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The retrieval of randomized clinical trials in liver diseases from the medical literature: manual versus MEDLARS searches.

Recently, the usefulness of MEDLARS computer searches in biomedical research was questioned; the conclusion was drawn that to completely capture a specific population of articles, the MEDLARS system was inadequate. This conclusion was based on a comparison of MEDLARS and manual searches for articles on random clinical trials in liver disease for the period 1966-1982. The present study re-evaluated the validity of this conclusion. In the initial revised search strategy, the recall of valid articles was not significantly improved, as compared with the original MEDLARS search strategy, but precision of this revised search was significantly increased. The number of valid articles recalled was significantly increased by broadening the MEDLARS search strategy criteria, but not without a simultaneous and significant decrease in precision. A limiting capture rate of about 79% of the population of articles on random clinical trials was reached when all logical expansions of the search strategy were exhausted. Strategies for increasing the efficiency of MEDLARS searches in general are discussed citing limitations specific to the population of random clinical trial articles.

Clinical Trials as Topic

Analysis of the use of MEDLARS in Mexico.

A statistical analysis of MEDLARS usage by Mexico's National Health Information and Documentation Center (CENIDS) is described. A total of 13,029 connect hours was registered during the period 1977-1986. MEDLINE was the MEDLARS database most frequently used, representing 82.83% of total use. Some 41,563 online searches, requested by 30,775 users, were performed by CENIDS' headquarters staff during this period. Findings from this study will be used to further research on information services in order to maximize the effectiveness of existing resources.

MEDLARS

MEDLEARN: a computer-assisted instruction (CAI) program for MEDLARS.

*MEDLEARN*, a second-generation computer-assisted instruction (CAI) program available (nationally) since October 1976, provides on-line training for MEDLINE, one of the National Library of Medicine's (NLM) Medical Literature Analysis and Retrieval System (MEDLARS) data base. *MEDLEARN* was developed as a joint effort between NLM and The George Washington University Medical Center. Using MEDLINE formats throughout, *MEDLEARN* combines tutorial dialogue, drill and practice, testing, and simulation. The program was designed in three tracks oriented to basic methods, advanced techniques, and new developments. Each topic is presented on two levels, permitting an alternate explanation for users encountering difficulty. *MEDLEARN*, coded in the computer language PILOT, was developed with a modular structure which promotes ease of writing and revision. A versatile control structure maximizes student control. Frequent interactions check immediate recall, general comprehension, and integration of knowledge. Two MEDLINE simulations are included, providing the student an opportunity to formulate and execute a search, have it evaluated, and then perform the search in MEDLINE. Commenting, news broadcasting, and monitoring (with permission only) capabilities are also available. Subjective field appraisals have been positive and NLM plans to expand *MEDLEARN* and produce similar programs for other data bases.

Computer-Assisted Instruction

The National Library of Medicine: from MEDLARS to the sesquicentennial and beyond.

The two decades since the introduction of MEDLARS and the passage of the Medical Library Assistance Act have been especially eventful in the history of the National Library of Medicine. The library's collections and services have grown to keep pace with the expanding health sciences literature and the needs of health professionals. Networking has emerged as an invaluable method for disseminating biomedical information. NLM has assumed new responsibilities for information services in toxicology, pharmacology, and environmental health, and for research and development in biomedical communications. Research now being carried out by NLM has the potential for enhancing the library's archival programs and for improving information dissemination in support of health sciences research, education, and practice.

Forecasting

Searching the MEDLARS file on NLM and BRS a comparative study.

A comparison of the MEDLARS data base as it is currently available from the National Library of Medicine and Bibliographic Retrieval Services (BRS), Inc., is presented in chart format, and some major capability differences between the two systems are highlighted. The information inlcuded justifies the dual availability of the data base in health sciences libraries. This paper is intended for searchers and others familiar with one or both systems. Administrators considering the acquisition of the BRS system may find the study useful.

MEDLARS

Corneal chromomycosis: double infection by Phialophora verrucosa (Medlar) and Cladosporium cladosporioides (Frescenius).

Phialophora verrucosa and Cladosporium cladosporioides were isolated from a corneal ulcer. The lesion had been previously treated with antivirals and steroids and did not respond to Pimaricin therapy or conjunctival flap. A penetrating keratoplasty was performed with good functional and optical results. Chromomycosis of the cornea is an unusual infection. This is the second case of Phialophora in Florida and the first case of Cladosporium infection.

Animals