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PubMed2001

LabVelocity: online tools for life science products, protocols, technical information, MEDLINE searches, and laboratory calculations.

As the pace of life science discovery increases, so do the demands on researchers. To remain competitive in the life science industry, researchers must use every tool at their disposal to keep up with new products, protocols, news, and literature in their field. While there are now myriad Web sites that assist researchers with this problem, many suffer from confusing user interfaces, poorly designed search engines, and a narrow information focus. Here, we present LabVelocity, a user-friendly Web site that provides a free multidisciplinary information-gathering service for the life science research community. Using LabVelocity, a researcher can quickly find the products, protocols, technical references, news, MEDLINE abstracts, and interactive software tools necessary for an experiment. This aggregation of information can streamline experimental planning and is especially useful when researchers want to set up a new laboratory or to venture outside their field of expertise.

Algorithms↗

PubMed2003

Important drug safety information on the internet: assessing its accuracy and reliability.

BACKGROUND: The Internet is becoming increasingly important as a source of health-related information, but the accuracy and reliability of information presented on the world wide web is debated. OBJECTIVE: We aimed to assess whether important, recent drug safety information is accurately reflected on Internet sites. METHODS: We evaluated whether major warnings issued by the US FDA between October 1, 2000 and September 30, 2001 on severe and life-threatening drug toxicity were mentioned 4-16 months later in the top ten web pages identified for these drugs by each of seven different search engines. We examined predictors of precise mention of the FDA warnings using logistic regressions. RESULTS: Twenty major safety warnings on 21 drugs (including three withdrawals) were eligible for the study. Among 519 different pertinent web pages retrieved (16-32 for each drug), precise mention of the safety issue was made in only 165 (31.8%). Best rates of precise mention were seen in web sites sponsored by attorneys (79.4%), in physician-oriented web pages (65.5%) and for withdrawn drugs (57.9%). In addition to these factors, better coverage of the FDA warnings was independently seen when no other adverse effects from the same organ system was mentioned (p < 0.001), while coverage was worse when there was no date on the site and web page (p = 0.020), and when the site owner could not be classified or was unknown (p = 0.014). CONCLUSIONS: Important safety warnings are inadequately covered in the majority of web pages. This deficiency creates a source of potentially harmful misinformation for health consumers.

Contraindications↗

PubMedDate not supplied

Co-operative health information networks in Europe: experiences from Greece and Scotland.

BACKGROUND: Internet technology is transforming the general approach to communication and dissemination of information in the field of healthcare. However, it is also creating problems in terms of finding information, and knowing what credibility to place on the information found. The chaotic nature of the World Wide Web (WWW) and the simplistic approach adopted by search engines can make the task of finding relevant information difficult, and the user can waste considerable amounts of time on the process. Even when information is found, there is no general quality assurance process that can guarantee the credibility of the resulting information. OBJECTIVE: The aim of this research was to develop an approach for establishing co-operative health information networks (CHINs) with different focuses, which can be used in different parts of Europe. The resulting CHINs would provide organised healthcare information and support comprehensive and integrated sets of healthcare telematic services for a broad range of users. Such developments would reduce the difficulties of finding information and knowing what credibility to ascribe to it. METHODS: A common approach has been developed based on drawing together contributions from the major healthcare service providers in the region. Standard structures are recommended so that information is presented in a uniform way. Appropriate mechanisms ensure adequate security and a level of quality assurance for the end user. RESULTS: Since 1996, CHINs have been developed in six European countries as part of a European Union (EU) project. This paper presents the overall approach adopted, and the achievements in two different regions of Europe (Greece and Scotland). Although the circumstances in these two regions are very different, in both cases the resulting CHIN has proved successful. CONCLUSIONS: CHINs offer a solution to the difficulty of finding relevant health information on the Internet and guaranteeing its credibility. They can be used in different ways in different regions, and have major benefits for both information providers and end users.

Community Networks↗

PubMed2002

eEurope 2002: Quality Criteria for Health Related Websites.

BACKGROUND: A number of organisations have begun to provide specific tools for searching, rating, and grading this information, while others have set up codes of conduct by which site providers can attest to their high quality services. The aim of such tools is to assist individuals to sift through the mountains of information available so as to be better able to discern valid and reliable messages from those which are misleading or inaccurate. OBJECTIVE: Recognising that European citizens are avid consumers of health related information on the internet and recognising that they are already using the types of rating system described above, the European Council at Feira on June 19-20 2000 supported an initiative within eEurope 2002 to develop a core set of Quality Criteria for Health Related Websites. The specific aim was to draw up a commonly agreed set of simple quality criteria on which Member States, as well as public and private bodies, may draw in the development of quality initiatives for health related websites. These criteria should be applied in addition to relevant Community law. METHODS: A meeting was held during 2001 which drew together key players from Government departments, International Organisations, non-governmental organisations and industry, to explore current practices and experiments in this field. Some sixty invited participants from all the Member States, Norway, Switzerland, and the United States of America took part in the meeting of June 7-8, 2001: they included delegates from industrial, medical, and patient interest groups, delegates from Member States' governments, and key invited speakers from the field of health information ethics. These individuals, and many others, also took part in the web-based consultation which was open from august to November 2001. RESULTS: The broad headings for quality criteria identified include Transparency and Honesty, Authority, Privacy and data protection, Updating of information, Accountability, Responsible partnering, Editorial policy, Accessibility, the latter includes attention to guidelines on physical accessibility as well as general findability, searchability, readability, usability, etc. A metadata labelling system may be used to make health data more findable. Such a system may also be used in conjunction with quality criteria to give higher ranking by search engines to those sites or pages labelled as complying with defined quality criteria. CONCLUSIONS: The set of quality criteria is based upon a broad consensus among specialists in this field, health authorities, and prospective users. It is now to be expected that national and regional health authorities, relevant professional associations, and private medical website owners will 1) implement the Quality Criteria for Health Related Websites in a manner appropriate to their website and consumers; 2) develop information campaigns to educate site developers and citizens about minimum quality standards for health related websites; 3) draw on the wide range of health information offered across the European Union and localise such information for the benefit of citizens (translation and cultural adaptation); 4) exchange information and experience at European level about how quality standards are being implemented.

Europe↗

PubMed2003

How adolescents use technology for health information: implications for health professionals from focus group studies.

BACKGROUND: Adolescents present many challenges in providing them effective preventive services and health care. Yet, they are typically the early adopters of new technology (eg, the Internet). This creates important opportunities for engaging youths via eHealth. OBJECTIVE: To describe how adolescents use technology for their health-information needs, identify the challenges they face, and highlight some emerging roles of health professionals regarding eHealth services for adolescents. METHODS: Using an inductive qualitative research design, 27 focus groups were conducted in Ontario, Canada. The 210 participants (55% female, 45% male; median age 16 years) were selected to reflect diversity in age, sex, geographic location, cultural identity, and risk. An 8-person team analyzed and coded the data according to major themes. RESULTS: Study participants most-frequently sought or distributed information related to school (89%), interacting with friends (85%), social concerns (85%), specific medical conditions (67%), body image and nutrition (63%), violence and personal safety (59%), and sexual health (56%). Finding personally-relevant, high-quality information was a pivotal challenge that has ramifications on the depth and types of information that adolescents can find to answer their health questions. Privacy in accessing information technology was a second key challenge. Participants reported using technologies that clustered into 4 domains along a continuum from highly-interactive to fixed information sources: (1) personal communication: telephone, cell phone, and pager; (2) social communication: e-mail, instant messaging, chat, and bulletin boards; (3) interactive environments: Web sites, search engines, and computers; and (4) unidirectional sources: television, radio, and print. Three emerging roles for health professionals in eHealth include: (1) providing an interface for adolescents with technology and assisting them in finding pertinent information sources; (2) enhancing connection to youths by extending ways and times when practitioners are available; and (3) fostering critical appraisal skills among youths for evaluating the quality of health information. CONCLUSIONS: This study helps illuminate adolescent health-information needs, their use of information technologies, and emerging roles for health professionals. The findings can inform the design and more-effective use of eHealth applications for adolescent populations.

Adolescent↗

PubMed2004

Web content accessibility of consumer health information web sites for people with disabilities: a cross sectional evaluation.

BACKGROUND: The World Wide Web (WWW) has become an increasingly essential resource for health information consumers. The ability to obtain accurate medical information online quickly, conveniently and privately provides health consumers with the opportunity to make informed decisions and participate actively in their personal care. Little is known, however, about whether the content of this online health information is equally accessible to people with disabilities who must rely on special devices or technologies to process online information due to their visual, hearing, mobility, or cognitive limitations. OBJECTIVE: To construct a framework for an automated Web accessibility evaluation; to evaluate the state of accessibility of consumer health information Web sites; and to investigate the possible relationships between accessibility and other features of the Web sites, including function, popularity and importance. METHODS: We carried out a cross-sectional study of the state of accessibility of health information Web sites to people with disabilities. We selected 108 consumer health information Web sites from the directory service of a Web search engine. A measurement framework was constructed to automatically measure the level of Web Accessibility Barriers (WAB) of Web sites following Web accessibility specifications. We investigated whether there was a difference between WAB scores across various functional categories of the Web sites, and also evaluated the correlation between the WAB and Alexa traffic rank and Google Page Rank of the Web sites. RESULTS: We found that none of the Web sites we looked at are completely accessible to people with disabilities, i.e., there were no sites that had no violation of Web accessibility rules. However, governmental and educational health information Web sites do exhibit better Web accessibility than the other categories of Web sites (P < 0.001). We also found that the correlation between the WAB score and the popularity of a Web site is statistically significant (r = 0.28, P < 0.05), although there is no correlation between the WAB score and the importance of the Web sites (r = 0.15, P = 0.111). CONCLUSIONS: Evaluation of health information Web sites shows that no Web site scrupulously abides by Web accessibility specifications, even for entities mandated under relevant laws and regulations. Government and education Web sites show better performance than Web sites among other categories. Accessibility of a Web site may have a positive impact on its popularity in general. However, the Web accessibility of a Web site may not have a significant relationship with its importance on the Web.

Cross-Sectional Studies↗

PubMed2004

Efficacy of quality criteria to identify potentially harmful information: a cross-sectional survey of complementary and alternative medicine web sites.

BACKGROUND: Many users search the Internet for answers to health questions. Complementary and alternative medicine (CAM) is a particularly common search topic. Because many CAM therapies do not require a clinician's prescription, false or misleading CAM information may be more dangerous than information about traditional therapies. Many quality criteria have been suggested to filter out potentially harmful online health information. However, assessing the accuracy of CAM information is uniquely challenging since CAM is generally not supported by conventional literature. OBJECTIVE: The purpose of this study is to determine whether domain-independent technical quality criteria can identify potentially harmful online CAM content. METHODS: We analyzed 150 Web sites retrieved from a search for the three most popular herbs: ginseng, ginkgo and St. John's wort and their purported uses on the ten most commonly used search engines. The presence of technical quality criteria as well as potentially harmful statements (commissions) and vital information that should have been mentioned (omissions) was recorded. RESULTS: Thirty-eight sites (25%) contained statements that could lead to direct physical harm if acted upon. One hundred forty five sites (97%) had omitted information. We found no relationship between technical quality criteria and potentially harmful information. CONCLUSIONS: Current technical quality criteria do not identify potentially harmful CAM information online. Consumers should be warned to use other means of validation or to trust only known sites. Quality criteria that consider the uniqueness of CAM must be developed and validated.

Complementary Therapies↗

PubMed2005

Vaccine criticism on the World Wide Web.

BACKGROUND: The incidence of vaccine-preventable diseases is directly related to the number of unvaccinated children. Parents who refuse vaccination of their children frequently express concerns about vaccine safety. The Internet can influence perceptions about vaccines because it is the fastest growing source of consumer health information. However, few studies have analyzed vaccine criticism on the Web. OBJECTIVE: The purposes of this paper are to examine vaccine criticism on the Internet and to analyze the websites in order to identify common characteristics and ethical allegations. METHODS: A structured Web search was conducted for the terms "vaccine," "vaccination," "vaccinate," and "anti-vaccination" using a metasearch program that incorporated 8 search engines. This yielded 1138 Web pages representing 750 sites. Two researchers reviewed the sites for inclusion/exclusion criteria, resulting in 78 vaccine-critical sites, which were then abstracted for design, content, and allegations. RESULTS: The most common characteristic of vaccine-critical websites was the inclusion of statements linking vaccinations with specific adverse reactions, especially idiopathic chronic diseases such as multiple sclerosis, autism, and diabetes. Other common attributes (> or = 70% of websites) were links to other vaccine-critical websites; charges that vaccines contain contaminants, mercury, or "hot lots" that cause adverse events; claims that vaccines provide only temporary protection and that the diseases prevented are mild; appeals for responsible parenting through education and resisting the establishment; allegations of conspiracies and cover-ups to hide the truth about vaccine safety; and charges that civil liberties are violated through mandatory vaccination. CONCLUSIONS: Vaccine-critical websites frequently make serious allegations. With the burgeoning of the Internet as a health information source, an undiscerning or incompletely educated public may accept these claims and refuse vaccination of their children. As this occurs, the incidence of vaccine-preventable diseases can be expected to rise.

Chronic Disease↗

PubMed2005

The effects of type 1 diabetes on cognitive performance: a meta-analysis.

OBJECTIVE: To investigate the exact nature and magnitude of cognitive impairments in patients with type 1 diabetes and the possible association with other disease variables, such as recurrent episodes of hypoglycemia and metabolic control. RESEARCH DESIGN AND METHODS: MedLine and PsycLit search engines were used to identify studies on cognitive performance in patients with type 1 diabetes. Effect sizes (Cohen's d), which are the standardized differences between the experimental and the control group, were calculated. In the meta-analysis, a combined d value was calculated, expressing the magnitude of associations across studies. RESULTS: A total of 33 studies were identified that met the inclusion criteria. Compared with nondiabetic control subjects, the type 1 diabetic group demonstrated a significantly lowered performance on the following cognitive domains: intelligence (d = -0.7), speed of information processing (d = -0.3), psychomotor efficiency (d = -0.6), visual (d = -0.4) and sustained attention (d = -0.3), cognitive flexibility (d = -0.5), and visual perception (d = -0.4). Lowered cognitive performance in diabetic patients appeared to be associated with the presence of microvascular complications but not with the occurrence of severe hypoglycemic episodes or with poor metabolic control. CONCLUSIONS: In patients with type 1 diabetes, cognitive dysfunction is characterized by a slowing of mental speed and a diminished mental flexibility, whereas learning and memory are spared.The magnitude of the cognitive deficits is mild to moderate, but even mild forms of cognitive dysfunction might hamper everyday activities since they can be expected to present problems in more demanding situations.

Attention↗

PubMed2001

Online data collection with special populations over the World Wide Web.

The quick ascendance of the World Wide Web as the dominant vehicle for internet communication has recently made experimentation in a multimedia environment feasible on the Internet. Although web sites containing online psychology demonstrations and experiments for non-handicapped individuals have appeared in recent years (especially in the areas of cognitive and social psychology), there appear to have been few attempts to conduct online experimentation with special populations. We recently completed two online pilot studies of families with Down syndrome or Williams syndrome members: a) A survey that asks (via Likert rating scales, adjective checklists, multiple-choice style questions, and text-entry boxes) about family background, computer use, and temperament of the special needs family member; and b) An experiment (completed by an individual with special needs) that includes auditory and visual digit span tasks and a memory-for-orientation task in which responses are entered via mouse clicks. Recruiting began with e-mail announcements to representative Down syndrome and Williams syndrome discussion groups, listserves, and bulletin boards, and submission of the project's URL (http://www.cofc.edu/~marcellm/testaw.htm) and key indexing terms to selected search engines. This paper reviews technical aspects of developing the online programmes as well as the strengths and weaknesses of online vs. traditional laboratory-based research in relation to issues such as experimental control, delivery of instructions, experimenter bias, participant recruitment, sample heterogeneity, generalization, attrition, privacy, financial costs, data integrity, and ethics. We conclude by offering our thoughts on two ways of implementing online experimentation with special populations: a) Using a remote parent 'helper' as a proxy to work with the target individual; and b) Collaborating with professional colleagues in Web-based projects conducted in traditional laboratory settings.

Child, Preschool↗

PubMedDate not supplied

MARVIN, multi-agent softbot to retrieve multilingual medical information on the Web.

The World-Wide Web is an unstructured, multimedia and multilingual information network. While most efforts have addressed the structuring issue, very few attempts have been proposed to provide support for multilingual information retrieval. Yet, medical information is now available all over the world. The MARVIN (Multi-Agent Retrieval Vagabond on Information Network) softbot and its associated medical search engine MedHunt (Medical Hunter) are a solution for helping people, who only understand a few languages, to access multilingual information.

Information Storage and Retrieval↗

PubMedDate not supplied

A first evaluation of a pedagogical network for medical students at the University Hospital of Rennes.

A pedagogical network has been developed at University Hospital of Rennes from 1996. The challenge is to give medical information and informatics tools to all medical students in the clinical wards of the University Hospital. At first, nine wards were connected to the medical school server which is linked to the Internet. Client software electronic mail and WWW Netscape on Macintosh computers. Sever software is set up on Unix SUN providing a local homepage with selected pedagogical resources. These documents are stored in a DBMS database ORACLE and queries can be provided by specialty, authors or disease. The students can access a set of interactive teaching programs or electronic textbooks and can explore the Internet through the library information system and search engines. The teachers can send URL and indexation of pedagogical documents and can produce clinical cases: the database updating will be done by the users. This experience of using Web tools generated enthusiasm when we first introduced it to students. The evaluation shows that if the students can use this training early on, they will adapt the resources of the Internet to their own needs.

Computer-Assisted Instruction↗

PubMed2006

Delay in final publication following abstract presentation: American College of Veterinary Anesthesiologists annual meeting.

RATIONALE FOR THE STUDY: A review of abstracts presented at nine annual meetings of the American College of Veterinary Anesthesiologists was undertaken to determine the average time to publication and the differences found between conference abstracts and final publications. Concerns about and advantages of using such abstracts in our teaching are considered. METHODOLOGY: Conference proceedings during the years 1990 through 1999 were considered. Key word and author searches using two common search engines were carried out to find whether abstracts presented had been published. The original article or its abstract was reviewed for consistency with the conference abstract. RESULTS: Of 283 abstracts examined, 73.5% were published in journals as full articles. The overall delay (+/-SD) in publication was 24.3 +/- 21.0 months. Common reasons for not publishing included too little time, more interest in carrying out the work than in writing it up, and other more demanding tasks. Authors indicated the intention of completing a submission on approximately 10% of the unpublished abstracts. The final articles reviewed showed major differences in key aspects from the abstract presented in 7% of the cases. In half of these cases, clinical action could have been affected by a change in emphasis of the conclusions. CONCLUSIONS: Because of the delay in publication of research, peer review of standardized abstracts should be encouraged. This material can be used to introduce students to new drugs, techniques, and results that may not otherwise become available until after their graduation. However, caution must be exercised in using this information, both because significant differences were noted in final publications and because unpublished research may be poorly interpreted at the time of presentation. This study emphasizes the value of critical review and lifelong learning in our careers.

Anesthesiology↗

PubMed2006

Neurofibromatosis-associated nerve sheath tumors. Case report and review of the literature.

In this paper the authors describe a patient with neurofibromatosis Type 1 (NF1) who presented with sequelae of this disease. They also review the current literature on NF1 and NF2 published between 2001 and 2005. The method used to obtain information for the case report consisted of a family member interview and a review of the patient's chart. For the literature review the authors used the search engine Ovid Medline to identify papers published on the topic between 2001 and 2005. Neurofibromatosis Type 1 appears in approximately one in 2500 to 4000 births, is caused by a defect on 17q11.2, and results in neurofibromin inactivation. The authors reviewed the current literature with regard to the following aspects of this disease: 1) diagnostic criteria for NF1; 2) criteria for other NF1-associated manifestations; 3) malignant peripheral nerve sheath tumors (PNSTs); 4) the examination protocol for a patient with an NF1-related NST; 5) imaging findings in patients with NF1; 6) other diagnostic studies; 7) surgical and adjuvant treatment for NSTs and malignant PNSTs; and 8) hormone receptors in NF1-related tumors. Pertinent illustrations are included. Neurofibromatosis Type 2 occurs much less frequently than NF1, that is, in one in 33,000 births. Mutations in NF2 occur on 22q12 and result in inactivation of the tumor suppressor merlin. The following data on this disease are presented: 1) diagnostic criteria for NF2; 2) criteria for other NF2 manifestations; 3) malignant PNSTs in patients with NF2; 4) examination protocol for the patient with NF2 who has an NST; and 5) imaging findings in patients with NF2. Relevant illustrations are included. It is important that neurosurgeons be aware of the sequelae of NF1 and NF2, because they may be called on to treat these conditions.

Family Health↗

PubMedDate not supplied

Internet use for health information among college students.

Use of the Internet to retrieve health information is increasingly common. The authors surveyed 743 undergraduate students at 2 academic institutions to examine their Internet use, health-seeking behaviors, and attitudes related to the use of the Internet to obtain health information. Fifty-three percent of the respondents indicated that they would like to get health information online, and 28% reported that they would like to attend a health program online. Overall, 74% of the students reported having ever received health information online, and more than 40% reported that they frequently searched the Internet for information. They used various search engines and multiple Web sites to find health information. Issues related to the credibility of the information on health Web sites were crucial considerations for students. The study found differences in Internet use for health information by gender and by level of Internet experience.

Attitude to Health↗

PubMed2004

Assessing the quality and contents of asthma-related information on the Korean internet as an educational material for patients.

Despite the substantial amount of asthma-related information available on the internet, little is known about the quality of such information. We assessed asthma-related information on the Korean internet intended as an educational material for asthma patients. By entering the key word, 'asthma', into 4 popular search engines, 32 web sites were identified and categorized with respect to authorship. The core asthma educational concepts and Health On the Net Code of Conduct principles were used to evaluate informational value and justifiability of unreliable information. Eight of 32 web sites were categorized as western physician, seventeen as oriental physician, four as commercial, and three as others. The mean number of core asthma educational concepts on the whole web sites was 2.7 out of 8. By type of authorship, 1.7 on the commercial sites, 2.1 on the oriental physician sites, 3.5 on the western physician sites, and 5.0 on the others sites in decreasing order. One of the western physician sites, two of the commercial sites, and all of the oriental physician and others sites contained unreliable information. However all of them except one site failed to satisfy our criteria of justifiability. Asthma-related information currently available on the Korean internet is highly variable in quality and lacks core asthma educational concepts and justifiability.

Asthma↗

PubMedDate not supplied

Nursing on-line for continuing education credit.

BACKGROUND: The Internet was evaluated as a source of continuing education credit for RNs. METHOD: Using the search engines Alta Vista, Excite, Magellan, and Infoseek, 600 World Wide Web sites were reviewed for on-line programs that would lead to the receipt of a continuing education (CE) certificate of completion for a varying number of CE hours. RESULTS: Five sites provided CE programs online and one site used e-mail to deliver the program to personal computers. All sites offered certificates and were approved to offer continuing nursing education credit through a state board of nursing or through the agency sponsoring the Internet site. The CE hours were also approved by the American Nurses Credentialing Center's Commission on Accreditation. CONCLUSION: The findings indicate the Internet is a source of CE units (hours) for nurses that may be used to satisfy requirements of state boards of nursing. The sites are easily accessible and eliminate travel and great expenses. The Internet is a rich source of current health-related information not approved for CE units but pertinent to health care professionals.

Certification↗

PubMed2003

A critical evaluation of Internet marketing of products that contain ephedra.

OBJECTIVE: To evaluate information contained within Internet sites that advertise and market dietary supplements containing ephedra. MATERIAL AND METHODS: We conducted an Internet search to identify Web sites advertising weight-loss supplements that contained ephedra. Between July 7 and July 18, 2002, 4 search engines were used by entering the term herbal weight loss. Outcome measures included disclosure of potential adverse effects of or contraindications to ephedra-containing supplements, disclosure of ephedra alkaloid dosage, and presence of misleading or incorrect information. RESULTS: Thirty-two products and advertisements were identified and systematically evaluated for deviance from truth-in-advertising standards. Of the 32 Web sites analyzed, 13 (41%) failed to disclose potential adverse effects or contraindications to supplement use. Seventeen (53%) did not reveal the dosage of ephedra alkaloids that was recommended. More importantly, 11 sites (34%) contained incorrect or misleading statements, some of which could directly result in serious harm to consumers. CONCLUSION: If dietary supplements containing ephedra are to continue to be marketed freely, substantial reform in advertising regulation and enforcement is warranted.

Advertising↗