Collaborating and Delivering Literature Search Results to Clinical Teams Using Web 2.0 Tools

8 08 2010

ResearchBlogging.orgThere seem to be two camps in the library, the medical and many other worlds: those who embrace Web 2.0, because they consider it useful for their practice and those who are unaware of Web 2.0 or think it is just a fad. There are only a few ways the Web 2.0-critical people can be convinced: by arguments (hardly), by studies that show evidence of its usefulness and by examples of what works and what doesn’t work.

The paper of Shamsha Damani and Stephanie Fulton published in the latest Medical Reference Services Quarterly [1] falls in the latter category. Perhaps the name Shamsha Damania rings a bell: she is a prominent twitterer and has written quest posts at this blog on several occasions (here, herehere and here)

As clinical librarians at The University of Texas MD Anderson Cancer Center, Shamsha and Stephanie are immersed in clinical teams and provide evidence-based literature for various institutional clinical algorithms designed for patient care.

These were some of the problems the clinical librarians encountered when sharing the results of their searches with the teams by classic methods (email):

First, team members were from different departments and were dispersed across the sprawling hospital campus. Since the teams did not meet in person very often, it was difficult for the librarians to receive timely feedback on the results of each literature search. Second, results sent from multiple database vendors were either not received or were overlooked by team members. Third, even if users received the bibliography, they still had to manually search for and locate the full text of articles. The librarians also experimented with e-mailing EndNote libraries; however, many users were not familiar with EndNote and did not have the time to learn how to use it. E-mails in general tended to get lost in the shuffle, and librarians often found themselves re-sending e-mails with attachments. Lastly, it was difficult to update the results of a literature search in a consistent manner and obtain meaningful feedback from the entire team.

Therefore, they tried several Web 2.0 tools for sharing search results with their clinical teams.
In their article, the librarians share their experience with the various applications they explored that allowed centralization of the search results, provided easy online access, and enabled collaboration within the group.

Online Reference Management Tools were the librarians’ first choice, since these are specifically designed to help users gather and store references from multiple databases and allow sharing of results. Of the available tools, Refworks was eventually not tested, because it required two sets of usernames and passwords. In contrast, EndNote Web can be accessed from any computer with a username and password. Endnoteweb is suitable for downloading and managing references from multiple databases and for retrieving full text papers as well as  for online collaboration. In theory, that is. In practice, the team members experienced several difficulties: trouble to remember the usernames and passwords, difficulties using the link resolver and navigating to the full text of each article and back to the Endnote homepage. Furthermore, accessing the full text of each article was considered a too laborious process.

Next, free Social bookmarking sites were tested allowing users to bookmark Web sites and articles, to share the bookmarks and to access them from any computer. However, most team members didn’t create an account and could therefore not make use of the collaborative features. The bookmarking sites were deemed ‘‘user-unfriendly’’, because  (1) the overall layout and the presentation of results -with the many links- were experienced as confusing,  (2) sorting possibilities were not suitable for this purpose and (3) it was impossible to search within the abstracts, which were not part of the bookmarked records. This was true both for Delicious and Connotea, even though the latter is more apt for science and medicine, includes bibliographic information and allows import and export of references from other systems. An other drawback was that the librarians needed to bookmark and comment each individual article.

Wikis (PBWorks and SharePoint) appeared most user-friendly, because they were intuitive and easy to use: the librarians had created a shared username and password for the entire team, the wiki was behind the hospital’s firewall (preferred by the team) and the users could access the articles with one click. For the librarians it was labor-consuming as they annotated the bibliographies, published it on the wiki and added persistent links to each article. It is not clear from the article how final reference lists were created by the team afterwards. Probably by cut & paste, because Wikis don’t seem suitable as a Word processor nor  are they suitable for  import and export of references.

Some Remarks

It is informative to read the pros and cons of the various Web 2.0 tools for collaborating and delivering search results. For me, it was even more valuable to read how the research was done. As the authors note (quote):

There is no ‘‘one-size-fits-all’’ approach. Each platform must be tested and evaluated to see how and where it fits within the user’s workflow. When evaluating various Web 2.0 technologies, librarians should try to keep users at the forefront and seek feedback frequently in order to provide better service. Only after months of exploration did the librarians at MD Anderson Cancer Center learn that their users preferred wikis and 1-click access to full-text articles. Librarians were surprised to learn that users did not like the library’s link resolvers and wanted a more direct way to access information.

Indeed, there is no ‘‘one-size-fits-all’’ approach. For that reason too, the results obtained may only apply in certain settings.

I was impressed by the level of involvement of the clinical librarians and the time they put not only in searching, but also in presenting the data, in ranking the references according to study design, publication type, and date and in annotating the references. I hope they prune the results as well, because applying this procedure to 1000 or more references is no kidding. And, although it may be ideal for the library users, not all librarians work like this. I know of no Dutch librarian who does. Because of the workload such a ready made wiki may not be feasible for many librarians .

The librarians starting point was to find an easy and intuitive Web based tool that allowed collaborating and sharing of references.
The emphasis seems more on the sharing, since end-users did not seem to collaborate via the wikis themselves. I also wonder if the simpler and free Google Docs wouldn’t fulfill most of the needs. In addition, some of the tools might have been perceived more useful if users had received some training beforehand.
The training we offer in Reference Manager, is usually sufficient to learn to work efficiently with this quite complex reference manager tool. Of course, desktop software is not suitable for collaboration online (although it could always be easily exported to an easier system), but a short training may take away most of the barriers people feel when using a new tool (and with the advantage that they can use this tool for other purposes).

In short,

Of the Web 2.0 tools tested, wikis were the most intuitive and easy to use tools for collaborating with clinical teams and for delivering the literature search results. Although it is easy to use by end-users, it seems very time-consuming for librarians, who make ready-to-use lists with annotations.

Clinical teams of MD Anderson must be very lucky with their clinical librarians.

Damani S, & Fulton S (2010). Collaborating and delivering literature search results to clinical teams using web 2.0 tools. Medical reference services quarterly, 29 (3), 207-17 PMID: 20677061

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Added: August 9th 2010, 21:30 pm

On basis of the comments below (Annemarie Cunningham) and on Twitter (@Dymphie – here and here (Dutch)) I think it is a good idea to include a figure of one of the published wiki-lists.

It looks beautiful, but -as said- where is the collaborative aspect? Like Dymphie I have the impression that these lists are no different from the “normal” reference lists. Or am I missing something? I also agree with Dymphie that instructing people in Reference Manager may be much more efficient for this purpose.

It is interesting to read Christina Pikas view about this paper. At her blog Christina’s Lis Rant (just moved to the new Scientopia platform) Christina first describes how she delivers her search results to her customers and which platforms she uses for this. Then she shares some thoughts about the paper, like:

  • they (the authors) ruled out RefWorks because it required two sets of logins/passwords – hmm, why not RefWorks with RefShare? Why two sets of passwords?
  • SharePoint wikis suck. I would probably use some other type of web part – even a discussion board entry for each article.
  • they really didn’t use the 2.0 aspects of the 2.0 tools – particularly in the case of the wiki. The most valued aspects were access without a lot of logins and then access to the full text without a lot of clicks.

Like Christina,  I would be interested in hearing other approaches – particularly using newer tools.


MedLibs Round 2.6

11 07 2010

Welcome to this months edition of MedLib’s Round, a blog carnival of “excellent blog posts in the field of medical information”.

This round is a little belated, because of late submissions and my absence earlier this week.
But lets wait no longer …..!

Peer Review, Impact Factors & Conflict of Interest

Walter Jessen at Highlight HEALTH writes about the NIH Peer Review process. Included is an interesting video, that provides an inside look at how scientists from across the US review NIH grant applications for scientific and technical merit. These scientists do seem take their job seriously.

But what about peer review of scientific papers? Richard Smith, doctor, former editor of the BMJ and a proponent of open access publishing, wrote a controversial post at the BMJ Groups Blog called scrap peer review and beware of “top journals. Indeed  the “top journals” publish the sexy stuff, whereas evidence comprises both the glamorous and the unglamorous. But is prepublication peer review really that bad and should we only filter afterwards?

In a thoughtful post at his Nature blog Confessions of a (former) Lab Rat another Richard (Grant) argues that although peer review suffers terribly from several shortcomings it is still required. Richard Grant also clears up one misconception:

Peer review, done properly, might guarantee that work is done correctly and to the best of our ability and best intentions, but it will not tell you if a particular finding is right–that’s the job of other experimenters everywhere; to repeat the experiments and to build on them.

At Scholarly Kitchen (about what is hot and cooking in scholarly publishing) they don’t think peer review is a clear concept, since the list of ingredients differ per journal and article. Read their critical analysis and suggestions for improvement of the standard recipe here.

The science blogosphere was buzzing in outrage about the adding a corporate nutrition blog sponsored by PepsiCo to ScienceBlog (i.e see this post at the Guardian Science Blog). ScienceBlogs is the platform of eminent science bloggers, like OracPharyngula and Molecule of the Day. After some bloggers left ScienceBlog and others threatened to do so, the Pepsico Blog was retracted.

An interesting view is presented by David Crotty at Scholarly Kitchen. He states that it is “hypocritical for ScienceBlog’s bloggers to have objected so strenuously: ScienceBlogs has never been a temple of purity, free of bias or agenda.” Furthermore the bloggers enjoy more traffic and a fee for being a scienceblogger, and promote their “own business” too. David finds it particularly ironic that these complaints come from the science blogosphere, which has regularly been a bastion of support for the post-publication review philosophy. Read more here.

Indeed according to a note of Scienceblog at the disappeared blog their intention was “to engage industry in pursuit of science-driven social change”, although it was clearly not the right way.

The partiality of business, including pharma, makes it’s presence in and use of Social Media somewhat tricky. Still it is important for pharma to get involved in web2.0. Interested in a discussion on this topic? Than follow the tags #HCSM (HealthCare Social Media) and #HCSMEU (Europe) on Twitter.
Andrew Spong, has launched an open wiki, where you can read all about #HCSMEU.

The value of journal impact factors is also debatable. In the third part of the series “Show me the evidence” Kathleen Crea at EBM and Clinical Support Librarians @ UCHC starts with an excerpt of an article with the intriguing title “The Top-Ten in Journal Impact Factor Manipulation”:

The assumption that Impact Factor (IF) is a number absolutely proportional to science quality has led to misuses beyond the index’s original scope, even in the opinion of its devisor.”

The post itself (Teaching & Learning in Medicine, Research Methodology, Biostatistics: Show Me the Evidence (Part 3)b) is not so much about evidence, but offers a wealth of information about  journal impact factors, comparisons of sites for citation analysis, and some educational materials for teaching others about citation analysis. Not only are Journal Citation Reports and SCOPUS discussed, but also the Eigenfactor, h-index and JANE.

Perhaps we need another system of publishing and peer review? Will the future be to publish triplets and peer review these via Twitter by as many reviewers as possible? Read about this proposal of Barend Mons (of the same group that created JANE) at this blog. Here you can also find a critical review of an article comparing Google Scholar and PubMed for retrieving evidence.

Social Media, Blogs & Web 2.0 tools

There are several tools to manage the scientific articles, like CiteULike and Mendeley. At his blog Gobbledygook Martin Fenner discusses the pros and cons of a new web-based tool specifically for discussing papers in Journal Clubs: JournalFire

At the The Health Informaticists they found an interesting new feature of Skype:  screen sharing. Here you can read all about it.

Andrew Sprong explains at his blog STweM how to create a PDF archive of hashtagged tweets using whatthehashtag?! and Google DocsScribd or Slideshare. A tweet archive is very useful in case of  live tweet or stream sessions at conferences. (each tweet is then labeled with a # or hashtag, but tweets are lost after a few days if not archived)

L1010201At Cool Toy of the DayPatricia Anderson posts a lot about healthcare tools. She submitted Cool Toys Pic of the day – Eyewriter“, a tool for allowing persons with ALS and paralysis to draw artwork with their eyes. But you find a lot more readworthy posts at this blog and her main blog Emerging Technologies Librarian.

Heidi Allen at Heidi Allen Digital Strategy started a discussion on the meaning of social-medicine for Physicians. The link to the original submission doesn’t work right now, but if you follow this link you see several posts on social-medicine, including “Physicians in Social Media”, where 3 well-known physicians give their view on the meaning of social-medicine.

Dr Shock at Dr Shock MD PhD, wonders whether “the information on postpartum depression in popular lay magazines correspond to scientific knowledge?” Would it surprise you that this is not the case for many articles on this topic?

The post of Guus van den Brekel at DigiCMB with the inspiring title Discovering new seas of knowledge partly goes about the seas of knowledge gained at the EAHIL2010 (European Association for Health Information and Libraries) meeting, with an overview of many sessions, and materials when possible. And I should stress when possible, because the other  part of the post is about the difficulty of obtaining access to this sea of knowledge. Guus wonders:

In this age of Open Access, web 2.0 and the expectancy of the “users” -being us librarians (…) one would assume that much (if not all) is freely available via Conferences websites and/or social media. Why then do I find it hard to find the extra info about those events, including papers and slides and possibly even webcasts? Are we still not into the share-mode and overprotective to one’s own achievements(….)

Guus makes a good point,especially in this era, when not all of us are able to go and visit far away places. Luckily we have Guus who did a good job of compiling as much material as possible.

Wondering about the evidence for the usefulness of web 2.0, then have a look at this excellent wiki by Dean Giustini:
The Health Librarianship Wiki Canada (the mother wiki) has a great new design and is a very rich source of information for medical librarians.

Another good source for recent peer reviewed papers about using social media in medicine and healthcare is a new series by Bertalan Mesko at Science Roll. First it was called Evidence Based Social Media News and now Social media journal club.

EHR and the clinical librarian.

Nikki Dettmar presents two posts on Electronic Health Records at, inspired by a recent Medical Library Association meeting that included a lot about electronic health records (EHRs). In the first part “Electronic Health Records: Not All About the Machine” she mentions the launch of an OpenNotes study that “evaluates the impact on both patients and physicians of sharing, through online medical record portals, the comments and observations made by physicians after each patient encounter.” The second post is entitled “a snapshot of ephemeral chaos“. And yes the title says it all.

Bertalan Mesko at Science Roll describes a try out of a Cardiology Resident and Research Fellow in Google Wave to see whether that platform is suitable for creating a database of the electronic records of a virtual patient. The database looks fine at first glance, but is it safe?

Alisha764’s Blog celebrated its 1 year anniversary in February. Alisha Miles aim for the next year is to not only post more but to focus on hospital libraries including her experience as a hospital librarian. Excellent idea, Alisha! I liked the post Rounding: A solo medical librarian’s perspective with several practical tips if you join the round as a librarian. I hope you can find time to write more like this, Alisha!

Our next host is Walter Jessen at Highlight HEALTH. You can already start submitting the link to a (relevant) post you have written here.

See the MedLibs Archive for more information.

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