MEDLINEplus through grants and contracts with a variety of community organizations -- public libraries, hospital libraries, local government agencies -- that provide electronic health information services directly to the public. 

## MEDLINEplus Features

- User friendly source
- Health information for patients and the public
- Quality filtered
- Credible sources
- Links to MEDLINE searches

**Notes:**
MEDLINEplus is a great starting point for patients and consumers
It focuses on health information provided by reliable sources written in easy-to-understand language.
It includes information about diseases, treatment and prevention.
It is organized into categories including health topics, dictionaries, doctors/dentists, hospitals, clearinghouses and databases.

## MEDLINEplus Selection Guidelines

- Quality
- Authority
- Accuracy
- Educational purpose
- Consistently available
- Accessible

**Notes:**
The source of the content is established, respected and dependable. A list of advisory board members or consultants is published on the site. 
The information provided is appropriate to the audience level, well-organized and easy to use. 
Information is from primary resources 
Lists of links are evaluated/reviewed/quality-filtered. 
The purpose of the web page is educational and is not selling a product or service. Most content is available at no charge. 
The web site is consistently available. 
Information is current or an update date is included.
The site provides unique information to the topic with a minimum of redundancy and overlap between resources. 
The site contains special features such as graphics/diagrams, glossary, or other unique information.
The content of the site is accessible to persons with disabilities. 

## MEDLINEplus Resources

- Health Topics
- Drug Information
- Dictionaries
- Medical Encyclopedia
- Doctors/Dentists

- Hospitals
- Organizations
- MEDLINE
- Databases
- Publications/News
- Libraries

**Notes:**
MEDLINEplus includes:
Information about diseases and conditions from the National Institutes and other authoritative sources. 
Prescription drug information from the US pharmacopeia
A medical encyclopedia, ADAM.Com
Links to dictionaries and glossaries to help you find the definition of medical terms.
Directories of physicians and other health care professionals such as psychologists, dentists, chiropractors.
Directories of hospitals, assisted living and  nursing homes, Veterans Health facilities, substance abuse treatment facilities

## MEDLINEplus Options

- Choose a topic by letter
-  **H**igh Blood Pressure
- Choose a topic by category
- Infections
- Use the search box
- Sickle Cell Anemia

**Notes:**
Health Topics - links to health information from NIH and other sources including MEDLINE searches.
MEDLINEplus includes extensive information about adolescent health and parenting topics
You have several options for finding information
Choose a topic by letter
Browse categories of information
Search for a specific term that doesn’t appear in the categories

## MEDLINEplus Demo

## Online Help

- Frequently Asked Questions (FAQs)
- MEDLINE*plus* TOUR

**Notes:**
The FAQs are designed to answer questions about information and links found on MEDLINEplus, its relationship to other library products, etc.
The MEDLINEplus Tour highlights the varied content found on the web site such as health topics, drug information, the medical encyclopedia, clinical trails.  The Tour allows users to page through each content area at their own pace or to go to individual sections to review content.

## Hands-On Exercises

## MEDLINEplus:Your Gateway to Consumer Health Information on the WebPart 2

## MEDLINEplus
ClinicalTrials.gov
DIRLINE
MEDLINE
LOCATORplus
NLM Gateway
TOXNET

- ClinicalTrials.gov
- DIRLINE
- MEDLINE
- LOCATORplus
- NLM Gateway
- TOXNET

- Overview of NLM Databases

**Notes:**
MEDLINEplus also includes:
Links to government agencies, medical societies and advocacy organizations such as the American Cancer Society
Links to MEDLINE for summaries of articles published in professional medical journals
Links to other databases of information on topics such as AIDS. Cancer, clinical trials, and dietary supplements 
Government publications in Spanish and English, newsletters and magazines, full text books and news sources
Links to libraries which provide consumer health information such as the Wheaton Regional Library in Maryland

## ClinicalTrials.gov

## ClinicalTrials.gov Features

- Information about clinical research studies
- 5,000 NIH clinical studies
- Multiple sources
- Browse by condition or sponsor
- Excellent user’s guide

**Notes:**
ClinicalTrials.gov is a Web site that provides patients, family members, health professionals, and members of the public access to information on clinical research studies, 
Clinical trials are research studies in which new treatments - drugs, diagnostic procedures, vaccines, and other therapies - are tested in people to see if they are safe and effective.
Clinical Trials.gov will include information from  the National Institutes of Health and other federal agencies, pharmaceutical companies and nonprofit organizations
Information includes the trial name and ID, sponsors, purpose,current status, who may be eligible, where trials are being held, whom to contact, and references to published papers that describe findings. 
Before searching for clinical trials, you may wish to gather some information about your particular disease or condition such as: 
    Diagnosis: What is your specific disease or condition? 
    Treatment History: What treatments have you received and what medications are you currently taking? 
    Ongoing medical conditions: Are you being treated for other diseases or conditions? 
Each study has its own specific eligibility requirements that you must meet before enrolling. For example, you may not be able to participate if you are taking certain medications. 

## DIRLINE

## DIRLINE Features

**D**irectory of **I**nformation **R**esources On**line**
- National, international, federal and state organizations
- Health focus
- Location, description and contact information

**Notes:**
DIRLINE (Directory of Information Resources Online) is the National Library of Medicine's online database containing location and descriptive information about a wide variety of information resources including organizations, research resources, projects, and databases concerned with health and biomedicine.
These information resources fall into many categories including federal, state, and local government agencies; information and referral centers; professional societies; self-help groups and voluntary associations; academic and research institutions and their programs; information systems and research facilities.
 Topics include HIV/AIDS, maternal and child health, most diseases and conditions including genetic and other rare diseases, health services research and technology assessment. 
Information is updated quarterly.

## PubMed

## PubMed Features

- User-friendly search engine for MEDLINE
- NLM’s database of references to articles
- Links to selected free articles
- Many include summaries
- Most articles are written for the health care professional

**Notes:**
PubMed is an easy-to-use  Internet search tool for finding journal articles of interest in the health and medical sciences. 
A basic search screen allows users to search by entering a few key words or phrases. 
A set of article titles is retrieved and their associated abstracts can be selected for viewing. 
A unique feature of PubMed is the ability to find all related articles to a given article instantly.
PubMed links to references to more than 11 million articles in fields of medicine, nursing, dentistry, veterinary medicine, health care systems, and preclinical sciences. 
PubMed also contains links to the full-text versions of articles at participating publishers' Web sites.

## LOCATORplus

## LOCATORplus Features

- National Library of Medicine online catalog
- Books, journals, audiovisuals
- Search by keyword, title, author, MeSH term or call number
*Quick Start Tutorial* & *Advanced Search Tutorial*

**Notes:**
LOCATORplus is NLM’s web accessible online catalog.
It is part of Voyager, NLM’s integrated library system.
Iot includes over 800,000 catalog records for books, audiovisuals, journals and computer files.
It includes links from catalog records to Interent resources, including online journals.
There are several online tutorials and FAQs.

## NLM Gateway

## Gateway Features

- Newest NLM resource
- Novice NLM searchers
- Simultaneous searches in multiple retrieval systems
- Databases, databanks, catalog
- Meeting abstracts

**Notes:**
The NLM Gateway was released this past Monday.
It provides a single entry point to several NLM databases permitting users to do one stop shopping for information from a variety of resources
Databases are being added in phases. 
Current databases include MEDLINE, OLDMEDLINE               ( citations from 1960-1965),  MEDLINEplus, LOCATORplus and HSRPRoj (health services research project records).
 Future additions include ClinicalTrials.gov, TOXNET and DIRLINE.
Searchers enter a term once and the Gateway retrieves all available resources on that topic.

## TOXNET

## TOXNET Features

- Toxicology and environmental health information
*Special Topics*
*Toxicology Tutors*

**Notes:**
Factual and bibliographic databases in toxicology and environmental health. (HSDB, CCRIS, GENE-TOX, IRIS, TRI, DART, EMIC, TOXLINE) 
Special topics include chemical warfare agents and the West Nile Virus
A series of Toxicology tutorials for learning more about toxicology and environmental health written on a college student level.

## Tools for Librarians

- HEALTHINFOQUEST
- Consumer Health: an Online Manual

## HEALTHINFOQUEST

- Web Tutorial
- Pathfinders
- Authoritative resources
- Traditional and alternative medicine
- Designed for public librarians

## Consumer Health: An Online Manual

- Planning a library
- Collection development
- Health literacy
- Readability analysis
- Materials for special populations
- Hot topics fact sheets

## Guides for Consumers

- National Library of Medicine Guide to Finding Health Information
- National Library of Medicine
- How to research a medical topic online
- 	- *Consumer Reports on Health*

## Tips for Trainers 

- Assess
- Decide
- Allocate
- Prepare
- Present
- Evaluate

**Notes:**
Teaching consumers to find health information on the web requires careful planning and enthusiasm.
Assess your audience
Decide on your focus
Allocate time
Prepare your presentation and materials
Present
Evaluate

## Assess Your Audience

- Computer competence
- Web experience
- Needs and interests
- Language and literacy

## Focus Your Teaching

- General health sources
- MEDLINE*plus*
- Specific health topics
- Diseases
- Drug information
- Tests and procedures

## Allocate Your Time

- Lecture
- Demonstration
- Hands-on Exercises
- Questions
- Discussion

## Prepare the Content

- Identify three to five objectives
- Locate resources
- Review web sites thoroughly
- Address quality issues
- Design/locate/copy handouts

## Present the Class 

- Introduce the topic
- Demonstrate the resources
- Let them search
- Answer questions
- Review and reinforce

## Evaluate

- Include an evaluation form
- Incorporate suggestions and observations
- Revise
- Re-evaluate

## Training Resources

- _[National Library of Medicine](http://www.nlm.nih.gov/)_
- National Network of Libraries of Medicine
- National Online Training Center

## National Library of Medicine

**Notes:**
The National Library of Medicine (NLM), on the campus of the National Institutes of Health in Bethesda, Maryland, is the world's largest medical library.
The Library collects materials in all areas of biomedicine and health care, as well as works on biomedical aspects of technology, the humanities, and the physical, life, and social sciences. 
The collections stand at 5.8 million items--books, journals, technical reports, manuscripts, microfilms, photographs and images. 
The Library's collection may be consulted in the reading room or requested on interlibrary loan. NLM is a national resource for all U.S. health science libraries through a National Network of Libraries of Medicine®. 
The NLM web site has an online Guide to Finding Health Information and a set of Frequently Asked Questions about Finding Consumer Health Information.

## National Network of Libraries of Medicine

**Notes:**
The mission of the National Network of Libraries of Medicine (NN/LM) is to advance the progress of medicine and    improve the public health by: 1) providing all U.S. health professionals with equal access to biomedical information;    and, 2) improving the public's access to information to enable them to make informed decisions about their health. The    Program is coordinated by the National Library of Medicine and carried out through a nationwide network of health    science libraries and information centers.
The National Network of Libraries of Medicine provides training materials including HEALTHINFOQUEST and the Consumer Health Manual.  There are tips sheets, outlines of classes developed by NN/LM staff, and other resources you can use when developing or presenting classes or workshops. 

## National Online Training Center

**Notes:**
There are many training opportunities available to librarians at no cost from the NLM through its Online Training Center.  Many of the classes are offered at NLM in Bethesda, Maryland. You can view a schedule of available classes with descriptions and the dates they are offered and register online at the Online Training Center web site.
Updated training manuals can be viewed or printed from the web.  Even if you can’t take a class, you may find them useful in your reference work or in helping consumers use the NLM databases.

## MEDLINEplus

- Good information is the best medicine.
- Depend on reliable sources
- Use current information
- Make treatment decisions with your physician

-        Your Information Prescription

**Notes:**
Just to review
All web sites are not created equal - sites vary in content and quality.  Always look for sources from authoritative organizations such as the federal government, educational institutions, medical societies or health advocacy organizations.
Don’t believe everything you read.  Quackery abounds on the Web just as it does elsewhere.  Make sure the information you use is current and based on medical research from credible sources.
Discuss information you find on the Web with your physician.  Every patient is different - only your health care provider can determine how effective a treatment or medication is for your condition.
Dr. Donald Lindbergh, the Director of the National Library of Medicine has said: “carefully used, the Internet offers the public a wonderful opportunity for accessing timely and critical health information.” MEDLINEplus is a great starting point for your health care research. It points you to high quality, current information from reliable sources.  
REMEMBER - Good Information is the best medicine.   

## Slide 47