Friday Foolery #48 Brilliant Library Notices

13 01 2012

Today’s Friday Foolery post is handed on a silver platter by my Australian friend Mike Cadogan @sandnsurf from Life in the Fast Lane

Yes, aren’t these brilliant librarian notices from the Milwaukee Public Library?!

Note:

@Bitethedust, also from Australian rightly noticed: there’s no better place to stick @sandnsurf than in Friday foolery

Indeed at Life at the Fast Lane they have fun posts amidst the serious (mostly ER) topics. Want more Friday Fun than have a look at the Funtabulously Frivolous Friday Five Posts.





National Library Week

12 04 2011

It is National Library Week! Did you know that?

To be honest I didn’t.

Today, Tuesday, is even National Library Workers Day — a time to thank librarians and the rest of the library staff (LA-Times).

I didn’t know that either, until I received a tweet from @doc_emer which was retweeted by doctor_V (see Fig).

Now I know.

Thank you Dr. Emer and Bryan Vartabedian (Doctor V). You made my day!

*********************************

Added:

 

@amcunningham (AnneMarie Cunningham) tweeted:
Since it’s national library week, thought I’d say thanks to all the great librarians on this list:) http://bit.ly/gkzKZm

 

 





Internet Sources & Blog Posts in a Reference List? Yes or No?

13 02 2011

A Dutch librarian asked me to join a blog carnival of Dutch Librarians. This carnival differs from medical blog carnivals (like the Grand Rounds and “Medical Information Matters“) in its approach. There is one specific topic which is discussed at individual blogs and summarized by the host in his carnival post.

The current topic is “Can you use an internet source”?

The motive of the archivist Christian van der Ven for starting this discussion was the response to a post at his blog De Digitale Archivaris. In this post he wondered whether blog posts could be used by students writing a paper. It struck him that students rarely use internet sources and that most teachers didn’t encourage or allow to use these.

Since I work as a medical information specialist I will adapt the question as follows:

“Can you refer to an internet source in a biomedical scientific article, paper, thesis or survey”?

I explicitly use “refer to” instead of “use”. Because I would prefer to avoid discussing “plagiarism” and “copyright”. Obviously I would object to any form of uncritical copying of a large piece of text without checking it’s reliability and copyright-issues (see below).

Previously, I have blogged about the trouble with Wikipedia as a source for information. In short, as Wikipedians say, Wikipedia is the best source to start with in your research, but should never be the last one (quote from @berci in a twitterinterview). In reality, most students and doctors do consult Wikipedia and dr. Google (see here and here). However, they may not (and mostly should not) use it as such in their writings. As I have indicated in the earlier post it is not (yet) a trustworthy source for scientific purposes.

But Internet is more than Wikipedia and random Googling. As a matter of fact most biomedical information is now in digital form. The speed at which biomedical knowledge is advancing is tremendous. Books are soon out of date. Thus most library users confine themselves to articles in peer-reviewed scientific papers or to datasets (geneticists). Generally my patrons search the largest freely available database PubMed to access citations in mostly peer-reviewed -and digital- journals. These are generally considered as (reliable)  internet sources. But they do not essentially differ from printed equivalents.

However there are other internet sources that provide reliable or useful information. What about publications by the National Health Council, an evidence based guideline by NICE and/or published evidence tables? What about synopses (critical appraisals) such as published by DARE, like this one? What about evidence summaries by Clinical Evidence like, this one? All excellent, evidence based, commendable online resources. Without doubt these can be used as a reference in a paper. Thus there is no clearcut answer to the abovementioned question. Whether an internet source should be used as a reference in a paper is dependent on the following:

  1. Is the source relevant?
  2. Is the source reliable?
  3. What is the purpose of the paper and the topic?

Furthermore it depends on the function of the reference (not mutually exclusive):

  1. To give credit
  2. To add credibility
  3. For transparency and reproducibility
  4. To help readers find further information
  5. For illustration (as an example)

Lets illustrate this with a few examples.

  • Students who write an overview on a medical topic can use any relevant reference, including narrative reviews, UpToDate and other internet sites if appropriate .
  • Interns who have to prepare a CAT (critically appraised topic) should refer to 2-3 papers, providing the highest evidence (i.e. a systematic review and/or randomized controlled trial).
  • Authors writing systematic reviews only include high quality primary studies (except for the introduction perhaps). In addition they should (ideally) check congress abstracts, clinical trial registers (like clinicaltrials.gov), or actual raw data (i.e. produced by a pharmaceutical company).
  • Authors of narrative reviews may include all kinds of sources. That is also true for editorials, primary studies or theses. Reference lists should be as accurate and complete as possible (within the limits posed by for instance the journal).

Blog, wikis, podcasts and tweets.
Papers can also refer to blog posts, wikis or even tweets (there is APA guidance how to cite these). Such sources can merely be referred to because they serve as an example (articles about social media in Medicine for instance, like this recent paper in Am Pharm Assoc that analyzes pharmacy-centric blogs.

Blog posts are usually seen as lacking in factual reliability. However, there are many blogs, run by scientists, that are (or can be) a trustworthy source. As a matter of fact it would be inappropriate not to cite these sources, if  the information was valuable, useful and actually used in the paper.
Some examples of excellent biomedical web 2.0 sources.

  • The Clinical Cases and Images Blog of Ves Dimov, MD (drVes at Twitter), a rich source of clinical cases. My colleague once found the only valuable information (a rare patient case) at Dr Ves’ blog, not in PubMed or other regular sources. Why not cite this blog post, if this patient case was to be published?
  • Researchblogging.org is an aggregator of expert blogposts about peer-reviewed research. There are many other high quality scientific blogging platforms like Scientopia, the PLOSblogs etc. These kind of blogs critically analyse peer reviewed papers. For instance this blog post by Marya Zilberberg reveals how a RCT stopped early due to efficacy can still be severely flawed, but lead to a level one recommendation. Very useful information that you cannot find in the actual published study nor in the evidence based guideline
  • An example of an excellent and up-to-date wiki is the open HLWIKI (maintained by Dean Giustini, @giustini at Twitter) with entries about health librarianship, social media and current information technology topics, having over 565+ pages of content since 2006! It has a very rich content with extensive reference lists and could thus be easily used in papers on library topics.
  • Another concept is usefulchem.wikispaces.com (an initiative of Jean Claude Bradley, discussed in a previous post. This is not only a wiki but also an open notebook, where actual primary scientific data can be found. Very impressive.
  • There is also WikiProteins (part of a conceptwiki), an open, collaborative wiki  focusing on proteins and their role in biology and medicine.

I would like to end my post with two thoughts.

First the world is not static. In the future scientific claims could be represented as formal RDF statements/triplets  instead of or next to the journal publications as we know them (see post on nanopublications). Such “statements” (already realized with regard to proteins and genes) are more easily linked and retrieved. In effect, peer review doesn’t prevent fraud, misrepresentation or overstatements.

Another side of the coin in this “blogs as an internet source”-dicussion is whether the citation is always appropriate and/or accurate?

Today a web page (cardio.nl/ACS/StudiesRichtlijnenProtocollen.html), evidently meant for education of residents, linked to one of my posts. Almost the entire post was copied including a figure, but the only link used was one of my tags EBM (hidden in the text).  Even worse, blog posts are sometimes mentioned to give credit to disputable context. I’ve mentioned the tactics of Organized Wisdom before. More recently a site called deathbyvaccination.com links out of context to one of my blog post. Given the recent revelation of fraudulent anti-vaccine papers, I’m not very happy with that kind of “attribution”.

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Implementing Twitter in a Health Sciences Library

23 11 2010

Twitter describes itself as “a service for friends, family, and co-workers to communicate and stay connected through the exchange of quick, frequent answers to one simple question: What are you doing?” [2].

The “answers” are equally simple, because the tweet (that what is being “said”) must fit in 140 characters. The tweet does not only contain plain text, but can contain short-URL’s which link to webpages, figures and videos.

However, tweets have evolved to more than everyday experiences, and take the shape of shared links to interesting content on the web, conversations around hot topics (using hashtags (#), like #cochrane OR #ev2010 (conference evidence2010)), photos, videos, music, and real-time accounts of a newsworthy event [2]. Furthermore, Twitter is now also used by institutions and companies  for branding, marketing and costumer service. This also applies to libraries, with public libraries leading the way. Health science libraries started twittering  in 2009 and as of 2010 there were (only) 24 of them. In addition, the National Library of Medicine (NLM) and most of the regional National Network of Libraries of Medicine (NN/LMs) have a Twitter presence.  I follow @NLM_LHC and @NLM newsroom, for instance.

The NYU Health Sciences Libraries (NYUHSL) began using Twitter in June 2009. The team, consisting of the Director, the Emerging Technologies Librarian and the Web Services Librarian of the NYUHSL, described their experience with the implementation of Twitter in the latest Medical Reference Services Quarterly [1]

The main aim of their Twitter account was to disseminate topics similar to what was posted on their Web site: news about facilities, resources, handy tidbits, services offered, downtime, events, and staff, as well as breaking news.

What was their approach and what were their main experiences?

  • Claim your name, as soon as you vaguely consider using Twitter!
    In the case of  NYUHSL, their usual library acronym was already taken, so they took a similar name: @NYU_HSL (because of the 140-character limit, it is advisable to use as few characters as possible: this will leave more room when somebody replies to you).
  • They added the library logo as a profile picture and included a link to the library website plus a short “bio”.
  • First the team shared responsibility for posting on Twitter (by logging in into the NYU_HSL account and posting), but this posed coordination problems (like double postings, irregular postings). Therefore it was decided that team members would post according to a schedule. Furthermore there was a 2-week rotation. Any important news was tweeted promptly and interesting news from other Twitter users was occasionally retweeted .
  • Later CoTweet was used. This is a free tool, which -as its name suggests- allows multiple people to communicate through corporate Twitter accounts and stay in sync while doing so. One person is the account owner, who creates and maintains the account and gives other people access to it. The individual members can post to Twitter via the Co_tweet account.  CoTweet uses bit.ly as an URL-shortener, displays some (rudimentary) stats, allows scheduling and archiving of tweets and has some other slick features for corporate Twitter use. (See  this post at News CNET for a comparison between CoTweet and the better known Hootsuite)
  • What I most liked about the paper – besides the description of CoTweet – is the content flow diagram the authors used (adapted below). Posts from their library blog were automatically cross-posted via RSS to Twitter using Twitterfeed, whereas tweets were in their turn automatically posted on Facebook. To this end a Twitter Tab was added to the NYUHSL Facebook fan page. In addition it remained possible to post manually to the different social networking tools and to respond to followers or retweet messages of other users.

  • The team also had to find the right tone for Twitter: the style of tweets is more informal than the style of blog posts. They emphasize the importance of keeping the nuances of different social networking sites in mind when establishing an institutional presence.
  • They promoted Twitter in many ways:
    • A large Twitter mascot (blue bird) with the text: “Follow NYU_HSL on Twitter” was placed on the prominent Web’s site feature bar (see Fig. below). Unfortunately the twitter message only appears when you press “next”. Most users will not do this.
    • Creation of a small poster about Twitter.
    • A word of mouth campaign (in orientation presentations, and a tag line with Twitter account information in e-mail correspondence to students: according to Pew Internet [3] college graduates are among the biggest users of Twitter.
    • description and promotion of the Twitter account in the library’s e-mail newsletter and in blog posts.

And finally, we have to come up with the Key Question: was it all worth the effort?

At the time of writing the NYU-HSL had 66 followers, 27 of which were affiliated with the NYU (others being other libraries and librarians for instance). This is not a very big (target) audience, but I agree with the authors that the definition of success in social media is relative.  There were clear (subjective) benefits, like the low cost, ease of use, low effort to maintain the service on the one hand and the possibility to engage the audience, get user opinions and the opportunity to fix problems quickly on the other hand. Furthermore it’s presence on Twitter enhances the library’s reputation, as the library is making an effort to extend beyond its walls and confirms the role of librarians as technology leaders.

I also agree with the library’s basic principle “to give users as many options as possible to keep current with library news, resources, and services.” In this regard Twitter is a simple and effective method for promotion.

Thus health, medical and other libraries. I would say, if you are not twittering, give it a try and read the reviewed paper [1] for more tips. One of these tips is to connect with other libraries on Twitter as to learn from their experiences.

Credits:  @DrShock dm-ed (direct messaged) me on Twitter to alert me to the paper. Thanks Walter!

References (all assessed 2010-11-23)

  1. Cuddy, C., Graham, J., & Morton-Owens, E. (2010). Implementing Twitter in a Health Sciences Library Medical Reference Services Quarterly, 29 (4), 320-330 DOI: 10.1080/02763869.2010.518915
  2. Mashable http://mashable.com/guidebook/twitter/
  3. Lenhart, A., and Fox, S. ‘‘Twitter and Status Updating.’’ Report: Web 2.0, Social Networking. Pew Internet & American Life Project (February 12, 2009). Pew Internet: http://www.pewinternet.org/Reports/2009/Twitter-and-status-updating.aspx




An Educator by Chance

13 10 2010

The topic of the oncoming edition of the blog carnivalMedical Information Matters“, hosted by Daniel Hooker, is close to my heart.

Daniel at his call for submissions post:

I’d love to see posts on new things you’re trying out this year: new projects, teaching sessions, innovative services. Maybe it’s something tried and true that you’d like to reflect on. And this goes for anyone starting out fresh this term, not just librarians!

When I started as a clinical librarian 5 years ago, I mainly did search requests. Soon I also gave workshops as part of evidence based practice courses.

Our library gave the normal library courses PubMed, Reference Manager etc. We did little extra for medical students. There was a library introduction at the beginning and a PubMed training at the end of the curriculum.

Thus, when the interns had to do a CAT (Critically Appraised Topic), they had to start from SCRATCH ;) : learn the PICO, domains, study types, searching the various databases.  After I gave  a dozen or so 1-hour long introductions to consecutive interns, repeating the same things over and over, I realized this was an ineffective use of time. So I organized a monthly CAT-introduction with a computer workshop. After this introduction I helped interns with their specific CAT, if necessary.

This course is appreciated very much and  interns usually sigh: “why didn’t we learn this before?! If we had known this…”, etcetera.

Thus we, librarians, were very enthusiastic when we got more time in the newly organized curriculum.

We made e-learning modules for the first year, two for the second year, a Pubmed-tutorial, and a computer workshop (150 min!). In the 4th year we grade the CATs.

The e-learning modules costed me tons of time. If you read the post “How to become a big e-learning nerd by mistake” at Finite Attention Span you understand why.

We used a system that was designed for exams. On my request the educational department embed the system in a website, so students could go back and forth. Lacking any good books on the topic, students should also be able to reread the text and print whatever they liked.

I was told that variation was important. Thus I used each and every of the 10 available question types. Drop down menus, clickable menus, making right pairs of terms etc. Ooh and I loved the one I used for PICO’s, where you could drag words in a sentence to the P, I, C or O. Wonderful.

Another e-learning module consisted largely of Adobe Captivate movies. As  described in the above mentioned post:

Recognise that you are on a learning curve. First of all, it is vital that your software does not always remind you to save individual files before closing the program. It is especially helpful if you can demonstrate this three times inside a week, so that you end up losing the equivalent of about two days’ work: this will provide you with a learning experience that is pretty much optimised.

Swear. Vigorously.

Become a virtuoso of the panic-save, performing Ctrl+S reflexively in your sleep, every three minutes (…)

Correcting the callouts and highlight boxes and animation timings so they don’t look like they were put together by committee is complicated. Also, writing really clear, unambiguous copy takes time.

It sounds familiar. It also regularly happened to me that I started with the wrong resolution. Then I heard afterwards: “Sorry, we can only use 800×600.”

But workshops are also time-consuming. Largely because the entire librarian staff is needed to run 30 workshops within a month (we have 350 students per year). Of course it didn’t end with those workshops. I had to make the lesson plan materials, had to instruct the tutors, make the time tables, the attendance lists and then put the data into an excel sheet again. I love it!

The knowledge is tested by exams. This year I had to make the questions myself -and score them too (luckily with help of one or two colleagues). Another time buster. The CATs had to be scored as well.

But it is worth all the pain and effort, isn’t it?

Students are sooo glad they learned all about EBM, CATS, scientific literature and searching…

Well, duh, not really.

Some things I learned in the meantime

  1. Medical students don’t give a da do not care much about searching and information literacy.
  2. Medical students don’t choose that study for nothing. They want to become doctors, not librarians.
  3. At the time we give the courses, the students not really need it. Unlike the interns, they do not need to present a CAT, shortly.
  4. Most of our work is undone by the influence of peers or tutors that learn the students all kind of “tricks” that aren’t.
  5. It is hard to make good exams. If the reasoning isn’t watertight, students will find it. And protest against it.
  6. …. Because even more important than becoming a doctor is their desire to pass the exams
  7. If the e-learning isn’t compulsory, it won’t be done.
  8. You can’t  test information literacy by multiple choice questions. It is “soft” knowledge, more a kind of approach or reasoning. Similarly PICO’s are seldom 100% wrong or right. The value of PICO-workshops lies in the discussions.
  9. The students just started their study. They’re mostly teens. These kids will have a completely other attitude after 4 years (no longer yelling, joking, mailing, Facebook-ing, or at least they are likely to stop after you ask).
  10. Education is something I did by chance. I just do it “in addition to my normal work”, i.e. in the same time.
  11. Even more important, I’m a beginner and have had no specific training. So I have to learn it the hard way.

Let me give some examples.

This year I wanted to update one of my modules. I had to, because practically all interfaces have changed the last two years (Think about PubMed for instance).

I made an appointment with the education department, because they had helped me enormously before.

Firstly I noticed that my name had been replaced by those of 3 people who hadn’t done anything (at least with regard to this particular e-learning course). Perhaps not so relevant here. But the first red flag…

The module was moved to another system. It looked much nicer, but apparently only allowed a few of those 10 types of questions. The drag and drop questions, I was so fond of, were replaced by irritating drop down menus. With the questions I made, it didn’t make sense.

The movies couldn’t be plaid fast forward, back or be stopped.

And the girl who I spoke to, a medical student herself, couldn’t disguise her dislike of the movies. First she didn’t like the call-outs and highlight boxes, she rather liked a voice (me speaking, deleting the laborious call-outs ?!). Then she said the videos were endless and it was nicer when the students could try it themselves (which was in fact the assignment). She ignored my suggestion that Adobe is suitable for virtual online training.

Then someone next to her said: Do you know “Snag-it”, you can make movies with that too!?

Do I know Snag-it? Yes I do. I even bought it for my home computer. But Snag-it is nowhere near Adobe Captivate, at least regarding call-outs and assembly. I almost mentioned Camtasia, which is from the same company as Snag-it, but more suitable for this job.

Then the girl said the movies were only meant to show “where to press the buttons”, which I repeatedly denied: those movies were meant to highlight the value of the various sources. She also suggested that I should do some usability testing, not on my colleagues, but on the students.

Funny how insights can change over times. The one who helped me considered it one of the best tutorials.

While talking to her, it stroke me that the movies were taking very long and I wondered whether each single call-out saying “press this” was functional. Perhaps she was right in a way. Perhaps some movies should be changed into plain screenshots (which I had tried to avoid, because they were so annoying Powerpoint like). If my aim wasn’t that students learned which button to press, why show it all the time?? (perhaps because Adobe shows every mouse click, it is so easy to keep it in..)

It is a long way to develop something that is educative, effective and not boring….

But little by little we can make things better.

Last year one of the coordinators proposed not to take an exam the first year but give an assignment. The students had to search for an original study on a topic in PubMed (2nd semester) and write a summary about it (3rd semester). The PubMed tutorial became compulsory, but the two Q & A sessions (with computers) were voluntary. Half of the students came to those sessions. And the atmosphere was very good. Most students really wanted to find a good study (you could only claim an article once). Some fished whether the answers were worth the full 4 points and what they had to do to get it. The quality of the searches and the general approach were quite good.

In good spirits I will start with updating the other modules. The first should be finished in a few days. That is… if they didn’t move this module to the next semester, as the catalog indicates.

That would be a shame, because then I have to change all the cardiology examples into pulmonology examples.

Gosh!…. No!!

Credits

The title is inspired by the  post “How to become a big e-learning nerd by mistake”.
Thanks to Annemarie Cunningham (@amcunningham on Twitter) for alerting me to it.

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May I Introduce to you: a New Name for the MedLibs Round….

30 09 2010

A couple of weeks or even months ago I asked you to vote for a new name for the MedLibs Round, a blog carnival about medical information.

The decision was clear.

Hurray!

And the winner is……

Drumroll….

Medical Information Matters!

…………………

I’m very pleased with the results because the name reflects that the blog carnival is about medical information and is not purely a carnival for medical librarians.

I hope that Robin of Survive the Journey is still willing and able to make the logo for Medical Information Matters.

Well it will not be long for Medical Information Matters will be “inaugurated”.
We won’t restart the counting. So it will be Medical Information Matters 2.8

There are only a few days left from submitting.
Daniel Hooker at Danielhooker.com: Health libraries, Medicine and the Web is eagerly awaiting your submissions.

You can submit the URL of your post HERE at the Blog Carnival.

Daniel at his call for submissions post:

I’d love to see posts on new things you’re trying out this year: new projects, teaching sessions, innovative services. Maybe it’s something tried and true that you’d like to reflect on. And this goes for anyone starting out fresh this term, not just librarians! We should all be brimming with enthusiasm; the doldrums of winter have yet to set in. If you can find the time to reflect and even just write up your busy workday, I’ll do my best to weave them all together. I, for one, hope to describe some of the projects that I’m involved with at my new workplace. But remember, this “theme” is only a suggestion, we’d be happy to see any contributions that you think would be of interest.

Educators, librarians, doctors or scientists please remember: your submission matters…. No interesting blog carnival without your contribution. I’m looking forward to the next MedLibs round, the first Medical Information Matters Edition (it is a mouth full isn’t it?)

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The University Library (UBA) goes Mobile.

4 04 2010
UBA mobielOur Medical Library at the AMC hospital is one of main (autonomous) libraries of the UBA, the University Library of the University of Amsterdam.

The UBA developed the Spoetnik (library 23 things-like) course -inspiring the start of this blog-, has a library-coach with chat function, a library blog (UBA-e), and is now on Twitter as @bibliotheekuva.
Plus, as I just learned, a small team of the UBA recently launched a mobile version of the library website.

I like their approach. This team consisting of Driek Heesakkers (project leader), Lukas Koster, Gre Ootjers, Roxana Popistasu en Alice Doek, realized this “perpetual beta version” in no more than 7 weeks (from first meeting till launch at April 1st). There aim was not to strive for perfection, but to develop a version first and to learn from their mistakes and the feedback from the users. Thus highly interactive.

Another excellent principle was that they designed ONE mobile app for all smart phones.

This is what UBA mobile offers right now:

  • The library catalog (searching; reserve items; renew loans)
  • Opening hours and addresses of library locations
  • Locations (on a map)
  • Contact phone numbers
  • Questions, feedback
  • News via @bibliotheekuva-tweets

The most important feature, full access to the digital library (with link to all subscriptions) is not yet realized.

I hope our medical library will follow this shining example. Many medical students and doctors use smart-phones and I’m sure a digital version of our medical library website would surely be appreciated by our clients.

Mobile is the future. What do you think?

Below a short and clear presentation by Lukas Koster at UGUL (UGame ULearn) 2010.

The web address of the mobile site is: http://cf.uba.uva.nl/mobiel.

Short notice about UBA mobile at the news section of the UBA.

Janneke Staaks (librarian for: Psychology, Cultural Anthropology and Pedagogical and Educational Sciences) has dealt more in depth with this subject. See this post at her (Dutch) blog FMG Library.





A Spooktacular Medlibs Round at Alisha764′s blog

17 10 2009

sunflower_looking_off_to_the_side alishaWhile I was attending the Cochrane Colloquium, Alisha Miles of Alisha’s blog wrote a really spectacular spooktacular Medlib’s Round, the blog carnival of *best* posts in the medical library blogosphere.

The official round comes with a whole bunch of bonus posts. Subjects included range from wikis to toolbar widgets, from unprofessional online content by medical students to H1N1-information, from the MidWest Medical Library Conference to social media (Side Wiki, Google Wave etc). As expected there are also many posts about the PubMed Redesign.

Interested? Please take a look at the spooktacular Medlibs Round here.

It is really incredible that so many posts were submitted in just 2 weeks and Alisha managed to include so many more.

Other good news about the round: we’ve got excellent hosts till April 2010! Really all sorts of *TOP* bloggers: (medical) librarians, a scientist, a physician and a Pubmed-3rd party host:

If you would like a host the MedLib’s Round please comment on this post, dm me at twitter or mail me at :

laika.spoetnik@gmail.com

The submission for each round is due the first Saturday of each month. The next round will already be published in about three weeks. Walter Jessen of Highlight Health looks forward to your posts. The main theme of the round will be:

Finding credible health information online

Other blogposts -if relevant to the MedLibs Round- will also be considered.

Submitting is easy (thanks Patricia Anderson):

  1. Write (a) blogpost(s) on your blog (or write a guest post on someone else’s blog) as usual.
  2. Pick the post you like that fits.
  3. Go to the blogcarnival submission from here, (register or log in),
  4. Fill in form to share the permalink of your post.
  5. The current host selects anthology of best submissions.
Reblog this post [with Zemanta]




Grand Rounds Vol. 6 No. 2

29 09 2009

grandroundsblank

Welcome to the latest edition of Grand Rounds, the weekly compilation of the best of the medical blogosphere! I presume you would rather take a tour through the Netherlands, visiting windmills and tulips, but we will save this for another time. Right now, let’s take a trip around the library.

Library_book_shelvesBecause you know what William Osler, the Father of Modern Medicine said:
“For the teacher and the worker a great library… is indispensable.
They must know the world’s best work and know it at once. They mint and make current coin the ore so widely scattered in journals, transactions and monographs.”
- William Osler, in Books and Men, in Aequanimitas, 210.

( Thanks to Chris alias @precordialthump for this quote, as a response to a Medical Librarian Round I just finished).

Although books are the library brand, libraries -including medical libraries- have been changing dramatically from book shelves to learning centers, print storage to digital storage, from loaning at the desk to loading from the web, from catalog-centered to database searching and education.PAR-TIC-I-PA-TION, or 37 pieces of library fla...

Well librarians adapt as well. We are also Internet-dependent.
Now let me take you by the hand and lets go through the first steps of searching.
Of course, if you have no time for this guided tour, feel free to skip the introductory sentences and read the posts that have been submitted to this round…

Readers of this blog know that I mostly search for Systematic Reviews and Evidence Based Guidelines. Although not really applicable to the submitted posts, I will briefly mention the way such subjects could have been structured for a search.

We don’t search for this…

73655708_366cd3c35b horses made of stoneOn most occasions there is no need to look up literature. A patient needs empathy of the ones he/she loves, wants to be well informed by ready-to-use and understandable information, needs to be in the hands of a skillful doctor and is happy with some useful tips. For a doctor experience and (social and technical) skills are a prerequisite.

The National Invisible Chronic Illness Awareness Week is held annually in September. The “How to cope with pain blog” gives  10 tips to make your invisible illness visible. This post proposes ways to educate others, decrease isolation and stigma, and allow others to help, when you have an invisible illness such as pain.

Jolie Bookspan of the “The Fitness Fixer” shows a simple mechanical stretching technique that can be applied by a partner to ease symptoms of menstrual cramps.

Moving books or whole labs requires some effort. But how much more effort does it take to move to a new children’s hospital, and at Christmas-time? Beth (Elizabeth Nelsen) of  “Not Terribly Ordinary” wrote down her thoughts on the night before the move.

Ramona Bates at “Suture for a Living” writes down her thoughts on the increase of suicides in ‘our soldiers’ and the way to prevent this. Thoughts that were generated by events close to her heart. A sad subject, but beautifully written.

Background  questions.

Foreground BackgroundThere’s a distinction between background and foreground questions. A background question asks for general knowledge or “facts” (questions often starting with who, what, when, why, which). “What is type 2 diabetes?” “How can one  diagnose appendicitis?” “Which treatments are available for advanced prostate cancer?”  These questions can be best answered by books, databases like UpToDate and good quality websites. The novice in a field usually has more background questions than the expert.

More and more doctors use the Internet to quickly access or to keep abreast of new information. “Clinical Cases and Images Blog” describes how doctors can add expert insights and comments about websites in the recently launched Google Sidewiki.

Books are good for background questions, and are especially useful if they debunk long existing myths. Amy Tenderich at “Diabetes Mine” describes one such book, “Diabetes Rising”. She received this book (coming out in 2010) as an advance review copy and simply could not put it down. Read her review of the book and an overview of some of the diabetes-causes-and-cure-myths here.

An excellent review allowing the readers to get good background knowledge about antiplatelet agents is offered by Flavio Guzman at “Pharmamotion”. His post gives an overview on the currently used agents in clinical practice, their classification, mechanisms of action and therapeutic use. It includes charts, figures and a video that reviews the most relevant aspects of antiplatelet therapy.

Foreground  questions: Domain Therapy2463850234_6a9851b622

Foreground questions ask specific clinical questions that try to find relationships between a patient and their condition, an exposure (therapeutic, diagnostic), and an outcome. They are generally very detailed questions that can best be answered with the information contained in published research studies (website UMDJ) or syntheses therof.
Foreground Questions are usually structured in 5 parts: P I C O and domain (or study type) and are answered by searching for the best available evidence.

The most common domain is Therapy/Prevention. The PICO stands here for Patient/Population/Problem, Intervention, Comparison/Control and Outcome

When looking for the best evidence one searches for a few (not all) components and for the best study design, in the case of therapy: controlled clinical trials in the first place and -if not found- for cohort and case control studies.

104311636_d8f2be6a7e P wit zwart“P” is definitively the most important letter in the PICO. It is the person suffering from a disease, the patient one desires to cure, the problem a doctor wants to solve. All health care should be ‘about them’: Patients.

The patient-centered and sympathetic Rob Lamberts (alias Dr. Rob) of “Musings of a Distractible Mind” muses about The Medically Homeless. He summarizes his post as follows: There’s much ado about the quality of medical care and the plight of the patient in all of this (it’s about them, remember?), but what’s the central problem? In this post I put forth the concept of “Medical Homelessness,” which is a description of the patient who doesn’t have any one place where things are in order. Data is scattered all over the place and confusion comes at a high cost. Why does this happen? What can be done about it?

The number of people affected by Alzheimer’s is growing at a rapid rate, and the increasing personal costs will have significant impact on the world’s economies and health care systems, according a new report on Alzheimer’s predicted rates. Alvaro Fernandez at “Sharp Brains” thinks that this report should act as wake-up calls for healthcare systems to focus on education & risk reduction initiatives and shares the main recommendations from an upcoming report prepared for the City of San Francisco. Recommendations include risk reduction (promote cognitive health and create a culture of “brain fitness” through mental stimulation, social engagement, physical exercise, and diet, early identification of dementia and ensuring that caregivers are aware of and have access to community resources, training and support.

247846944_a24020fa54 LETTER I “I” is also an important component of the PICO. In case of a therapeutic or preventive question the I stands for Intervention.

Dr Shock, a psychiatrist from the Netherlands has an outstanding blog with the electrifying name “Dr Shock MD”. With respect to interventions, the emphasis is not only on electroconvulsive therapy, but also on sex, drugs and….. chocolate! Which may or may not be typically Dutch. It should be noted, however, that the large number of posts mentioning a positive effect of chocolate, may imply a positive publication bias towards chocolate in favor of “good” results.  Last week he claimed that  Chocolate Saves Your Teeth, but his current submission is about the strong reverse association between (one year) chocolate consumption and cardiac mortality after a first acute myocardial infarction. It should be noted that this was a retrospective study, thus the evidence is much less convincing than would be obtained by  long-term, randomized controlled trials.

Another post about nutrition, but more about the direct “Special Nutrition Needs for the Rescued (and the Rescuer!)” can be found at the “Medicine for the Outdoors blog”. Here, Paul Auerbach summarizes the key points from a presentation given at the Wilderness Medical Society Annual Meeting. The medical and psychological importance of providing proper nourishment to rescued individuals is of utmost importance.

I don’t know whether it is our (Dutch) reputation, but there were (relatively speaking) an awful lot of sex-related submissions: almost 15%…
First Daryl Rosenbaum at “Listed as Probable” looks at the pros and cons of “sex before the match”, as has been advocated by the coach of India’s cricket team; the coach tells his players to have more sex in order to improve performance on the field. But is this really the case? Well everything preceded by “too” is “too much”, my mother used to say…

Dr. Val at “Better Health” is wondering whether Francis Collins, former director of the Human Genome Project and new director of the NIH is “bringing sexy back to science” In an age where celebrities are treated as credible sources of health information, scientists need to find a way to communicate with the public in a new and more engaging way. Collins, has started a new initiative called “Rock Stars of Science” to promote the field, protect people from misinformation, and get the public excited about science again.  “Whatever works”, dr Val concludes.

The “UN Guidelines for Sex Education” are stirring opposition (before they are even published) from conservative and religious groups who are attacking the guidelines because of their portrayal of issues like sex education, abortion and homosexuality. Nancy Brown of “Teen Health 411″ mentions 9 convincing reasons why these guidelines should not be blocked. Nancy concludes with: “Need I see more?” No, you don’t Nancy.

477120721_db7f83921f CMost intervention studies compare an “I” with a “C”, Comparison or Control. Preferably efficacy should be tested in a randomized controlled trial (RCT), which has the least form of bias if well performed.

Only one submitted post presents evidence that has been gathered through an RCT. Faith Martin of “Highlight Health” highlights a recent RCT published in the journal Health Technology Assessment (HTA). Results of this non-inferiority trial showed that home-based care in the United Kingdom is no worse than attendance at a day hospital for older adults. Surprisingly, the cost of the home-based rehabilitation provision was not significantly different to that of day hospital rehabilitation, Indeed, given there is no difference found in outcomes or costs, patients could potentially be given the choice.249722873_1b417cdb3a blauwe O

The “O” in interventions is the outcome. It is important to look for outcomes that matter most to the patients and not for surrogate markers.

Once it has been established that a treatment is effective it is important that there is compliance and the patients know “what to do”. With two videos “Allergynotes” shows how MDIs, Spacers, and Dry Powder Inhalers should and should not be used. Patients often use them wrong.

It is in itself not enough to show the effectiveness of an interventions Costs aspects also come into play, politics, insurances, and decision support systems. The following 3 posts kinda fit in this subject. Since my knowledge of these US-specific subjects is poor I will stick to the descriptions given.

Elyse Nielsen at “Anticlue” wrote “Using Rules to support clinical decisions. “It is all about using the CDS 5 rights model to plan to have the right rule based support in the right place in the systems.”

“InsureBlog”‘s Henry Stern makes the case that CMS (The Centers for Medicare & Medicaid Services) overstepped its bounds by slapping down Humana’s efforts to educate its policyholders.

Jeffrey Seguritan at “Nuts for Healthcare” writes about the Baucus bill. The Baucus bill being considered in the Senate Finance Committee is depending on an excise tax on high-end (“Cadillac”) plans as the biggest revenue driver for reform. While President Obama and health economists agree that this tax discourages wasteful health spending, many Democrats are pointing out how the tax would easily hit the middle-class. According to Jeffrey, this issue touches on the greater problem of our highly regressive and unfair tax subsidy on health benefits.

Domain Diagnosis

733162553_d694bb56d0 diagnosisIn EBM, diagnosis studies are mostly diagnostic accuracy study: one wants to know how good a test can predict or exclude a suspected disease. No examples of diagnostic accuracy studies here, but two examples of when diagnostic tests should be applied or not.

At “Life in the Fast Lane” Toxicology Conundrum 018 (written by Chris Nickson) deals with the myth that “necrotizing arachnidism” can be caused by a spider bite of white-tailed spiders. A wrong diagnosis (i.e. a patient thinking a nasty sore is due to a spider bite) may lead to other disorders, often infections or cancers, being mistreated.  One of the embedded videos is typical of the misinformation about white-tailed spiders in Australia (presented by an exported Dutchman no less!).

Bongi feels bad about the time when a registar “forced” him and another fourth year medical student to perform a useless “diagnostic test” on a stillborn baby just as a precautionary measure against the anticipated rage of her professor at handover: “you!” she indicated my friend and i, “you are going to go down to the morgue and get that baby’s blood. and you’d better move it. the sun will be up soon.”
Soon the juniors found out that sampling of blood from a dead baby is not that easy. A very morbid story indeed.
The best description is given by Bongi in South-African – a language I can understand (thanks Bongi):
“dis ‘n storie van die ou dae tydens my mediese opleiding to iets gebeur het met ‘n oorlede baba wat nooit moes gebeur nie.
ek is ‘n chirurg in nelspruit in suid afrika. die spesifieke ervarings van hierdie deel van die wereld voorsien baie interessante stories.”
(inderdaad)
Please read the entire story (in English) at “Other Things Amanzi”.

Domain: Etiology/Harm

3880192862_6d0f931e64 HARMOtherwise than regularly suggested the best evidence of harm or causality is often not provided by RCT’s, but by observational studies (preferably prospective cohort studies).  RCT’s are either not ethical, or are not suited to detect rare or late harmful effects. The same is true for the domain prognosis, which studies the influence of prognostic factors in the natural course of disease

Other than with interventions the Outcome in this domain is the disease and the P is the population. The I is the causative factor.

Although  “causation” can seldom be demonstrated by controlled clinical trials, care must be taken that any conclusions are based on sound observational studies. Anne Marie Cunningham, a doctor from the UK with interest in the use of social media and technology in education wondered whether a news article on the BBC with the Headline “Tech addiction ‘harms learning’” was based on good evidence. Downloading (at $24.99) and reading the report confirmed her suspicions that the BBC-conclusion about the relationship between Internet and mobile phone addiction and poor learning was based on poor science. Read the details on her blog “Wishful Thinking in Medical Education”.

Sometimes new studies reveal that causes are different than thought. The failure of the U.S. to match longevity statistics of other developed countries is well-known, but Stacey Butterfield of the “ACP Internist blog” points at a study of the demographer Dr. Preston (reviewed in a column in the New York Times) that offers a different explanation for the gap. Stacey explains: “To put it simply, the study shows that it is lifestyle (particularly smoking) that sets Americans apart from other countries, not the quality of the health care. Other researchers have calculated that if deaths due to smoking were excluded, the United States would rise to the top half of the longevity rankings for developed countries. However, the good news is that many Americans have quit smoking in the past decade, so we should be seeing continuing gains in health. The bad news is that we’re working hard to make up the difference by getting fatter.”

Indeed obesity is becoming a pandemic. Astoundingly, WHO figures from 2005 suggested that there are more people suffering from overweight-related problems than malnutrition. David Bradley Science Writer based in Cambridge, UK, reviews  a recent study on his blog  “ScienceBase” showing evidence from the UK with respect to the effects of current dietary trends and consumption patterns on health. Although the rewards of developing a safe and effective anti-obesity medication will be in the tens of billions of dollars, David regards it “highly unlikely that the growing epidemics of overweight and obesity are to be solved by popping a pill”.

Sometimes harm is caused by mistakes.  In Fertility Clinic Mistake Ends Up Good Toni Brayer of “EverythingHealth” tells about the accidental implantation of an in-vitro embryo into another woman at the clinic. But some lemons can be made into lemonade: the woman with the wrong embryo kept the baby (without demanding custody) and recently gave birth to a healthy baby boy.

Adverse conditions in a patient can result from the activity of physicians. Mostly this will be unintentional, but sometimes “doctors” deem other  factors more important than what is best for the patient. Technology consultant and blogger, Sarah Cortes, went by ambulance to a rural Hospital after she suffered a serious spinal fracture after diving. The hospital staff  intimidated and coerced her into accepting unnecessary reconstructive spinal surgery. Unnecessary, because she was able to swim and thus mobile, after the diving accident.  Sarah thinks that boosting of accreditation was the main motive for the hospital. This story, too, has a happy ending: with the help of Twitter, Sarah was able to leave for Boston, where she was successfully treated without the need for surgery. Without Twitter it might have had a less happy ending. Read her story here at her blog “Security Watch”.

Thoughts about social media and patient safety can also be found on “Florence dot com”, the blog of  Barbara Olson. She wrote the post to suggest that social networking sites can help reveal beliefs, practices, and norms in healthcare systems that undermine patient safety. She noted that these might not be readily visible using more traditional means.

An article in last month’s New England Journal of Medicine documented some disturbingly high exposures of Low-Dose Ionizing Radiation from Medical Imaging Procedures among patients. David Williams has been writing about patients getting too much radiation from diagnostic imaging for years.  At least in the US, patients and physicians have no way of tracking their lifetime dose. At the “Health Business Blog” David applauds a local initiative of a Boston hospital to track radiation exposure. He reasons that Personal Health Records could help keep track and also reduce the need for excessive scans.

Well this concludes the official part of the Grand Rounds. I hope you enjoyed it. Thanks for your submissions.
It was a pleasure reading them, although -I must admit- quite an effort writing them down….

741879088_29d01c359b_m-another-dead-librarian

Acknowledgements

Thanks to Nick Genes for starting the Grand Round and Dr. Val Jones at Better Health and Colin Son at Residency Notes for keeping the carnival up and running.
The Next Round will be hosted by Christian Sinclair, see here for the announcement

Bonus

I asked the contributors to spend one line telling me their thoughts on medical information (MI) and/or medical librarians (ML). Here is a selection of answers (I will leave out too obvious examples of self-promotion). I especially liked that doctors mentioned their own librarian or somebody they knew (i.e. from Twitter). In order of appearance:

Beth (Elizabeth Nelsen) of  “Not Terribly Ordinary”  (ML): They help to bridge the gap between what We (the medical establishment know) and what They (patients and families) should know. Our new hospital will have a family resource center staffed by a medical librarian!

Ramona Bates of “Suture for a Living” (ML): Invaluable

Rob Lamberts at Musings of a Distractible Mind” (MI): chose this post because it focuses on medical information – both that of the patient and the information that informs decisions. The crux of our problem is not a lack of information, it is a lack of organization of the information we have.

Alvaro Fernandez at “Sharp Brains” (ML, MI): libraries overall, and medical libraries in particular, can play a crucial role in educating professionals and lay audiences on the cognitive health implications from growing research on cognitive neuroscience and neuropsychology. In fact, I just gave a talk yesterday at New York Public Library precisely on this topic!

Daryl Rosenbaum at “Listed as Probable” (ML): Don’t have any creative thoughts about medical librarians, just that our department has one that works with us and she is a very valuable resource.

Dr Val at “Better Health” (ML):  they are the unsung guardians of truth in medicine. We need their help to combat the tidal wave of Internet misinformation that is confusing and harming patients everywhere.

Nancy Brown at “Teen Health 411″ (MI): “Teens need adults they can talk with and medically accurate information to facilitate healthy decisions. The habits they start as teens and the choices they make will influence their adult health.”

Jeffrey Seguritan at “Nuts for Healthcare” (ML): With the rise of the Internet as the premier information portal, medical librarians are essential in helping providers navigate through sources of information that are accurate and credible. An alarming poll this year suggested that 50% doctors use Wikipedia, not the authority patients are looking for.

Chris Nickson at “Life in the Fast Lane” (ML): Well, as you well know, we love medical librarians – especially the helpful tech-savvy ones that populate the Web!

AnneMarie Cunningham at “Wishful Thinking in Medical Education” (MI): We have more publications (journals, guidelines and user-generated content) than ever but still many of those searching (clinicians and patients) can not find what they want or need. That is the challenge. Hopefully as time passes it will feel as if we are getting closer to the solution

David Bradley at “ScienceBase” (ML): Medical, and subject specialist, librarians in general now play an even more critical role in helping their “customers” keep on top of the vast quantities of information available to them. Thankfully, there are some around who are quite expert and can pin down even the rarest of information beasts.

Barbara L. Olson at “Florence dot com” (ML): I recently compiled a list of tweeps people interested in patient safety should watch on Twitter I’ve been following Sarah Vogel @sevinfo (Pharma/Biotech information researcher, librarian) for awhile and included her.

David E. Williams at the “Health Business Blog” (MI, ML): Providing information at the point of care is critical to improving quality and reducing costs. Medical librarians can help clinicians learn to access and apply these tools

Several contributors spontaneously said that they were going to, loved or had happily lived in The Netherlands. Amy even had a baby while over here!

Interview will appear at http://www.medscape.com/index/section_2624_0

Image Credits (CC-licence)

  1. Library Book Shelves, Wikimedia
  2. PAR-TIC-I-PA-TION, or 37 pieces of library flair Flickr.com: trucolorsfly-611479605
  3. Stone Horses: Flickr.com: automania-73655708
  4. The Background/Foreground picture is used everywhere, I’ve adapted it from the excellent book: Guyatt G, Rennie D, Meade M, Cook D. JAMA Evidence Users’ Guides to the Medical Literature. A Manual for Evidence-Based Clinical Practice. 2nd ed. Chicago, IL: McGraw Hill Co; 2008.
  5. Dolk-Banana Therapy Flickr.com: imagesniper- 2463850234
  6. P Flickr.com:duncan-104311636
  7. I [Aye-Aye] Flickr.com: urbanmkr-247846944
  8. C Flickr: urbanmkr-477120721
  9. O Flickr: urbanmkr-249722873
  10. Stethoscope Flickr: ponyapprehension-733162553
  11. An Honest Question Flickr: photos/hryckowian/3880192862/
  12. Another Dead Librarian by Doug! Flickr.com: librarygeek- 741879088

You might also like:

Dear Laika,This is my suggestion for Grand Rounds:Doctors add expert insights and comments about websites in Google Sidewiki
http://casesblog.blogspot.com/2009/09/doctors-add-expert-insights-and.htmlAlternative:Myths About Health Care Around the World
http://casesblog.blogspot.com/2009/09/myths-about-health-care-around-world.htmlLooking forward to Grand Rounds on Tuesday,
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Beware of Top 50 “Great Tools to Double Check your Doctor” or whatever Lists.

1 09 2009

Just the other week I wrote a post “Vanity is the Quicksand of Reasoning: Beware of Top 100 and 50 lists!”

In short this post describes that (some) Top 100 etc lists may not be as useful or innocent as they seem. Some of these lists are created by real scam-sites, who’s only goal is to make money via click-troughs and to get as much traffic as possible, via YOU (and me)!

The scam appears in many guises.

  1. As submissions for a  blog carnival, i.e. 100-weight-loss-tips-tricks.
  2. An offer of a health care student who asks you to do a guest post (you only have to link back to his/her site).
  3. In the form of a mail, dropping you a quick line that you’re included in a top 100 list, possibly worth mentioning to your audience.
  4. You just noticed a top 100 list with excellent sites, worth mentioning on Twitter or Friendfeed, so your followers become aware of the sites and pass the message.

The first two are pretty obvious scam. The latter two are more difficult to see through.

Why do I write another post? Because it happened again, today. And I think I should bring the message home more clearly.

Below you see what happens. Berci has found a list with 50 great tools to “Double check your Doctor”. He tweets the link to what he considers a great resource list, and in no time the message and the link are tweeted several times. Some people also post a link on their blog.

  1. Bertalan Meskó
    Berci 50 Great Tools to Double Check Your Doctor http://ff.im/-7q7DA
  2. Liza Sisler
    lizasisler Good resource list RT @Berci 50 Great Tools to Double Check Your Doctor http://ff.im/-7q7DA
  3. Bart Collet
    bart RT @Berci: 50 Great Tools to Double Check Your Doctor http://ff.im/-7q7DA
  4. Guy Therrien
    gtherrien RT @bart: 50 Great Tools to Double Check Your Doctor – Online Nursing Classes http://ff.im/-7q9pK
  5. zorgbeheer
    zorgbeheer DELI 50 Great Tools to Double Check Your Doctor – Online Nursing Classes: You probably know that Googling yo.. http://bit.ly/n1NXc
  6. ekettell
    ekettell RT@Berci 50 Great Tools to Double Check Your Doctor http://ff.im/-7q7DA
  7. Robert L. Oakes
    RobertLOakes RT @Berci: 50 Great Tools to Double Check Your Doctor http://ff.im/-7q7DA (via @ahier)
  8. dr. Horváth Tamás
    ENTHouse RT @Berci 50 Great Tools to Double Check Your Doctor http://ff.im/-7q7DA
  9. Sagar Satapathy
    sagar13d 50 Great Tools to Double Check Your Doctor. URL: http://tinyurl.com/mlmf47

this quote was brought to you by quoteurl

Finally this will result in more traffic to the website onlinenursingclasses and a higher rank in Google.

Indeed 12 hours after Berci’s tweet, searching for “50 Great Tools to Double Check Your Doctor” (between quotes) gives just 21 hits (similar hits not shown), many of which can be traced back to the twitter posts.
All but one are positive: the last hit is my warning, which was only received by ahier and TheSofa. Ahier deleted his original positive tweet from Twitter.

Also worrying is that the spam site was bookmarked by various Stumble upon visitors. And that the one person that made the Stumble upon review also “liked” similar sites, like Online Classes and Learn Gasms. So probably a whole team takes care that the site is socially bookmarked. When several people “like” a site others may be attracted to the site as well. That is the principle of social bookmarking sites. And you and I do the rest….

1-9-2009 0-55-13 Google results 50 great tools

Why is this bad? You can read more in my previous post or in the post “Affiliate sites” at Ellie <3 Libraries.
In addition, Shamsha brought another post to my attention, again from a librarian:

Top 100 Librarian Friendfeeds to follow at cheapie online degrees com at Tame the Web.com.

which refers to

http://www.librarian.net/stax/2970/why-i-dont-accept-guest-posts-from-spammers-or-link-to-them/

Tame the web gives some very good advice

I sometimes see other libloggers linking to sites like these and I have a word of advice: don’t. When we link to low-content sites from our high-content sites, we are telling Google and everyone that we think that the site we are linking to is in some way authoritative, even if we’re saying they’re dirty scammers. We’re helping their page rank and we’re slowly, infinitesimally almost, decreasing the value of Google and polluting the Internet pool in which we frequently swim. Don’t link to spammers.

How do you know that you can’t trust that particular site?

Well here are some features I’ve noticed (for the spam sites in “my”field)

  • All the sites that publicized such list were educational, mostly directed at nurses or other health practitioners. Some even end at org. Examples:
    • nursingschools.net
    • associatedegree.org
    • rncentral.com
    • Learn-gasm
    • onlineclasses.org
    • onlinenursepractitionerschools.com
    • searchenginecollege.com
    • collegedegree.com
    • ultrasoundtechnicianschools.org
    • phlebotomytechnicianschools.com
    • MiracleFruitPlus.com.
  • All sites have a Quick-degree, nursing degree, technician school etc finder. Mostly it is the only information at the ABOUT-section (?!)
  • The home page often contains prominent links (clicks) to Kaplan University, University of Phoenix, Grand Canyon University, and/or others.
  • People behind the site often approach you actively (below are some examples) to gain your interest.
  • It is unclear how the lists are made and who is behind it.
  • There is no real information, only lists and degree finders.

So spread the word! Be careful with those list. DON’T LINK TO THEM! And if you see a possible interesting list, first CHECK the site: WHO, WHY, WHAT, WHERE AND WHEN. Once you’ve seen one, you’ve seen them all!

31-8-2009 21-23-07 online nursing

The degree finder at the about page

1-9-2009 1-32-11 about 100 list

Prominent links to some Universities

1-9-2009 2-30-23 universities online nursing

An example of a letter drawing your attention to a list

1-9-2009 2-56-49 hi we just posted an articleAn example of a letter asking to write a guest post.

31-8-2009 23-56-03 guest post

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

26 08 2009

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?

25-8-2009 13-32-32 shamsha

25-8-2009 17-40-09 bitethedust

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:

25-8-2009 14-31-57 aarontay 3 lists

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)


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