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At least 145 records · Page 8Linked to original sources

PubMed1999

Vascular surgery and the Internet: a poor source of patient-oriented information.

OBJECTIVE: Increasing numbers of patients use the Internet to obtain medical information. The Internet is easily accessible, but available information is under no guidelines or regulations. We sought to evaluate the type, quality, and focus of vascular disease information presented on the Internet and the role in patient education with simple search techniques. METHODS: The arbitrarily chosen search phrases "abdominal aortic aneurysm (AAA)," "carotid surgery (CEA)," "claudication surgery," and "leg gangrene surgery" were entered into five common Internet search engines. No attempt was made to refine searches. As indicated by the search engines, the 50 most commonly encountered web sites for both AAA and CEA were reviewed. The first 25 claudication sites and the first 25 gangrene sites were combined for a total of 50 leg ischemia (LIS) sites. An information score (IS) was developed as a weighted score ranging from 0 (poor) to 100 (outstanding) and was designed to assess how well the web page educated the patient about the disease, the treatment options, and the medical and surgical complications. Each vascular surgery web site was classified according to the author, the referenced information source, and the therapeutic recommendations. This was followed by an evaluation of each web site with the IS independently scored by two observers. RESULTS: Of the 150 web sites, 146 were accessible. Ninety-six sites (65.8%) had no useful patient-oriented information (IS < 10). The mean IS and the ranges were: AAA, 14.9 (0 to 72.0); CEA, 17.5 (0 to 77.0); and LIS, 12.2 (0 to 44.5; P =.9). The mean IS of the 59 sites with scores of more than 10 were: AAA, 39.8 (n = 17); CEA, 44.8 (n = 19); and LIS, 24.8 (n = 23; P <.01, as compared with LIS scores). Differences in IS between observers were not significant (P =.9). Misleading or unconventional care recommendations were recognized in one AAA site (1 of 47, 2.1%), two CEA sites (2 of 49, 4.1%), and 13 LIS sites (13 of 50, 26.0%). The Joint Vascular Societies web page was identified only as a tertiary link. CONCLUSION: Patient-oriented vascular surgery information, for common vascular diseases, is difficult to find on the Internet. The overall quality is poor, and information is difficult to obtain in part because of the large number of irrelevant sites. Of the sites that were relevant to patient education (33%), one third presented information that was classified by the authors as misleading or unconventional. This was most apparent in the leg ischemia sites. The Internet is a poor overall source of patient-oriented vascular surgery information and education. Focused and refined searches and improvements in search engines and educational web sites may yield improved information. Public and medical community awareness needs to be improved regarding the severe limitations of the Internet as an information resource.

Aortic Aneurysm, Abdominal↗

PubMed2003

Patterns of searching for information on the World Wide Web: a pilot study.

The influences of task type on search of the World Wide Web using search engines without limitation of search domain were investigated. 9 graduate and undergraduate students studying psychology (1 woman and 8 men, M age=25.0 yr., SD=2.1) participated. Their performance to manipulate the search engines on a closed task with only one answer were compared with their performance on an open task with several possible answers. Analysis showed that the number of actions was larger for the closed task (M=91) than for the open task (M=46.1). Behaviors such as selection of keywords (averages were 7.9% of all actions for the closed task and 16.7% for the open task) and pressing of the browser's back button (averages were 40.3% of all actions for the closed task and 29.6% for the open task) were also different. On the other hand, behaviors such as selection of hyperlinks, pressing of the home button, and number of browsed pages were similar for both tasks. Search behaviors were influenced by task type when the students searched for information without limitation placed on the information sources.

Adult↗

PubMed2003

Investigation of colposcopy information on the internet.

The Internet is a massively expanding body of information which includes medical resources. It is easier than in the past for anyone with some knowledge and effort to access the Internet. Medical professionals as well as patients have a similar ability to research a medical topic through the Internet. As medical professionals, we are concerned whether the medical information found on the Internet by patients is current and accurate. There are relatively few reports that critically examine where patients and family members acquire medical information. To assess the accuracy and completeness of information regarding colposcopy on the Internet, we categorized and defined the information on the Internet through systematic study. We chose eight search engines available on the homepage of Explorer to search and analyze the information obtained from a search for the topic of colposcopy. In addition, we analyzed whether the colposcopy information contained peer-review or reference in order to evaluate its reliability. The numbers of uniform/universe resource locators (URLs) varied considerably, ranging from 11 to 23300, when we tested the search engines using different combinations of capitalization and spellings. Descriptions of information from 181 sites located by a search engine (Yahoo) were also evaluated into five types, ranging from diagnostic to anecdotal information. In terms of the peer-review system, inaccurate or misleading information was found on web pages which might lead patients to doubt and distrust their medical specialists whose information was contradictory to that which they had obtained themselves. We recognize that the Internet has a positive and potential power in partnership with medical professionals to educate patients, helping them to overcome their disease. Nevertheless, we suggest the need to take an active role in identifying the Web sites containing accurate medical information and evaluating their quality.

Colposcopy↗

PubMed2006

Accuracy of physician self-assessment compared with observed measures of competence: a systematic review.

CONTEXT: Core physician activities of lifelong learning, continuing medical education credit, relicensure, specialty recertification, and clinical competence are linked to the abilities of physicians to assess their own learning needs and choose educational activities that meet these needs. OBJECTIVE: To determine how accurately physicians self-assess compared with external observations of their competence. DATA SOURCES: The electronic databases MEDLINE (1966-July 2006), EMBASE (1980-July 2006), CINAHL (1982-July 2006), PsycINFO (1967-July 2006), the Research and Development Resource Base in CME (1978-July 2006), and proprietary search engines were searched using terms related to self-directed learning, self-assessment, and self-reflection. STUDY SELECTION: Studies were included if they compared physicians' self-rated assessments with external observations, used quantifiable and replicable measures, included a study population of at least 50% practicing physicians, residents, or similar health professionals, and were conducted in the United Kingdom, Canada, United States, Australia, or New Zealand. Studies were excluded if they were comparisons of self-reports, studies of medical students, assessed physician beliefs about patient status, described the development of self-assessment measures, or were self-assessment programs of specialty societies. Studies conducted in the context of an educational or quality improvement intervention were included only if comparative data were obtained before the intervention. DATA EXTRACTION: Study population, content area and self-assessment domain of the study, methods used to measure the self-assessment of study participants and those used to measure their competence or performance, existence and use of statistical tests, study outcomes, and explanatory comparative data were extracted. DATA SYNTHESIS: The search yielded 725 articles, of which 17 met all inclusion criteria. The studies included a wide range of domains, comparisons, measures, and methodological rigor. Of the 20 comparisons between self- and external assessment, 13 demonstrated little, no, or an inverse relationship and 7 demonstrated positive associations. A number of studies found the worst accuracy in self-assessment among physicians who were the least skilled and those who were the most confident. These results are consistent with those found in other professions. CONCLUSIONS: While suboptimal in quality, the preponderance of evidence suggests that physicians have a limited ability to accurately self-assess. The processes currently used to undertake professional development and evaluate competence may need to focus more on external assessment.

Clinical Competence↗

PubMed2006

Chronic musculoskeletal pain in patients with the chronic fatigue syndrome: a systematic review.

BACKGROUND: In addition to debilitating fatigue the majority of patients with chronic fatigue syndrome (CFS) experience chronic widespread pain. AIMS: Conducting a systematic review to critically assess the existing knowledge on chronic pain in CFS. We focussed on the definition, the prevalence and incidence, the aetiology, the relevance and the therapy strategy for chronic musculoskeletal pain and post-exertional pain in CFS. METHODS: To identify relevant articles, we searched eight medical search engines. The search terms "chronic fatigue syndrome" AND "pain", "nociception", "arthralgia" and "myalgia", were used to identify articles concerning pain in CFS. Included articles were reviewed by two blinded researchers. RESULTS: Twenty-five articles and two abstract were identified and selected for further appraisal. Only 11 search results focussed on musculoskeletal pain in CFS patients. Regarding the standardized review of the articles, a 96% agreement between the researchers was observed. There is no consensus in defining chronic widespread pain in CFS, and although there is little or no strong proof for the exact prevalence, chronic pain is strongly disabling in CFS. Aetiological theories are proposed (sleep abnormalities, tryptophan, parovirus-B, hormonal and brain abnormalities and central sensitisation) and a reduction of pain threshold after exercise has been shown. Furthermore depression seemed not related to pain in CFS and a staphylococcus toxoid vaccine caused no significant pain reduction. CONCLUSIONS: The results from the systematic review highlight the clinical importance of chronic pain in CFS, but only few studies addressing the aetiology or treatment of chronic pain in CFS are currently available.

Chronic Disease↗

PubMed2003

Linking clinical data using XML topic maps.

Most clinical data is narrative text and often not accessible and searchable at the clinical workstation. We have therefore developed a search engine that allows indexing, searching and linking different kinds of data using web technologies. Text matching methods fail to represent implicit relationships between data, e.g. the relationship between HIV and AIDS. The international organization for standardization (ISO) topic maps standard provides a data model that allows representing arbitrary relationships between resources. Such relationships form the basis for a context sensitive search and accurate search results. The extensible markup language (XML) standards are used for the interchange of data relationships. The approach has been applied to medical classification systems and clinical practice guidelines. The search engine is compared to other XML retrieval methods and the prospect of a "semantic web" is discussed.

Databases, Factual↗

PubMed2003

Searching the evidence: the clinically-effective nutritionist.

As a clinically-effective nutritionist faced with needing to find the answer to a clinical question quickly it is necessary to search the best evidence efficiently. The requirements are to: (1) avoid having lots of papers to read; (2) be able to access this information at one's place of work; (3) restrict reading to trials and systematic reviews of trials. If a decision has to be made while on the ward, the best resource is probably an easy-to-use book, Clinical Evidence. This resource is also available on-line, but there may not be access to the Internet on the ward. If a little more time is available, and access to the Internet, the following plan is suggested: (1) work out what the question is and highlight the search terms; (2) using the best search engine available, search MEDLiNE from 1990 for titles and abstracts of papers containing the search terms, this is the search strategy (limit the search by publication type by requesting randomised controlled trials only, English language only and human only); (3) if more or less than approximately ten hits are obtained, alter the limits of the search (not the search strategy); (4) read the abstract, or full paper where available, of the relevant hits and appraise this evidence.

Dietetics↗

PubMed2000

The protein information resource (PIR).

The Protein Information Resource (PIR) produces the largest, most comprehensive, annotated protein sequence database in the public domain, the PIR-International Protein Sequence Database, in collaboration with the Munich Information Center for Protein Sequences (MIPS) and the Japan International Protein Sequence Database (JIPID). The expanded PIR WWW site allows sequence similarity and text searching of the Protein Sequence Database and auxiliary databases. Several new web-based search engines combine searches of sequence similarity and database annotation to facilitate the analysis and functional identification of proteins. New capabilities for searching the PIR sequence databases include annotation-sorted search, domain search, combined global and domain search, and interactive text searches. The PIR-International databases and search tools are accessible on the PIR WWW site at http://pir.georgetown.edu and at the MIPS WWW site at http://www. mips.biochem.mpg.de. The PIR-International Protein Sequence Database and other files are also available by FTP.

Databases, Factual↗

PubMed2005

Transdermal drug delivery: clinical considerations for the obstetrician-gynecologist.

INTRODUCTION: The first transdermal drug delivery system was introduced in the United States over 20 years ago. Created as an alternative route of administration to improve patient compliance as well as to reduce side effects, the transdermal delivery of drugs now represents a $1.5 to $2 billion market and is growing rapidly. DATA SOURCES: The medical literature from 1980 to 2005 was searched using the PubMed search engine. The search term was "transdermal," limited to human clinical trials. Abstracts were used to identify clinical trials that compared transdermal preparations and their oral counterparts in the same study. TABULATION, INTEGRATION, AND RESULTS: In this article, we review the rationale for the transdermal administration of drugs; discuss aspects of the anatomy and physiology of the skin relevant to drug transport; examine the qualities required for a drug to be a good candidate for transdermal delivery; and consider key principles for the evaluation of the relative benefits of transdermal delivery, using studies of hormone replacement therapy and oral contraceptive as examples. CONCLUSION: The data reviewed here suggest that certain clinical situations support the use of the transdermal administration of drugs over their oral counterparts.

Administration, Cutaneous↗

PubMed2004

Evaluating the quality of Internet-derived information on plantar fasciitis.

Patients seeking medical advice increasingly turn to the World Wide Web. To test the hypothesis that Internet-provided medical information often is inaccurate and biased, we selected a common musculoskeletal condition. Three common Internet search engines were used to search "plantar fasciitis" and "plantar fascitis." Combining the first 50 web addresses from each search engine for both phrases and eliminating duplicate sites resulted in a database of 152 websites. Each website then was analyzed for authorship, sponsoring agency, and presence of financial incentive. The informational value score of each site then was graded using a 10-point scale evaluating the following parameters: basic definition of plantar fasciitis, causes and risk factors, clinical symptoms, diagnostic tests, differential diagnosis, conservative and surgical treatment options, and complications. The overall mean information value score for all 152 sites was 3.8 points; 36% of the sites showed financial bias. The highest mean scores among all authorship and sponsorship categories belonged to orthopaedic surgeons and academic institutions with mean scores of 7.1 and 6.1 points, respectively. Sites without obvious financial bias had significantly higher information value scores than sites with financial interests. Healthcare professionals should consider these findings when advising patients.

Authorship↗

PubMed2005

Issues and challenges in international doctoral education in nursing.

Education is a driving force in improving the health and welfare of communities globally. Doctoral education of nurses has been identified as a critical factor for provision of leadership in practice, scholarship, research, policy and education. Since the genesis of doctoral education in nursing in the USA in the 1930s, this movement has burgeoned to over 273 doctoral programs in over 30 countries globally. The present article seeks to identify the issues and challenges in nursing doctoral education globally, and those encountered by doctoral program graduates in meeting the challenges of contemporary health care systems. Information was derived from a comprehensive literature review. Electronic databases and the Internet, using the Google search engine, were searched using the key words "doctoral education"; "nursing"; "International Network for Doctoral Education in Nursing"; "global health"; "international research collaboration". Doctoral education has been a critical force in developing nurse leaders in education, management, policy and research domains. An absence of consensus in terminology and of accurate minimum data sets precludes comparison and debate across programs. The complexity and dynamism of contemporary globalized communities render significant challenges in the conduct of doctoral programs. Addressing funding issues and faculty shortages are key issues for doctoral programs, especially those in developing countries, to achieve an identity uniquely their own. These challenges can also afford considerable opportunities for discussion, debate and the formulation of innovative and collaborative solutions to advance nursing knowledge and scholarship. In spite of discrete differences between countries and regions, the similarities in the issues facing the development of doctoral programs internationally are more striking than the differences. The harnessing of a global collective to address these issues will likely serve to not only forge the future viability of doctoral education of nurses but to improve the health and well-being of communities. This paper proposes international collaborative strategies to address a number of the challenges identified.

Cooperative Behavior↗

PubMed2004

Child safety education and the world wide web: an evaluation of the content and quality of online resources.

The purpose of this study was to assess the content, quality, and type of internet resources available for safety education. Using 19 search engines with search strings targeting major forms of injury, identified resources were classified by audience group, accessibility, and authorship. Two independent reviewers rated each resource on the basis of its content and a set of quality criteria using a three point scale. Overall, 10 (18.2%) resources were of highest quality, four (7.3%) were intermediate, and 41 (74.5%) were not recommended. Eighteen months after the original search, 67.3% of all resources and 90% of the highest quality resources were still on the internet. This study provides a methodology for evaluating child safety resources on the world wide web and demonstrates that most internet resources for safety education are of dubious quality. A rating system such as the one developed for this study may be used to identify valuable internet materials.

Accident Prevention↗

PubMed1999

From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection.

OBJECTIVES: To review the scientific data on the role of sexually transmitted diseases (STDs) in sexual transmission of HIV infection and discuss the implications of these findings for HIV and STD prevention policy and practice. METHODS: Articles were selected from a review of Medline, accessed with the OVID search engine. The search covered articles from January 1987 to September 1998 and yielded 2101 articles. Methods used to uncover articles which might have been missed included searching for related articles by author, and combing literature reviews. In addition, all abstracts under the category "sexually transmitted diseases" from the XI and XII International Conferences on AIDS (Vancouver 1996 and Geneva 1998) and other relevant scientific meetings were reviewed. Efforts were made to locate journal articles which resulted from the research reported in the identified abstracts. All original journal articles and abstracts which met one of the following criteria were included: (1) studies of the biological plausibility or mechanism of facilitation of HIV infectiousness or susceptibility by STDs, (2) prospective cohort studies (longitudinal or nested case-control) which estimate the risk of HIV infection associated with specific STDs or STD syndromes, or (3) intervention studies which quantitate the effect which STD treatment can have on HIV incidence. RESULTS: Strong evidence indicates that both ulcerative and non-ulcerative STDs promote HIV transmission by augmenting HIV infectiousness and HIV susceptibility via a variety of biological mechanisms. These effects are reflected in the risk estimates found in numerous prospective studies from four continents which range from 2.0 to 23.5, with most clustering between 2 and 5. The relative importance of ulcerative and non-ulcerative STDs appears to be complex. Owing to the greater frequency of non-ulcerative STDs in many populations, these infections may be responsible for more HIV transmission than genital ulcers. However, the limited reciprocal impact of HIV infection on non-ulcerative STDs and the evidence that non-ulcerative STDs may increase risk primarily for the receptive partner (rather than bidirectionally) may modulate the impact of these diseases. The results of two community level randomised, controlled intervention trials conducted in Africa suggest that timely provision of STD services can substantially reduce HIV incidence, but raise additional questions about the optimal way to target and implement these services to achieve the greatest effect on HIV transmission. CONCLUSIONS: Available data leave little doubt that other STDs facilitate HIV transmission through direct, biological mechanisms and that early STD treatment should be part of a high quality, comprehensive HIV prevention strategy. Policy makers, HIV prevention programme managers, and providers should focus initial implementation efforts on three key areas: (i) improving access to and quality of STD clinical services; (ii) promoting early and effective STD related healthcare behaviours; and (iii) establishing surveillance systems to monitor STD and HIV trends and their interrelations.

Disease Susceptibility↗

PubMed2000

Basic knowledge of Internet in forensic medicine: logging on, fetching files and information.

The Internet stands at the forefront of telecommunications in medicine, including forensic medicine, since information technology (IT) has been able to revolutionize medical and scientific practices. Today, forensic physicians and professionals need to be familiar with the use of computers and the key applications of information technology: multimedia and the Internet. From the office, the forensic physician can communicate with other physicians by means of e-mail, take part in discussion groups, obtain information on meetings and get information from public libraries and various databases by means of file transfer protocol. The search among the huge amount of information is facilitated by the 'click and play' use of the Internet, by its increased ease and availability of access and by faster communications to an increasing number of accessible technical, scientific and biomedical resources. Therefore, it is useful to introduce some of the most frequent concepts encountered when exploring the Internet, to give simple references for any forensic physician exploring the Internet and to present typical Internet aspects by illustrations saved from worldwide websites and linked to the accompanying text. Some of the main forensic websites and basic Internet procedures are described, explaining how to search and exchange information in the domain of forensic medicine and sciences. Search engines and search procedures on the worldwide web are briefly explained. The aim of this paper is to give forensic physicians, scientists and law professionals some basic tools and references to access the vast possibilities of the Internet.

Forensic Medicine↗

PubMed2026

Published Database Resources for Traditional, Complementary, and Integrative Medicine: Update of a Systematic Review.

BACKGROUND: Traditional, Complementary, and Integrative Medicine (TCIM) has been established in the academic context of universities. In recent years, strategies have been developed worldwide to strengthen the role of TCIM in supporting the health of the population. Online databases are a common way for obtaining evidence-based information. This article is an update of a former systematic review from 2010 on published databases resources for TCIM. METHODS: The databases CINAHL, CAMbase, Web of Science, MEDLINE/PubMed, and Google Scholar search engine were searched for databases related to TCIM published in peer-reviewed journals between 2010 and November 2024. All included databases were visited online, and information on the origin, content, and scope of the database was extracted. RESULTS: A total of 6579 articles were identified through the literature search. After exclusion of irrelevant articles, full-text screening of 127 articles yielded 37 new databases. Together with 16 still available old databases, these mainly contained information on herbal therapies (n = 15) and Traditional Chinese Medicine (n = 11) from 18 different countries. Newly identified medicinal plant databases offer various scientific resources such as crude drugs, indigenous plants, and structures for natural and phytochemical components with molecular biological content. CONCLUSIONS: This literature review illustrates the dynamic development in the database landscape over the last 15 years. While the number of bibliographic databases is shrinking, databases in the field of medical plants/herbal therapy content are on the rise, which might be due to advances in plant genomics and molecular biology.

Humans↗

PubMed2006

A systematic review of the health, social and financial impacts of welfare rights advice delivered in healthcare settings.

BACKGROUND: Socio-economic variations in health, including variations in health according to wealth and income, have been widely reported. A potential method of improving the health of the most deprived groups is to increase their income. State funded welfare programmes of financial benefits and benefits in kind are common in developed countries. However, there is evidence of widespread under claiming of welfare benefits by those eligible for them. One method of exploring the health effects of income supplementation is, therefore, to measure the health effects of welfare benefit maximisation programmes. We conducted a systematic review of the health, social and financial impacts of welfare rights advice delivered in healthcare settings. METHODS: Published and unpublished literature was accessed through searches of electronic databases, websites and an internet search engine; hand searches of journals; suggestions from experts; and reference lists of relevant publications. Data on the intervention delivered, evaluation performed, and outcome data on health, social and economic measures were abstracted and assessed by pairs of independent reviewers. Results are reported in narrative form. RESULTS: 55 studies were included in the review. Only seven studies included a comparison or control group. There was evidence that welfare rights advice delivered in healthcare settings results in financial benefits. There was little evidence that the advice resulted in measurable health or social benefits. This is primarily due to lack of good quality evidence, rather than evidence of an absence of effect. CONCLUSION: There are good theoretical reasons why income supplementation should improve health, but currently little evidence of adequate robustness and quality to indicate that the impact goes beyond increasing income.

Civil Rights↗

PubMed1999

Safety issues with herbal products.

OBJECTIVE: To review safety issues associated with the use of herbal products. DATA SOURCES: Literature accessed through MEDLINE and other Internet search engines. Key search terms included herbs, dietary supplements, and safety. DATA SYNTHESIS: A misconception exists among consumers that herbal remedies are safe because they are natural. In an effort to provide healthcare practitioners with information necessary for a patient discussion, a review of safety concerns with herbal products was conducted. CONCLUSIONS: Several safety concerns exist with herbal products including lack of safety data, absence of quality-control requirements for potency and purity, and lenient labeling standards.

Advertising↗

PubMed2000

Evaluating the source and content of orthopaedic information on the Internet. The case of carpal tunnel syndrome.

BACKGROUND: The Internet has become a popular source of medical information for patients. Authors of health-related web pages are not required to adhere to any standard for medical content or accuracy. The goal of the present study was to assess the type, quality, and reliability of information about carpal tunnel syndrome that is available on the Internet. METHODS: The search phrase "carpal tunnel syndrome" was entered into five commonly used World Wide Web search engines. The search results then were given as an ordered list of universal resource locators, or web-site addresses. The top (first) fifty web sites from each of the five searches were combined to create a master roster of 250 web-site addresses. These web sites then were evaluated for authorship and content, and an informational value score ranging from 0 to 100 points was assigned to each. RESULTS: Thirty-three percent of the sites sold commercial products for the evaluation or treatment of carpal tunnel syndrome. An additional 30 percent were commercial web sites that did not sell products. Only 23 percent of the sites were authored by a physician or an academic organization. Fewer than half of the sites offered conventional information. Twenty-three percent of the sites offered unconventional or misleading information. The mean informational value of the web sites was 28.4 of a possible 100 points. CONCLUSIONS: The information about carpal tunnel syndrome on the Internet is of limited quality and poor informational value. The public and the medical communities need to be aware of these limitations so that the quality of medical information available on the World Wide Web can be improved.

Carpal Tunnel Syndrome↗