Friday Foolery [2]. How to use your inhaler. NOT.

For the first time seen on Allergynotes: “Compliance” or “Are you using your inhaler right.” I really had to laugh out loud when I saw it, and so did my daughter and husband.

Therefore I would like to share it with you.

Text with the video: As a doctor half the battle is figuring out if your patients are actually doing what you tell them. Here’s a prime example where Dr. House is trying so hard to be nice for the holidays….

If you’re looking for more serious posts on the matter, please see Allergynotes, another blog of Ves Dimov.

And House is also on the Dutch t.v. My daughter told me it is even one of her favorite series. I wouldn’t know, it was the first time I saw House. Most of my evenings are filled with Twitter, blogging or sports.

Vanity is the Quicksand of Reasoning: Beware of Top 100 and 50 lists!

During the weekend I added some links to sites referring to this blog in the sidebar. There was the 3rd place in the Medgadget competition for the Best New Medical Weblog in 2008,  a nice critique by Danielle Worster (the Health Informaticist) in the “Library + Information Gazette”, the inclusion in the Dutch Twitterguide and a place in the Top 50 Health 2.0 Blogs list of RNCentral (”the place to learn about nursing online”) in 2008.

And recently I was included in another ranking lists, to which I was alerted by a personal email of Amber, saying:

Hi,

We just posted an article, “100 Useful Websites for Medical Librarians” (http://http://www.nursingschools.net/blog/2009/100-useful-websites-for-medical-librarians/). I thought I’d drop a quick line and let you know in case you thought it was something you’re audience would be interested in reading. Thanks!

Both the RNCentral and the nursingschools.net lists are subjective ranking list of useful sites on nurses-oriented webpages. And although subjective, they contain numerous excellent and trustworthy sites. I was honored and pleased that I was included in those lists together with the Krafty Librarian, David Rothman, the MLA, the NIH, and NLM.

In all fairness, there are also many list (in fact far more such lists) that do not include me. I remember that there was a list of 100 top librarians with quite a number of Australians and no @laikas. I found one post at Lucacept – intercepting the web saying:

BestCollegesonline.com has posted a list of the Top 100 Librarian Tweeters and I’m honoured to say I appear on the list. In fact, there are five Australian Librarians who made it on the list. The other four were heyjudeonline, neerav, bookjewel, gonty.

Unfortunately, they didn’t include Kathryn Greenhill, an amazing librarian who is currently in the US and putting out some very helpful tweets from conferences she is attending while there. She is sirexkathryn on Twitter.

Other great Teacher-Librarians to follow include …..

Check out the list and see who else is there you might like to follow. I know that my professional learning has benefited from the generous nature of Librarians who are active on Twitter.

This shows that people are pretty serious about those lists and sensitive to who is included or not.
There were some mild protests from a few people on Twitter, i.e. from Shamsha here (RT means you repost a tweet, so @shamsha retweets my retweet of @philbradley‘s tweet of the bestcollegesonline list) and from @BiteTheDust (here) regarding @laikas’  omission from the list. However, I’m sure there were many others studying the top 25, 50 or 100 lists with a frown. But wouldn’t any list look different?

Apparently it concerns the same bestcollegesonline.com-list as referred to by Lucacept.

Back in April there was also a Top 50 Librarian Blogs- list published at the getdegrees.com. This provoked a blogpost from the UK-blog Cultural Heritage ” Top 50 (insert topic of choice here). Quote:

The colleague who alerted me to this noted that all of the blogs listed were published by librarians in the US and wondered whether we should be doing our own list of top UK librarian blogs. Further, she wondered, if we did, who would we be putting at the top and why?

Who (are on the list)? and Why? Those are good questions!

This reminded me of a recent remark of @aarontay on Twitter, He sighed something like. “Now I’ve seen 3 of those list. Who makes those lists anyway?” That is a 3rd relevant question.

I couldn’t find @aarontay’s original Tweet (Booh!, these are not archived), but here is a message I found on FriendFeed:

Friendfeed not only keeps the messages but also shows the comments. Apparently Ellie (from Ellie <3 Libraries) found evidence that such sites were dodgy as @aarontay had suggested. Some quotes from her post:

Both this site (http://associatedegree.org) and Learn-gasm – who has the top 100 blogs post going around currently (www. bachelorsdegreeonline. com) are sites designed solely to earn revenue through click-throughs.

The “bachelorsdegreeonline” at the end is a tracking mechanism to allow collegedegrees.com to reward sites that send them visitors.
While all the schools linked to are legitimate schools, both are misleading sites since they only link to schools that offer an affiliate kickback. They also only link to forms to enter your contact information at third party sites, not to the actual school websites.

While the content of the top 100 blogs and 25 predictions lists is completely non-objectionable, the fact that librarians are taking these sites seriously is.

What the author is doing is trying to increase his traffic and SEO. He likely does some minimal investigation to determine what sites would have the biggest impact – so in that sense, the lists are probably somewhat representational of influential sites – like I said, the content isn’t the objectional part. He creates the page with the links to the 100 top whatever, then emails all of them to let them know they’re on the list. Every one of them that posts that they’ve made a top 100 list and links back to him increases his site’s page ranking. The more important your site is, the more it helps him, both in search engine algorithm terms (being linked to by someplace important counts for more than being linked to from less popular sites) and because it brings him more incoming traffic. Which also increases his site’s page ranking (and the chance of someone clicking through in a way that gets him paid).

…But, this particular little batch of sites that is currently targeting higher education – they are ones that are ostensibly trying to help people find colleges, choose degrees, etc., when in fact they are only linking to forms to enter your contact information for a small subset of online only colleges that offer affiliate linking programs.

…on the surface they seem related to education, some have .org addresses, but when we start looking at them critically they fail every test easily – no about page (or at least nothing informative on it), unauthored posts,  little to no original content. One of the main components of being a librarian is teaching people to think critically about information, so when we fail to do so ourselves I find it incredibly frustrating.

O.k. that hit the mark.

A good look at the sites that linked to my blog showed they were essentially the same as those mentioned by @aarontay and Ellie. With links to the same schools.

Vanity or naivety, I don’t know. I didn’t pay much attention, but I still (wanted to) quot(ed) them and didn’t doubt their intentions. Nor did I question Clinical Reader’s intentions at first (see previous post).

In some respect I really dislike to be so suspicious. But apparently you have to.

So, I hope you learned from this as well. Please be careful. Don’t link to such sites and/or remove the links from your blog.

“Vanity is the quicksand of reason” George Sand quotes (French Romantic writer, 1804-1876)

Top 50 Health 2.0 Blogs list

Friday Foolery [1]: On Homeopathy, Nutritionists and Toothiologists

Widely referred to on twitter, shown on the blog of drShock, and already cited in 2008…

But for those who do not know the Irish standup comedian Dara Ó Briain or his “Homeopathy & Nutritionists vs Real Science!” here is the video:

Some great oneliners:

• (Hé but) “Science knows it doesn’t know anything, otherwise it would stop … That doesn’t mean you can fill in the gaps with whatever fairytales”
  
• “Homeopathy is water… You can’t overdose on us, but you can fucking drown in it”
• “A dietitian is to a nutritionist as a dentist is to a toothiologist”

What does Dara Ó Briain mean with the latter?

Holford Watch, a (naughty) blog against about the “media nutritionist” Patrick Holford explained a while ago:

A ‘dietitian’ is a protected title, they need to be educated to a high level, etc., while anyone can call themselves a ‘nutritionist’. Dara drew a comparison with dentists: you have to meet certain, fairly stringent, criteria to call yourself a dentist or dietitian; anyone, though, can call themselves a toothiologist or nutritionist.

However, that Nutrionist is not a protected term is not entirely true. The title “nutritionist” is protected in Quebec, Alberta and Nova Scotia, as I learned from Wikipedia and Weighty Matters, the blog of Yoni Freedhoff, a Canadian Family doc and founder of Ottawa’s Bariatric Medical Institute.

Yoni is also not very fond of Nutritionists either. At his blog I found the (Funny Friday) video below about this profession. Made by Mitchell and Webb.

I also came across a video about homeopathy made by the same British comedians. Awesome.

Have a great weekend and be sure to take some Bach Flower Therapy to prevent your hangover. And remember, to take cocktails shaken not stirred with 1 ppm alcohol!

References:

Image by el patojo via Flickr

• http://www.shockmd.com/2009/08/18/on-homeopathy/
• http://holfordwatch.info/2008/12/23/dara-o-briain-a-dietitian-is-to-a-nutritionist-as-a-dentist-is-to-a-toothiologist/
• http://bmimedical.blogspot.com/2009/07/trip-to-nutritionist.html

More Friday Foolery:

• http://eagledawg.blogspot.com/search/label/friday%20foolery
• http://en.wordpress.com/tag/the-friday-post/
  ( from http://creakysites.wordpress.com/)

Dara Ó Briain: a dietitian is to a nutritionist as a dentist is to a toothiologis

Invisible Chronic Illness: Addison’s Disease

This week the Grand Round will be hosted by Invisible Illness Week, a blog dedicated to the National Invisible  Ilness Week, which runs September 14 -20, 2009. The purpose:

National Invisible Chronic Illness Awareness Week  (..) is a worldwide effort to bring together people who live with invisible chronic illness and those who love them. Organizations are encouraged to educate the general public, churches, healthcare professionals and government officials about the impact of living with a chronic illness that is not visually apparent.

The theme of the Grand Round is, not very surprisingly: Invisible chronic Illness.

I won’t write about this professionally -being a librarian-, but I will speak from my own experience.

As many of you know, I’ve the chronic illness Addison’s Disease. Not that I feel ill. It doesn’t affect me, really… Not anymore.. I think.

But many people with Addison’s disease suffer silently from this disease. And like many other diseases this disease is seldomly understood by partners, colleagues, friends ….. and doctors.

Before I explain more about Addison’s disease, first let me say that almost every disease is “invisible” to others. People can never fully understand what an illness means to someone suffering from it.

Cortisol, Image via Wikipedia

Patients with Addison’s disease make no or too small amounts of cortisol, a hormone made by the adrenal cortex. Cortisol has a bad reputation as the stress hormone among many people. It doesn’t deserve this reputation as this hormone is vital to life. Corticosteroids are involved in a wide range of physiologic systems such as stress response, immune response and regulation of inflammation, carbohydrate metabolism, protein catabolism, blood electrolyte levels, and behavior (Wikipedia)

Too much of this hormone causes Cushing’s disease, too little causes Addison’s disease. If you want to know what Cushing does to your body and mind, then please read the letter of Kate when she was first diagnosed with Cushing’s, at Robin’s “Survive the Journey”.

Here, I will confine myself to Addison’s disease. It is a very good example of an invisible yet serious disease.

There are 3 forms of Addison: primary (defect in the adrenal cortex itself, often also leading to a defect in aldosteron production), secondary Addison (by a defect in the hypophysis or hypothalamus) and iatrogenic Addison (caused by overtreatment with corticosteroids)

Here some reasons why the illness, although “invisible”, can have great impact on your live.

1. Diagnosis.

well-ville.com/images/adrenalQA2.jpg

Diagnosis is often a challenge, especially in patients with primary Addison, most of whom look healthy because of their pigmented skin. Nowadays, the main cause of primary Addison’s disease is immune destruction of the adrenal cortex. This has often a slow onset and in 50% of the patients the diagnosis takes more than 2, sometimes even more than 10 years [1]. 38% of the patients even experience vague complaints, that can later be attributed to Addison, during 11->30 years before diagnosis [1].

Before the diagnosis is made, people with Addison’s Disease often feel extremely tired and miserable. Even when the disease fully manifests itself the symptoms are largely vague and aspecific. The most common symptoms are fatigue, dizziness, muscle weakness, weight loss, difficulty in standing up, vomiting, anxiety, diarrhea, headache, sweating, changes in mood and personality, and joint and muscle pains. Often the symptoms aren’t taken seriously (enough) or the illness is mistaken for anorexia or depression.

My secondary Addison was the consequence of an injury to the pituitary gland as result of heavy blood loss during complicated childbirth (see previous post). The week between the cause and the diagnosis of the disease, was the most terrible week of my life. I felt awful, weak, (well I lost >3 liters of blood to start with), couldn’t give breast milk (no prolactin), and I disgusted food so much, you can’t imagine. I couldn’t get anything down my throat, only the look of it made me vomit. And I felt so bad not being able to care for the baby, but I just couldn’t. I couldn’t even stand for more then a few minutes, couldn’t walk.  And then there was unstoppable diarrhea, dizzyness, and speaking with double tongue. And practically no one took it seriously, not the gynaecologists, not the nurses, not the paediatricians, nor my friends or family.

But this was only one week. How would it have been if it durated 5 or 10 years?

2. Grieve and adaptation.

Once the disease is diagnosed you have to learn to live with a body that has let you down (grieve) and you have to learn to become confident again (adapt). You also have to find a new balance. I’ve lost a few hormones overnight (ACTH, cortisol, thyroid hormone, growth hormone, prolactin, gonadotrope hormones) and believe me, it took me a few years to feel reasonable normal again. It is quite surprising how badly I was informed. Very little information about the risk of an Addisonian crises, the dosing of cortisol under various conditions.
It was also confronting how little people wanted to know about the disease or what I had been through. Visitors after the birth wanted me to be euphoric and didn’t want me to go into any detail of what had happened. They cut me short by saying: “But you have a lovely baby”. Somebody cried that she didn’t want to hear it. So I stopped trying to speak about it.

I took no sick leave, immediately went back to work. My boss – a nephrologist, never asked after my health, not once.

As I said it took a few years before my “come-back”. I didn’t feel myself. It was as if I couldn’t think, as if my head was filled with cottonwool. Afterwards I think the main reason for improval was the reduction of the cortisol from 30 mg to 12.5 per day and the use of DHEAs plus that I regained confidence in myself.

3. Comorbidity

With cortisol I lost some other hormones which are also essential. Patients with primary Addison often miss aldosteron as well, which makes them more liable for an Addisonian crisis. Primary Addisonians may also have other immune diseases, like autoimmune thyroid disease, gonadal failure, type 1 diabetes and vitiligo.

4. Addisonian crisis

An addisonian crisis is an emergency situation, with possible fatal outcome, associated mainly with an acute deficiency of the glucocorticoid cortisol. This occurs in (extremely) stressful situations. Some Addisonpatients are more prone to it than others. You can -and should – take precautions, like wearing alert bracelets or necklaces, so that emergency personnel can identify adrenal insufficiency and provide stress doses of steroids in the event of trauma, surgery, or hospitalization.

Some Addisonians fear these crises so much that they dear not walk or run alone. Many Addison patients don’t go to a country far away, some don’t even pass the border (and you know the Netherlands aren’t that big).

5. Addison’s disease can be treated but not cured.

Addison patients are treated with corticosteroids like hydrocortisone and are substituted with other hormones that they may lack. Without treatment, the disease is lethal, with treatment the disease is not cured. I do feel all right now, but many of my fellow patients don’t. I think that the following excerpt from a Seminar of Wiebke Arlt and Bruno Allolio about adrenal insufficiency [2] makes this very clear.

Despite adequate glucocorticoid and mineralocorticoid replacement, health-related quality of life is greatly impaired in patients with primary and secondary adrenal insufficiency. Predominant complaints are fatigue, lack of energy, depression, and anxiety. In addition, affected women frequently complain about impaired libido. In a survey of 91 individuals, 50% of patients with primary adrenal insufficiency considered themselves unfit to work and 30% needed household help. In another survey of 88 individuals the number of patients who received disablility pensions was two to three times higher than in the general population. The adverse effect of chronic adrenal insufficiency on health-related quality of life is comparable to that of congestive heart failure. However, fine-tuning of glucocorticoid replacement leaves only a narrow margin for improvement, and changes in timing or dose do not result in improved wellbeing.

References

1. Zelissen PM. Addison patients in the Netherlands: medical report of the survey. The Hague: Dutch Addison Society, 1994.
2. Wiebke Arlt, Bruno Allolio. Adrenal Insufficiency, Lancet 2003; 361: 1881–93 , full text on http://www.addisonssupport.com/Documentation/adrenal-insufficiency-2003.pdf

Earlier posts on the subject:

• http://laikaspoetnik.wordpress.com/2008/10/19/changing-care-for-addison-patients/
• http://laikaspoetnik.wordpress.com/2008/10/27/the-importance-of-early-intervention-in-an-addisonian-crisis/

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• Multimorbidity, and why it’s difficult to care for complex medical patients (kevinmd.com)
• Dear Family and Friends…. (survivethejourney.blogspot.com)
• Please Don’t Ask Me ‘How are You?’ (somebodyhealme.dianalee.net)

List(s) of Tweeting Journals: Your Votes Please!

In the previous post “Biomedical Journals on Twitter” I showed a spreadsheet of biomedical Journals

This list was made on request of and for doctors, hence the original list name: Medical Journals.

As this Google-spreadsheet serves as a wiki, anyone (having g-mail) can edit the list. This was quite successful, as there were many additions made.

However, some of the journal titles I would not regard as biomedical. For instance purely (analytical) chemistry, physics, social sciences or history Journals. To me, Medical Biology is Medicine, Biology and disciplines on the interface (histology, anatomy, etc).

But let’s not discuss semantics and be practical. How would you like to see it?

Just like it is (see here) , with all disciplines mixed, all disciplines in a different spreadsheet or one spreadsheet with different tabs (per discipline).
In case of the latter two options, we could also add humanities/social sciences, such as suggested by Dean Giustini

I made a (non-editable)* sample of a spreadsheet with different tabs per discipline to see what it looks like: see here
Below is only a Figure (showing the Medical Tab). Click to enlarge.

The choice is yours.

*The alternative spreadsheet is not editable, because it is not manageable to have two spreadsheets. Data might get lost.

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• List of biomedical journals on Twitter (casesblog.blogspot.com)

MedLib’s Round 1.5 at Pharmamotion

The new Medlib’s Round (vol 1. no 5) with a compilation of interesting posts in the field of medical librarianship is up at Pharmamotion run by Flavio Guzmán. This is the first -and hopefully not the last- time that a MD has offered to host the round. Indeed the MedLib’s round is not only aimed at medical librarians, but also at physicians, researchers, nurses etcetera.

Please enjoy reading the posts at: MedLib’s Round 1.5: the best of medical librarianship. For those not knowing much about Medical librarianship, Flavio has embedded a short video about medical librarians.

Want to stay informed? You can take a RSS subscription to the Medlib’s Round. An aggregated feed of credible, rotating health and medicine blog carnivals is also available (thanks Walter Jessen).

The next round will be hosted by Laika’s Medliblog, September 8th.
Please submit your favorite blog article to the next edition of MedLib’s Round before or at September 5 by using the carnival submission form (here) (!). Submission to the form makes it easier for the host to summarize the articles.

My advise: already start submitting links of good posts if you have them, and bookmark the submission form. September is sooner than you think. For links to Faqs and previous posts see the Medlib’s archive.

p.s. Perhaps you would like to host a future edition as well. If so, please inform me which edition you would like to host.

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• MedLib’s Round 1.3 (laikaspoetnik.wordpress.com)

Biomedical Journals on Twitter

Because of my vacation I was unable to publish about the list of Medical Journals on Twitter that I had initiated in the form of a spreadsheet.

Meanwhile this list has been widely covered in the medical blogosphere, i.e. here, here (nature blogs, yeah), here, here and here, (without -correct- attribution) and here (Ves Dimov) and here (Andrew Spong) (with attribution). And possibly many more.

Do I have anything to add? No not really.

Nevertheless, I would like to point my readers who may not be yet aware of this list. It is open to anybody to edit. Thus if you know of a medical journal on Twitter that is not included, then please feel free to add it to the spreadsheet (if you have Google mail) or ask me to do it for you.

For those who are not used to editing Google spreadsheets, please follow the detailed description of Andrew Spong at his blog.

The reason why I started this spreadsheet was that Walter van den Broek (drshock) asked me “how to find which medical journals on Twitter (see part of the Twitter discussion rescued from Friendfeed (tweets get lost after a few days).

I made a spreadsheet, and asked input from the twitterverse: the easiest and most efficient way to compile a list. There were many initial suggestions of @artadobbs: (see @UCONNHealthLib). She already followed many e-resources updates, as a service for UCONN Health Library users. Ves Dimov (@drves) also had great input. The other editors have added their names on the spreadsheet (and I have added mine too now ). Thanks to all! With Ves I’m truly impressed of how well Google Spreadsheets work as a structured wiki.

Here is a Figure of part of the list (click to enlarge), the actual spreadsheet can be found here.

Yesterday drshock asked me “Any pharmaceutical drug companies using twitter?” so the Medical Journal spreadsheet may not be my last one.

Twitter discussion. Read from down up

A Cracking Grand Rounds at Emergiblog

Image via Wikipedia

Vacation time, and still able to compile such a wonderful Grand Round overnight (!), excisting of almost 40 high quality submissions in a dressing of  crackers, consumed by the loveable, wacky duo, unknown to me: Wallace and Gromit!

The Affair of Clinical Reader published at this site is included in the section: “Uh oh! Looks like Gromit has about had it with the antics of Feathers McGraw, evil penguin!”

So, no, Grand Round has no off-season. Take your computer with you to the beach and on vacation and enjoy reading the 38 great stories at Emergiblog, run by nurse Kim. These flowers, “taken” at my vacation in Canada, are for you, nurse Kim, for your truly cracking round ànd your 4 year blogging anniversary!

The next Grand Round will be hosted by DrRich at The Covert Rationing Blog!

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Clinical Reader, a Fancy New Aggregator – But All is not Gold that Glitters

Before I went on vacation (July 14th) I started a blogpost about Clinical Reader, a new aggregator. However, a Twitter riot -started July 13th- drastically changed my view of Clinical reader and I decided to await further developments till my return. Alas, things have only worsened.

The adapted blogpost consists of two parts: a neutral look from the outside (original draft) and a look behind the scenes: how social media and web 2.0 tools should not be used.

I submit this post to the Grand Rounds, not only to inform you about a potential fancy aggregator, but also to warn potential users to “look before you leap”.

Please note that the figures shown in the first part are all screendumps taken at July 13th or earlier and might no longer exist in this form (note added after publication, as all sentences in this color)

——————————————————————————————————

Earlier this year (see post) I compared PeRSSonalized Medicine, a new aggregator, created by Bertalan Meskó to various other aggregators: Amedeo, MedWorm and Libworm, Netvibes, I-Google and RSS-Readers, (i.e.) Google Reader.

Most of these readers (can) track medical journals or news, some (can) also track blog posts and web 2.0 tools (like PeRSSonalized Medicine and MedWorm).  PeRSSonalized Medicine excels by the input from the readers (doctors, health 2.0 people and patients), Amadeo and especially Medworm have large lists of journals to choose from. All these aggregators can be personalized. Of course Netvibes, I-Google and RSS-Readers give the utmost freedom in compiling list feeds, but one first has to learn how to use them. And although it is not difficult, it means a hurdle to many.

June 29th, a new aggregator was launched, Clinical Reader, specifically designed for busy clinicians to reduce the information overload.

1. From the Mission Statement:

We are building a user-friendly platform that will enable medical professionals around the world the ability to easily interact with the latest developments in their respective specialties. Our aim is to bring academic content together and create a semantic digital medical library.

——————

2. What it is and what it isn’t.

Clinical Reader is website that syndicates content via RSS/Atom (aggregator), enabling busy clinicians to easily browse top medical journals, health news sources and multimedia without having a clue what RSS is about (and for free). The same is true for other aggregators discussed previously: PeRSSonalized Medicine, Amedeo and MedWorm. In fact the presentation of the feeds looks pretty similar (see Fig. for comparison of Clinical Reader and Perssonalized Medicine). Disadvantage of these kind of aggregators is that only the first items are shown, and as these often are editorials, comments, correspondence and news, the physician still has to follow the link to the journal to see most of the (true) articles.

In contrast to the aforementioned  services, the “RSS-feeds” of Clinical Reader cannot be personalized (a personal selection of journals). There is however the possibility to select an entire clinical section, each with its own selection of specialist journals. And according to Rashada Henry, associate editor of ClinicalReader.com (commenting on Bertalan Mesko’s post), open or closed personal pages may become an option in due course.

3. What’s new?

As said, the idea isn’t new, Clinical Reader is an old concept in a new guise. But what a guise. It is a glimmering site with prints of the main journals on the home page. It has the appearance of an i-pod touch: you can scroll the sources with your mouse and click the ones you would like to read. Wow, I was immediately taken by it.

4. Coverage

The emphasis is on medical journals and news. But there is also a page for with a selection of 14 Medical Blogs. There are also plans to include top Twitter doctors worth following (spreadsheet prepared by Ves Dimov, MD), for nurses, open access … and top medical librarians blogs (worth following for doctors). Following Ves’ example I made a spreadsheet of useful medical librarian blogs, open to editing here

The original spreadsheet looked like this:

The preview of the medical librarian page (how it would look when incorporated) looked like this.

The address was: http://medical-librarians.clinicalreader.com/phase3.php - but when I came back the link was dead?!….

The other side of the coin

Apart from the fact that the site was not as revolutionary as suggested, there were some basic things about the site that were of some concern. The “About us” section contains no names, picture, verifiable info, etc. It only says: “Clinical Reader was brought to life in 2009 by a junior doctor and a small group of forward thinking young tech programmers spread across London and Toronto.” Furthermore I wondered whether NLM would ever give stars to commercial tools like this. I wondered, but no more than that….

1. Starry ethics fail
Nikki Dettmar, a medical librarian at the National Network of Libraries of Medicine (NNLM) did take a closer look. In a blogpost Starry ethics fail she says that:

it is with concern that I’ve heard about some of my colleagues promoting and collaborating with the newly launched company, Clinical Reader.

Why? (red scrawl emphasis mine)

This above-the-page-fold graphic is intentional (not accidental, this is clear marketing intent to lend quick visual credibility to the organization) and currently displayed everywhere (homepage, sections pages, multimedia page, the newsletter, etc.) throughout the resource.

It is bogus as far as the National Library of Medicine (NLM) is concerned since the U.S. Government doesn’t endorse or grant 5 stars to anything. The NLM Copyright Information page offers more elaboration, ….

Later Ben Goldacre (MD, columnist for the Guardian) concludes in a Twitter discussion regarding the endorsement by the Guardian (source http://eagledawg.blogspot.com/2009/07/gratitude.html).

bengoldacre @ClinicalReader so youre supported by the guardian in the sense that you went to an event they organised and some people gave you sm advice? 2 weeks, 5 days ago from TweetDeck in reply to ClinicalReader

2. Infringement of copyright

Nikki was also the first to notice the use of two copyrighted, unattributed images:

Clinical Reader also currently uses two copyrighted images on their Partners (specific original source, copyright notice at bottom) and Advertising pages (from somewhere on Signalnoise). A ‘credit’ link to a source doesn’t honor an image copyright. (….) Commercial organizations can well afford to purchase or design their own graphics.

In a later post, Nikki also showed that the multimedia wrongfully used SpringerImages, that must not be (…) used for commercial purpose  including the placement or upload of the Licensed Content on a commercial entity’s internet website.

Peter Murray twittered to @allan marks, co-founder of Clinical Reader:

@allan_marks It seems your Clinical Reader radiology image (http://bit.ly/3YbLa) was swiped from a Flickr user http://bit.ly/3XXKGm

In addition, the logo that was used by Clinical Reader to indicate the untangling of a maze of information (that I copied in my original draft above), was taken without permission from the website of FeedStitch where it was created by their designer Owen Shifflett. (see discussion).

You kind of wonder what wasn’t copied.

3. Threat to Nikki (Eagledawg) via Twitter

For me the most astonishing event was the immature “response” of Clinical Reader to Nikki after publishing her first post with appropriate critique. It was in the from of a real threat.

From several sources I now  understand Clinical Reader also reacted kind of offensive to other librarians, including @DataG and lukelibrarian. One was warned “I will contact Twitter and have your accounts shut down. Stick with the real deal – EBSCO, Ovid .. etc” or something to that effect. @DataG (Murray) also found a version of a Clinical Reader newsletter, still catched by the Google search engine entitled: “wave goodbye to the library journal shelf”, which was later withdrawn. (source: Murray on Twitter as @DataGhis blog dltj.org (6)) and

I immediately responded (while packing) to the initial threat and so did dozens of other medical librarians. Mostly on Twitter and Friendfeed, but also via their blogs (see below and Nikki’s blog). Some also retracted their initial support (i.e. see this mail of  Connie Schardt, who like many of us -including me- was “temporarily dazzled by the flashy display and ease of use of the product.”)

4. Change of Twitter-accounts, deleting tweets

Quite confusingly Twitter-accounts have been changed and deleted. First initials appeared after tweets to designate the person who tweeted for @clinicalreader, which I thought was a good thing. I followed @clinicalreader, but now the account was discontinued. The archive was kept at @clinical_tweets, which vanished as well. Now there is @clinical_reader, that states that tweeting has not really begun?? The only Clinical Reader account I know of is that of allan_marks. ALL previous tweets have been deleted. What remains are dm’s (direct messages) and tweets that are preserved by services like QuoteURL.
(for a detailed account of the switching of the original Twitter account’s name ‘at the speed of light’ see this blogpost of pegasuslibrarian)

It is all very confusing. Why would one do that other to conceal what has been said?

One salient detail. At their website Clinicalreader still refers to @clinicalreader, which is taken over by someone taking the opportunity to register the account when it moved to @clinical_tweets

5. More lying

There are several examples of making up retweets (quoting someone), see here (@ClinicalReader “I didn’t RT anything from y’all. Y’all aren’t very good at the whole social media thing, huh?”-David Rothman) and here (@ClinicalReader – “Would you mind not attributing fabricated quotes to me please? I never said this: http://tr.im/sCFb #ClinicalCheater“) (source: 6)

6. Denial

The behaviors of the ones in charge are so immature. It’s really unbelievable. You always have to take critique seriously, and if you choose to use social media and make a mistake, than apologize openly (see the blogpost of Peter Murray below, 7).

Look at this discussion with Ben Goldacre (thanks Nikki). It is really ridiculous, QuoteURL: one, two, three, and four. Clinical Reader is playing dumb.

I might not have been exhaustive, but I know enough for the moment. Also in my eyes, Clinical Reader has lost all its credibility.

In contrast to the massive protest of Medical Librarians only one doctor (Ben Goldacre) took a stand against Clinical Reader (see here).

Clinical Reader = zero stars: non-existent endorsements, threaten blogger, nasty and silly, avoid! http://tr.im/sdJA

The others remained erily silent. Why?

——————————

More extensive reading:

1. http://eagledawg.blogspot.com/2009/07/clinical-reader-starry-ethics-fail.html
2. http://eagledawg.blogspot.com/2009/07/gratitude.html
3. http://stevelawson.name/seealso/archives/2009/07/clinical_reader_from_zero_to_negative_sixty_with_one_bogus_threat.html
4. http://healthinformaticist.wordpress.com/2009/07/14/clinical-reader-malicious-or-just-stupid/
5. http://davidrothman.net/2009/07/14/watch-nikki-pound-clinical-reader/
6. http://dltj.org/article/clinical-reader-background/ (in depth coverage by @dataG or Peter Murray)
7. http://dltj.org/article/learning-from-clinical-reader/ (excellent advice)
8. http://pegasuslibrarian.blogspot.com/2009/07/best-bad-marketing-ever.html
9. http://pegasuslibrarian.blogspot.com/2009/07/clinical-reader-train-wreck-just-keeps.html (detailed coverage of deleting and changing accounts) (8-9 added after comment Steve Lawson)
10. Friendfeed discussions: http://friendfeed.com/search?q=%22clinical+reader%22

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MedLib’s Round: Call for submisions and hosts

At the nick of time*, I would like to call for submissions for the MedLibs’round, the blog carnival about medical librarianship in the broadest sense of the word. Anyone can submit, as long as the post is relevant and of good quality. See the Medlib’s archive for examples.

Because of the small number of submissions, the deadline will be postponed by one day, which means that you can submit till (Sunday) midnight (EST). Submitting is easy: just submit the permalink (web address) of a post (you have already written on your blog) here at the Blog Carnival (registering required).

This MedLib’s Round (nr. 1.5) will appear at Pharmamotion, the blog of Flavio Guzmán (MD). Planned date: Tuesday August 4th.

And then there is an URGENT call for HOSTS for the coming months: September, October, November, December …
(submission deadline on every first Saturday of the month). It is my intention not to host more than one issue myself.

You’re welcome as a host when you’ve (some) knowledge of and interest in publication and medical information (searching, citing, managing, writing, publishing, social networking). And -of course- you also should have a blog.

Interested? Please contact me by email (laika dot spoetnik at gmail dot com), by twitter or by commenting to this post.

Jacqueline.

* still suffering from a jet lag after a wonderful vacation in Quebec, Canada.