Webicina Presents: PeRSSonalized Medical Librarianship: Selected Blogs, News, Journals and More

13 08 2010

One and a half-year ago I wrote about PeRSSonalized Medicine, developed by Bertalan Mesko or Berci. It is part of Webicina, which “aims to help physicians and other healthcare people to enter the web 2.0 era with quality medical information and selected online medical resources”.

The RSS in PeRSSonalized Medicine stands for Real Simple Syndication, which is a format for delivering regularly changing web content, i.e. from Journals. However, if you use PeRSSonalized Medicine, you don’t need to have a clue what RSS is all about. It is easy to use and you can personalize it (hence the name)

In the previous post I discussed several alternatives of PeRSSonalized Medicine. You can never tell how a new idea, or project or a new business will develop. We have seen Clinical Reader come and disappear. PeRSSonalized Medicine however really boomed. Why? Because it is free, because it has an altruistic goal (facilitate instead of earning money), because users are involved in the development and because it keeps evolving on basis of feedback.

PeRSSonalized Medicine develops fast. There is not a week that I don’t see a new section: Nephrology, Genetics, Diabetes whatever.

And this week tada tada tada … it is the turn of the Medical Librarianship, with Journals, Blogs, News and Web 2.0 tools. Please have a look yourself. You can personalize it at wish, and if you miss something, please mail to Webicina.

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MedLibs Round: Update & Call for Submissions June 2010

4 06 2010

In the past months we had some excellent hosts of the round, really “la crème de la crème” of the medical information/libarary blogosphere:

2010 was heralded by Dr Shock MD PhD, followed by Emerging Technologies Librarian (@pfanderson) The Krafty Librarian (@krafty) and @Eagledawg (Nikki Dettmar).

Nikki  hosted the round for a second time, but now on her new blog: Eagledawg.net. The title: E(Patients)-I(Pad)-O(pportunities):Medlibs Round

Last Month the round was hosted by Danni (Danni4info) at The Health Informaticist, my favorite English EBM-library blog. It is a great round again, about “dealing with PubMed trending analysis, liability in information provision, the ‘splinternet’, a search engine optimisation (SEO) teaser from CILIP’s fresh off the presses Update magazine, and more. Missed it? You can read it here.

And now we have a few days left to submit our posts for the Next MedLibs Round, hosted by yet another excellent EBM/librarian blogger: @creaky at EBM and Clinical Support Librarians@UCHC.

She would like posts about “Reference Questions (or People) I Won’t Forget” (thus “memorable” encounters that took place in a public service/reference desk setting, over your career) or “how the library/librarian” has helped you.
But as always other relevant and good quality posts related to medical information and medical librarianship will also be considered.

For more details see the (2nd!) Call for submissions post at EBM and Clinical Support Librarians@UCHC

I am sure you all have a story to tell. So please share it with @creaky and us!

As always, you can submit the permalink (URL) (of your post(s) on your blog) here.

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I would also like to take the opportunity to ask if there are any med- or medlib-bloggers out there who would like to host the MEDLIBS round August, September, October.

The MEDLIBs Round is still called the MedLibs round because I got too little response (6 votes including mine) to the poll with other name suggestions. Neither did I get any suggestions regarding the design of the MEDLIBS-logo, Robin of Survive the Journey has offered to make [for details see request here]. I hope you will take the time to fill in the poll below, and to think about any suggestions for a logo. Thanks!

@ links to the twitteraccounts





Medlibs Round 1.9 – Call for Submissions

30 11 2009

The MedLib’s Round Blog Carnival is a monthly blog carnival that showcases excellent posts in medical librarianship. The  carnival is not restricted to librarians – anyone can submit as long as the post is relevant and of good quality. If you have an article on medical librarianship, PubMed, evidence-based medicine, information literacy or Web 2.0 tools etc., you’re welcome to submit to our next host, Knowledge beyond words. There is no special theme.

If you have no personal blog, be my guest to post an article at this blog.

Please submit your article before December 5th through this form. The MedLib’s Round 1.9 should be available on December 8th.

An archive of all previous editions of MedLibs Round is listed at the MedLib’s Archive on Laika’s MedLibLog.

Are you a Twitter user? Tweet this!

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MedLib’s Round 1.5 at Pharmamotion

5 08 2009

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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Stories 3. Science or Library Work: what is more rewarding?

20 04 2009

2267526122_f4376fc6bfAmy Tenderich of Diabetesmine, will celebrate her birthday at the very same day as she hosts the next Grand Round. She has therefore chosen a very appropriate theme (see announcement):

I’m favoring any and all posts having to do with birthdays and special occasions – or anything that smacks of serendipity, perks, or gifts related to the work you all do.

First of all I would like to congratulate Amy on her birthday.

I have been hesitating whether I should contribute to this round. It is not an easy subject and a bit out of scope. However, thinking about it, many ideas came up and it even became difficult to choose one. But here it is. It is even the first post in a series: STORIES, a selection of personal stories.

Most of you will know that I’m a medical librarian by profession, but a medical biologist by education. Many years I worked as a scientist, with mice, patients, cells, DNA and proteins.3419163183_91968b96d6

I was an avid scientist. My motivation was to unravel mechanisms and understand life. I liked to ask questions: “why is this? why do I find that? how does it work?” The greatest reward you can get is: looking for explanations and finding the answer to a question. Thinking about it and discussing it with others is exciting.The more difficult a question is, the more rewarding it is to find the answer. The gift that science gives you is science itself.

In those twenty years I did have my little successes. I had a press conference at a congress (1) (because it was the only subject that was understandable for the public) and I had two papers that were frequently cited (2).

The finding that gave rise to those two publications was very serendipitous. We found a very tiny band in B cells that were used as a negative (!) control for follicular lymphoma in a PCR for the t(14;18) chromosomal translocation. This translocation is considered the hallmark of this type of B-cell cancer. If this was true, it would mean that the lymphoma-associated t(14;18) involving the BCL2 oncogene could also occur outside the context of malignancy. My task was to prove that this was true. This was not an easy task, because we had to exclude that the tiny bands in the tonsils were due to contamination with exponentially amplified tumor DNA. A lot of tricks were needed to enable direct sequencing of the tonsil DNA to show that each chromosomal breakpoint was unique. To be honest, there were quite some moments of despair and most of the time I believed I was hunting ghosts. Certainly when the first band I sequenced was from a contaminating tumor. But finally we succeeded.

And although science can be very rewarding:

  • Most ideas aren’t that new.
  • There are many dead leads and negative results (see cartoon).
  • Experiments can fail.
  • There is a lot of competition
  • It takes very long before you get results (depending on the type of experiment)
  • It takes even longer before you get enough results to publish
  • It takes still longer before you have written down the first version of the paper
  • … and to wait for the first comments of the co-authors (see cartoon)
  • … and to rewrite the paper and to wait …
  • … and to submit to the journal and wait..
  • … to get the first rejection, because your paper didn’t get a high enough priority
  • and to rewrite, wait for the comments of the co-authors, adapt and submit
  • to be rejected for the second time by referees that don’t understand a bit of your subject or are competitors
  • to rewrite etcetera, till it is accepted…and published
  • to wait till somebody other than you or your co-authors find the paper relevant enough to cite.
  • but most importantly even with very good results that make you feel very happy and content:
    • each answer raises more questions
    • most research, whatever brilliant, is just a drop in the ocean or worse:
    • it gets invalidated

I loved to do research and I loved to be a researcher. However, it is difficult for post-doc to keep finding a job and wait for the contract renewals each year. So almost 4 years ago, just before another renewal of the contract, I was happy to get the opportunity to become a medical librarian at a place not far from where I lived. In fact, after all these years it is my first permanent job.

And it is a far more rewarding job than I ever had before, although perhaps not as challenging as research.

  • Results are more immediate.
  • Answers are clearcut (well mostly)
  • People (doctors, nurses, students) are very happy when you learn them how to search (well generally)
  • they are also happy when you do the search for them
  • or when you help them doing it
  • It is very rewarding to develop courses, to teach, to educate
  • the job has many facets

The rewards can vary from a happy smile, a hand shake and “a thank you” to acknowledgments and even co-authorships in papers. Sometimes I even get tangible presents, like chocolates, cookies, wine or gift tokens.

Last week a patron suddenly said when seeing the presents gathered: “Is it your birthday?”
Presumably it is about time to drink the wine I got.Cheers!

2717145005_0546fa0755

Photo credits (Flickr-CC):





MedLib’s Round 1.3

8 04 2009

The 3rd Medlib’s Round, a blog carnival of medical-library related blogposts, is up at First Person Narrative. Anne Welsh did a great job pulling together an interesting collection of posts.

From Anne’s introduction

This month’s theme was “evidence” – not just in the terms of “Evidence Based Medicine” but in the widest possible sense. Evidence is a hot topic in the UK at the moment – indeed, the National Library for Health (NLH) is to be relaunched at the end of this month as NHS Evidence, “a web-based service that will help people find, access and use high-quality clinical and non-clinical evidence and best practice.”

Please have a look at the First Person Narrative and enjoy reading.

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)

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The Next MedLib’s Round will be hosted by Nicole S. Dettmar at Eagle Dawg Blog. Nikki is a medical librarian at the National Network of Libraries of Medicine (NN/LM). The main theme will be PubMed or 3rd party PubMed tools. Post addressing this subject will get extra emphasis.

You can submit the permalink (url) of the post (you have already written on your blog) at the Blog Carnival submission form (you have to login, scroll down (!), submit links to selected posts and give an optional description). Don’t forget to submit before Saturday May 2, 2009 round midnight (EST)

Perhaps you would like to host a future edition as well. If so, please inform me which edition (June, July or August) you would like to host.

Further Reading:





MedLib’s Round 1.2

11 03 2009

dragonfly

The second Medlib’s Round is up at Dragonfly. This month’s edition of the blog carnival has a loose theme: “enhancing access to health information for health professionals and the public.”

Alison (@aldricham) did a superb job compiling all the submitted post (read them here)

Like the first Medlib’s Round, both medical librarians and doctors (at least 4 MD’s) contributed to the carnival.

I’m not giving anything away, please go to Dragonfly and enjoy reading the carnival.

We hope that you keep contributing to the Medlib’s Round and if you haven’t done so, to give it a try. The more good quality posts, the better.

Submit your blog article (only the link) to the next edition of Medlib’s Round using our carnival submission form. Past posts and future hosts can be found on our blog carnival index page.

The April edition will be hosted by Anne Welsh at First Person Narrative.
Look for it on April 7 or take a subscription to the Medlib’s Round by email or RSS feed.
An aggregated feed of credible, rotating health and medicine blog carnivals is also available (thanks Walter Jessen)





MedLib’s Round, First Edition

13 02 2009

Welcome to the first edition of MedLib’s Round, a blog carnival of the “best blog posts in the field of medical librarianship”.

shht-librarian-costume1Starting a new blog carnival is often difficult. You have to recruit bloggers, who want to participate by submitting blogposts and/or hosting future editions. (see this older post on Scienceroll Thanks @hleman).

I didn’t sound out people to find if they were interested, but just gave it a try. — Therefore, I was very pleased that the idea was so enthusiastically received by many medical librarians ànd physicians from all over the world. Emergency physician Mike Cadogan (@sandnsurf) of Life in the First Lane already added the MedLib’s Round to his listing of Blogs Rankings and Rounds before it had even started.

Blog carnivals are meant to spread the word not only about established, but also about new bloggers. I’m therefore delighted that several librarians were inspired to (re)start blogging.

Shamsha Damani (@shamsha) accepted the invitation to become a guest writer on this blog to be able to submit a post (see below).

Alisha Miles (@alisha764) who start tweeting in Januari started her own blog Alisha 764 with the post “I am a Tree” saying: “I am no longer a mushroom, I am now a tree. Thank you to all of the other librarians’ posts & tweets that inspired me to start this blog.” Which clearly refers to the comment of @sandnsurf to the blogpost “What I learned in 2008 (about Web 2.0)“: “the most important thing is that you are actually a tree in this ecosystem, you are out there experimenting, thinking and trying to drive the revolution further…Most of my colleagues are still mushrooms…

The Pilgrimthinkera librarian explores health literacy, patient education and consumer health issues) even wrote a blogpost entitled “Thank you, Laika, for taking the initiative to start up a MedLib Blog Carnival. It was just the kick in the pants I needed to get back to blogging, with the added promise of some increased interest and posting from everyone.”

Thus apart from being a post-aggregator, a blog carnival can also inspire people with similar interests and connect them. From my own experience I know you can feel lonely as a blogger. So please  take a look at the above mentioned blogs/twitter accounts and help them to flourish into full grown trees, so we can all enjoy their fruits (and vice versa).

AND NOW FOR…..THE FIRST MEDLIB’S ROUND

The MedLib’s Round is about medical librarian stuff. This field is much broader than searching PubMed or interlibrary loaning; it is related to all stages in the publication and medical information cycles (searching, citing, managing, writing, publishing, social networking).

This carnival covers many facets of that cycle.

SEARCHING THE WEB

For medical librarians searching is an important facet of their job. There are different sources to search, including “the World Wide Web” and bibliographic databases like PubMed.

Hope Leman of AltSearchEngines has compiled a list of Top 10 Health Search Engines of 2008. She urges all those interested in medical search to give these tools a spin. Her Top 10 bares great resemblance to the Top 8 Bedside Health Search Engines 2008 of @sandnsurf (Mike Cadogan), indicating that the same engines are appreciated and used by physicians as well.
GoPubMed ranks 2 in both lists. According to Hope “GoPubMed is a useful complement to PubMed proper, particularly to determine who the leading authorities are on particular topics.
For further details on how to use GoPubMed see an earlier post of Mike and several posts of David Rothman (here and here).

On first position in both lists is the federated search engine Mednar. Hope submitted a second post merely devoted to this health search engine: Mednar Search…and Hope said, “It is good.” Well, if Hope, an expert in search engines, recommends Mednar it must be good. According to Hope Mednar is useful for (medical) librarians, as well as busy front-line clinicians and clinical researchers. Its main advantages are its ease of use, its elegant interface and “the access to an array of databases that are simply not mined by other health search engines, also called “The Invisible Web” (gray literature and similar hard-to find content)“. It is an useful complement to PubMed in that there is a shorter lag time before the very latest articles can be found.
Recently others have also reviewed Mednar, including (of course) @sandnsurf , as well as Creaky of EBM and Clinical Support Librarians@UCHC who concluded “I liked the results well-enough, but won’t give up using the precise technical limits and search filters available in PubMed, or the comprehensive, deep searches available by using the 15,000 journals indexed in Scopus”.

SEARCHING PUBMED (and Widgets)

3262152119_a1cc3c28a4-sl-award-guusGuus van den Brekel of DigiCMB , who just won the Alliance Virtual Library Golden Leaf Awards 2009 (Second Life), told me that PubMed is by far the most frequently used search database by the hospital staff and students of the University Medical Center Groningen, where he works. In 2007, EVERY 2 MINS somebody used the Pubmed link, and every 30 seconds somebody clicked the SFX-link resolver in PubMed. Guus believes that such a tool needs to be published to as many platforms as possible, and in any format the patrons would like them. So far a Toolbar, Widget, HTML-box, OpenSearch pretty much covers that wish. The Widgets can be found at PubMed Search & News Widget

PubMed has introduced (or rather continuously introduces) several changes, that have been amply discussed here. Major changes include the Advanced Search, the citation sensor and the way terms typed in the search bar are translated. Non-librarians often don’t know that PubMed automatically maps the words, but the way this is done has changed, i.e. multi-term words are split. In her post Mapping door PubMed, written in Dutch and English, de Bibliotheker shows that this altered mapping can have both unexpected positive and negative effects, and that it is always important to check the Details Tab.

Among the things that Nicole Dettmar (Eagle Dawg) of the Eagle Dawg Blog addresses at her post Eagle Dawg Blog: Hidden in the Bookshelf: PubMed & Discovery Initiative is the new Discovery Initiative of the NCBI, which is an effort to make the full potential of the NCBI Web services and underlying databases more available to users. Nicole gives various interesting links, which will tell you more about the upcoming changes.

MANAGING INFORMATION AND REFERENCES

Like many of her colleagues medical librarian Anne Welsh First Person Narrative noticed clinicians prefer to perform one word Google-style searches (hé, does that sound familiar!). However, realizing that her medical library “expert opinion” was based on nothing more than a series of anecdotes, Anne decided to have a  fish around for research on clinicians’ search strategies and information needs. Curious about the outcome? Then read the summary of the evidence in her well written research blogging post “Limiting the Dataset.

Indeed it is hard to keep up with the literature. Apart from specific (often Google-style searches), most clinicians also try to read a few interesting journals, for instance the BMJ and the Lancet. Instead of going to the library it is also possible to take an email alert or a RSS feed to the journals of your choice. You can generate custom RSS feeds in PubMed for you favorite search and/or Journal, but this is a kind of cumbersome procedure for most people not used to it (see for instance my earlier post in Dutch and this post of David Rothman – a must-read for people not acquainted with the use of RSS for this purpose).
Physician and medicine2.0 pioneer Ves Dimov of the Clinical Cases and Images – Blog has another solution to set up a RSS feed to journals, which I found astonishing simple and pretty awesome, because of the conveniently arrangement of the results. All you need is a free Google account to create Your Own “Medical Journal” with iGoogle Personalized Page. Want to know how it works, then please read his easy-to-follow post, which he has specially updated for this occasion. Ves has also included some ready made RSS feeds of the “Big Five” medical journals (NEJM, JAMA, BMJ, Lancet and Annals) plus 2-3 subspecialty journals as well as several podcasts in iGoogle.

Now, once you have the PDF’s of the papers you like you would like to store them in a handy way. Another physician, the Dutch psychiatrist Dr Shock MD PhD with a very eloguent blog of the same name, explores the use of Mendeley, a free social software for managing and sharing research papers and a Web 2.0 site for discovering research trends and connecting to like-minded academics (see Mendeley Manage Share and Discover Research Papers). Dr. Shock didn’t make up his mind yet whether he prefers Mendeley or Labmeeting (described in another post) as an online library. But offline he uses Sente, which he finds absolutely perfect. A chimera between Sente and one of the other tools would be his ideal management system.

PUBLISHING

Michelle Kraft of The Krafty Librarian was totally blown away by a presentation on Interactive Science Publishing at PSP 2009 Annual Conference (where she also gave a presentation herself). I didn’t know what interactive science publishing really meant, but Michelle can illustrate things so well, that you can readily imagine it all. This was needed as I could not access the examples she referred to without the risk of my computer becoming too slow or worse. But I understand from Michelle that it is a revolutionary new method of viewing online journals, although there are some answers to be addressed as well (see her post)

Imagine having the “PDF” of an article on congenital heart defects and be able to hear the heart sounds plus the video recording of the heart. The video would be more than just a snippet, it would be the entire video sectioned into “chapters” referenced within the various areas of the article. So while you are reading the article you can click on the link within the text referencing the image, sound, etc. and the image immediately jumps to that section the video. Imagine the data behind a large randomized controlled trial available in its entirety to all readers to be manipulated, reused, and viewed.

Another new publishing format is discussed by Shamsha Damani (@shamsha) on this blog (see: “How to make EBM easy to swallow“). Shamsha informs us that the BMJ will be publishing two summaries for each research article published. One called BMJ PICO, prepared by the authors, breaks down the article into the different EBM elements. The other called Short Cuts is written by BMJ itself. Here she hopes BMJ will shine, providing an easy to follow unbiased view of the article. Indeed, it would be very welcomed if more papers were in the ready-appraised-format, similar as found in the ACP-Journal Club. However, in the BMJ, it is the PICO-format written by the authors themselves which has the EBM structure, and is most preferred by the readers. According to some (including me) the Short Cuts are a bit woolly. Or as Shamsha says: “Personally I think it would have been better to have the BMJ reviewers write the PICO format, and do a bit more thorough critiquing”.

SOCIAL MEDIA & NLM, GOVERNMENTAL ORGANIZATIONS AND MEDICAL LIBRARIANS

In the same blogpost as mentioned above @Eagledawg mentions that the recent introduction of the #pubmed tag in Twitter (with the aim that you can later search for messages with this tag, see real time results here) led to various responses, which are not really appreciated as useful by the NLM because of the extreme short length of the tweets (140 characters including tag). It strikes Nicole that the NLM is not present on twitter (in contrast to the FDA and the CDC, also see a post of David Rothman). A good example of how the government could use using social media to respond to citizens is given by Andrew Wilson, a member of the recently introduced social-media team of the Department of Health and Human Service, who responded to the peanut-butter-and-salmonella recall issue on Twitter.

An interview with Andrew Wilson can be found here.
And, by the way The Library of Congres (see Dean Giustini’s blog) and the Cochrane Collaboration have also joined Twitter.

Health 2.0 people are well represented on Twitter. See for instance this list of Twitter Doctors, Medical Students and Medicine-related. made by @medicalstudent There is also a great slideshare presentation of @PhilBaumann on 140 health care uses for Twitter.

But how is Twitter used by medical librarians? David Rothman is not a huge fan of Twitter (he prefers friendfeed), but he does refer to a list of Great & growing resource for libraries/librarians on Twitter!
Dean Giustini
of UBC Academic Search – Google Scholar Blog wonders why there aren’t More Canadian (mapple Leaf) Librarians on Twitter? Well, I don’t know whether this is typical for Canadians, I don’t see many Dutch medical librarians either.
Dean plans to
write something for an upcoming issue of a health library journal about Twitter. Want to have an idea what Twitter is about, please read his short post on Twitter. Already on twitter but looking for twitterers in all the wrong places” than forget one bad idea and follow the half dozen good ideas Patricia gives in her excellent post on Twitter.

And what about the presence of the abovementioned contributors to this first Grand Round? Without exception they are all on Twitter and all but one use it on a regular basis. Now, assuming that most medical librarians aren’t on Twitter, doesn’t tell that something about this group? I wonder if Twitter presence is not the main reason for the swift start of this First MedLib’s Round.

That’s it for this edition.

741879088_29d01c359b_m-another-dead-librarian
I hope you enjoyed this first MedLib’s Round.
I surely enjoyed reading the many interesting and good quality posts that were submitted.

The next round will be hosted by Dragonfly, March 10.
Please submit your
favorite blog article to the next edition of medlib’s round before March 8 by using the carnival submission form (here) (!). Submission to the form makes it easier for the host to summarize the articles.

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

Jacqueline (“Laika”)


Photo credits (Flickr-CC)

Librarian’s Costume by Librarian Avenger

Namro Orman, SL

Another Dead Librarian by Doug!





A New Blog Carnival: Medlib’s Round

13 01 2009

I’ve participated in several Blog Carnivals in the field of Medicine (and hence called Grand Round). i.e. The Grand Round, the Dutch Grand Round (i.e. see here), and SurgeXperiences. Blog Carnivals are a regular compilation of the “best blogs in a certain area”, hosted by a different blogger each time.

I enjoy participating in a Grand Round, either as submitter or as hosts, and being a medical librarian, I asked myself, why aren’t there any medical blog carnivals around?

Participating in a blog carnival is easy and informative. Why should medical librarians do this? Because you get a quick overview of the best posts in the field of medical librarianship, you learn to know other librarians, you keep well informed about what is going on and you generate traffic to your site (both as a host and a submitter).

Finally librarians not having a blog or people not being medical librarians (health 2.0, web 2.0 people, doctors) might also be interested in getting a quick overview of a field that has their interest.

These are the facts/rules:

  • The Blog Carnival’s name is Medlib’s Round. Please let me now if you have a more original carnival title.
  • For the time being it is a once-monthly Grand Round. The publications are on Tuesday, the submissions are due at Saturdays 00.00 (Dutch Time), or 18.00 EST.
  • All submissions and the Grand Round itself should be written (at least partially) in English.
  • Whether there is a theme or not is up to the host. The advice though is not to be too strict and give a nice compilation.
  • The host posts a call for submissions as early as possible at his or her blog.
  • The schedule and the archive are listed on Laika’s Medliblog on a separate page here.
  • You can submit your post (the permalink) to the blog carnival here or mail the next host before the deadline
    .
  • The first Grand Round (deadline February 7th) is at my place: Laika’s MedLibLog. The theme is rather loose: write about a subject that is close to your heart, whether it is about your patrons, education, PubMed, twitter …. whatever you find important.

What should you do now?

  • Tell me whether you like the idea or not and whether you want to join.
  • Write a post and submit it here (preferred) or mail me at laika dot spoetnik at gmail dot com. laika.spoetnik@gmail.com
  • Tell me whether you want to host a next edition: March*, April, May or June. (comment, mail,twitter)!!
  • Inform others that a Medlibrarian Grand Round is in the making.

Added:

We have a host for the March edition: Dragonfly. Thanks @aldricham

** For schedule see: medlibs-archive

*** Several librarians asked for a more extensive description. I will post this soon.







The Web 2.0-EBM Medicine split. [1] Introduction into a short series.

4 01 2009

Since the three years I’m working as a medical information specialist, I’ve embraced the concept of evidence based medicine or EBM. As a searcher I spend hours if not days to find as much relevant evidence as possible on a particular subject, which others select, appraise and synthesize to a systematic review or an evidence based guideline. I’m convinced that it is important to find the best evidence for any given intervention, diagnosis, prognostic or causal factor.

Why? Because history has shown that despite their expertise and best intentions, doctors don’t always know or feel what’s best for their patients.

An example. For many years corticosteroids had been used to lower intracranial pressure after serious head injury, because steroids reduce the inflammation that causes the brain to swell. However, in the 1990’s, meta-analyses and evidence-based guidelines called the effectiveness of steroids into question. Because of the lack of sufficiently large trials, a large RCT (CRASH) was started. Contrary to all expectations, there was actually an excess of 159 deaths in the steroid group. The overall absolute risk of death in the corticosteroid group was shown to be increased with 2%. This means that the administration of corticosteroids had caused more than 10,000 deaths before the 1990’s.[1,2,3]

Another example. The first Cochrane Systematic Review, shows the results of a systematic review of RCTs of a short, inexpensive course of a corticosteroid given to women about to give birth too early. The diagram below, which is nowadays well known as the logo of the Cochrane Collaboration, clearly shows that antenatal corticosteroids reduce the odds of the babies dying from the complications of immaturity by 30 to 50 per cent (diamond left under). Strikingly, the first of these RCTs showing a positive effect of corticosteroids, was already reported in 1972. By 1991, seven more trials had been reported, and the picture had become still stronger. Because no systematic review of these trials had been published until 1989, most obstetricians had not realized that the treatment was so effective. As a result, 10.000s of premature babies have probably suffered and died unnecessarily. This is just one of many examples of the human costs resulting from failure to perform systematic, up-to-date reviews of RCTs of health care.[4,5]

The Cochrane logo explained

Less than I year ago I entered the web 2.0-, and (indirectly) medicine 2.0 world, via a library 2.0 course. I loved the tools and I appreciated the approach. Web 2.0 is ‘all about sharing‘ or as Dean Giustini says it: ‘all about people. It is very fast and simple. It is easy to keep abreast of new information and to meet new interesting people with good ideas and a lot of knowledge.

An example. Bertalan Mesko in a comment on his blog ScienceRoll:

I know exactly that most of these web 2.0 tools have been around for quite a long time. Most of these things are not new and regarding the software, there aren’t any differences in most of the cases. But!
These tools and services will help us how to change medicine. In my opinion, the most essential problem of medicine nowadays is the sharing of information. Some months ago, I wrote about a blogger who fights Pompe disease, a rare genetic disorder and he told me about the diagnostic delay. I try to help physicians how they can find information easier and faster. For example: I gave tips how to search for genetic diseases.

Other examples are good functioning and dedicated patient web 2.0 sites, like PatientsLikeMe.

In the medical literature, blogs and slideshare, differences between medicine 2.0 and 1.0 are already described in detail (for instance see the excellent review of Dean Giustini in the BMJ), as well as the differences between medicine 1.0 and EBM (e.g. see the review of David Sackett et al in BMJ).

However, the longer I’m involved in web 2.0, the more I feel it conflicts with my job as EBM-librarian. The approach is so much different, other tools are used and other views shared. More and more I find ideas and opinions expressed on blogs that do EBM no justice and that seem to arise out of ignorance and/or prejudice. On the other hand EBM and traditional medicine often are not aware of web 2.0 sources or mistrust them. In science, blogs and wiki’s seldom count, because they express personal views, echo pre-existing data and are superficial.

split-1231

I’m feeling like I’m in a split, with one leg in EBM and the other in web 2.0. In my view each has got his merits, and these approaches should not oppose each other but should mingle. EBM getting a lower threshold and becoming more digestible and practical, and medicine 2.0 becoming less superficial and more underpinned.

It is my goal to take an upright position, standing on both legs, integrating EBM, medicine 2.0 (as well as medicine 1.0).

As a first step I will discuss some discrepancies between the two views as I encounter it in blogs, in the form of a mini-series: “The Web 2.0-EBM Medicine split”.

Before I do so I will give a short list of what I consider characteristic for each type of medicine, EBM-, Web 1.0 (usual)- and Web 2.0- medicine. Not based on any evidence, only on experience and intuition. I’ve just written down what came to my mind. I would be very interested in your thoughts on this.

EBM – medicine

  • centered round the best evidence
  • methodology-dependent
  • objective, transparent
  • thorough
  • difficult (to make, but for many also to find and also to understand)
  • time-consuming
  • published in peer reviewed papers (except for guidelines)
  • searching: PubMed and other bibliographic databases (to produce) and guideline databases, TRIP, and PubMed (Clinical Queries) or specific sources, i.e. specialist guidelines (to find).
  • Mostly Web 1.0 (with some web 2.0 tools, like podcasts, RSS and e-learning)

Web 1.0 – traditional medicine*

  • centered round clinical knowledge, expertise and intuition
  • opinion-based
  • authority based, i.e.strong beliefs in opinion leaders, expert opinion or ‘authority opinion’ (i.e. head of departments, professor) and own authority versus patient.
  • subjective
  • fast
  • act! (motto)
  • searching: browsing ( a specific list, site or Journals), quick search, mostly via Google**, in pharmacopeia, or protocols and UpToDate seldom in Pubmed (dependent on discipline)
  • Web 1.0: mail, patient-records, quick search via Google and Pubmed

Web 2.0 medicine

  • people-centered and patient-centered (although mostly not in individual blogs of doctors)
  • heavily based on technology (easy to use and free internet software)
  • social-based: based on sharing knowledge and expertise
  • (in theory) personalized
  • subjective, nondirected.
  • often:superficial
  • fast
  • generally not peer reviewed, i.e. published on blogs and wiki’s
  • searching: mostly via free internet sources and search engines, e.g. wikipedia, emedicine, respectively Google**, health metasearch engines, like Mednar and Health Sciences Online. PubMed mainly via third-party-tools like GoPubMed, HubMed and PubReminer. (e.g. see recent listings of top bedside health search engines on Sandnsurf’s blog ‘Life in the Fast Lane’
  • heavily dependent on web 2.0 tools both for ‘publishing’, ‘finding information’ and ‘communication’

*very general. of course dependent on discipline.
** this is not merely my impression, e.g. see: this blogpost on the “Clinical Cases and Images blog” of Ves Dimov, referring to four separate interviews of Dean Giustini with Physician bloggers.

Other references

[1] Final results of MRC CRASH, a randomised placebo-controlled trial of intravenous corticosteroid in adults with head injury-outcomes at 6 months. Edwards P et al. Lancet. 2005 Jun 4-10;365(9475):1957-9.
[2] A CRASH landing in severe head injury. Sauerland S, Maegele M. Lancet. 2004 Oct 9-15;364(9442):1291-2. Comment on: Lancet. 2004 Oct 9-15;364(9442):1321-8.
[3] Corticosteroids for acute traumatic brain injury.Alderson P, Roberts IG. Cochrane Database of Systematic Reviews 2005, Issue 1. Art. No.: CD000196.
[4] http://www.cochrane.org/logo/
[5] Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth.Roberts D, Dalziel SR.Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD004454
[6] How Web 2.0 is changing medicine. Giustini D. BMJ. 2006 Dec 23;333(7582):1283-4.
[7] Evidence based medicine: what it is and what it isn’t. Sackett DL et al. BMJ. 1996 Jan 13;312(7023):71-2.