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Rapid Responses: Rapid Responses published:
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Has there been a recent gender change?:
- Leonard Finegold (26 December 2005)
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Selective reporting of medical science?
- Steve Hickey (27 December 2005)
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IT liberalisation of Medicine
- M Nadeem Attar, Attar MN, Habib K (27 December 2005)
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Google Medicine - health information for the people
- Martin Winkler (29 December 2005)
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Emergency Medical Ontology Project
- Jayanth Paraki, Paraki (30 December 2005)
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Google is changing the world
- Yu-Chuan Li, Min-Huei Hsu (30 December 2005)
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Re: Selective reporting of medical science?
- Ellen C G Grant (2 January 2006)
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I love Google but rely and trust Scirus
- Kumara Mendis (2 January 2006)
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Googling for diagnosis
- Kate M Bradley (7 January 2006)
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Spelling while Googling
- Svend O. Mortensen (9 January 2006)
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Re: Google Medicine - health information for the people
- Ann R. Viera (10 January 2006)
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The Computer Assisted Diagnostician – From Osler to Google
- Joseph Britto, Sanjay Pai MD (11 January 2006)
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Re: Re: Selective reporting of medical science?
- Robert J Shaw (13 January 2006)
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Doctor Evidence passes google
- todd feinman (14 January 2006)
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Should Professionals and Patients use Google for Medical Searches?
- Gordon John Brooks MBChB, PhD (Med Informatics, Lond.) (25 January 2006)
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The Use of Teaching Materials from the Internet
- P Vivekananda-Schmidt, Professor Nigel Bax, Professor of Medical Education and Director of Teaching (1 March 2006)
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Re: The Use of Teaching Materials from the Internet
- Paul G Champion (4 March 2006)
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Googling your treatment for labour analgesia
- James Holding, Michael V. Holmes (23 March 2006)
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"Google surgeon"
- Richard H. Riley (27 June 2006)
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Dear Google - Whither Google Medicine
- Dean Giustini, Dean Giustini (21 June 2007)
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Re: Dear Google - Whither Google Medicine
- Phillip J. Colquitt (26 June 2007)
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Leonard Finegold, Physicist Physics, Drexel University, Phila. PA 19104
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Has there been a recent gender change?: Editorial (v. 331 p. 1487) says "...a professor asked the presenting fellow to explain how HE arrived at HIS diagnosis...".4 Reference 4 says: "...Finally, the visiting professor asked the fellow if SHE had made a diagnosis, and SHE reported that SHE had indeed..." Competing interests: Has karyotype of one X and one Y. |
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Steve Hickey, PhD Department of Biological Sciences, Metropolitan University of Manchester
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Pubmed may be giving doctors a biased view of the progress of medical science. Recently, I presented a paper, on the microevolutionary model of cancer, to a meeting of the British Society for Ecological Medicine (BSEM), at the Royal College of General Practitioners in London. Afterwards, I happed to mention that I was looking into claims of bias in the selection of journals for indexing by Medline. I gave the example of the Journal of Orthomolecular Medicine (JOM). Although this journal has included papers by leading scientists and physicians, it has not yet been indexed, despite numerous applications to Medline. Dr Abram Hoffer, editor of JOM for over 35 years, believes this is a clear example of censorship in medicine. Considering the widespread interest in nutrition and medicine, and the status of many of the journal’s contributors, JOM should be indexed because of its relevance to medical science. However, the decision to index a journal is based on selection by a panel, which appears to be privately appointed. Furthermore, the procedure lacks a set of published and objective criteria. I was unable to obtain a viable reason for the rejection of JOM from the US National Library of Medicine. The ostensible reason was weakness of scientific content, which may be considered an inaccurate explanation, given the list of currently indexed magazines. These include many that would claim little scientific content, such as Time magazine, Newsweek, the Indian Journal of American Studies, and the Kansas Historical Quarterly. My offer to demonstrate the relevance of JOM to the medical profession, by providing an application signed by several thousand physicians, medical professionals and scientists, was not accepted. Coincidentally, BSEM members told me that they had just had a meeting to discuss a second Medline rejection of the Journal of Nutritional and Environmental Medicine. They implied that a further application for indexing would be a waste of time, as their impression was that the selection process was biased against nutritional approaches to treatment. Fortunately, this bias is less worrying than it might once have been, as Medline and Pubmed are gradually becoming redundant. These once definitive sources of information appear to be in the process of being replaced by Google Scholar, which is more open and covers a greater depth of scientific journals. At the time of writing, a search on Pubmed for the word “orthomolecular” generates 213 papers. Google Scholar yields 841 papers, while a standard Google search produces 228,000 responses. Competing interests: None declared |
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M Nadeem Attar, Staff Cardiologist Royal Preston Hospital, Attar MN, Habib K
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Excellent and timely article.Google search for medicine or any health issue does yield enormous information.The difficulty one encounters is to differentiate peer reviewed articles which can be relied on and non peer reviews or blogs which can be doubtful Google Medicine as suggested by you could do yeoman's service to Medicine if they provide source of information and rate reliability of the information provided.This could lead to real liberalisation of Medicine , especially in developing nations where doctors could then confidently provide evidence based medicine. Competing interests: None declared |
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Martin Winkler, medical doctor Seepark Klinik Bad Bodenteich
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Searching the web for medical information is a rather difficult task. Some people rely on the HON-code and the search options they offer, but it is difficult to find the realy useful pages of interest. Pubmed is nice for scientific issues but not very good if you have any common medical question. If you are not involved in university work you are better off to ignore the newest publications and wait for a while. This is one reason why Google Scholar is more popular... During the last couple of years the role of eHealth in Europe has become more important. We try to give rather simple answers to psychological question with our project and try to combine our search engine with Google search since most of our readers will find our pages with Google. We attended a high level conference in Cork in 2004 with our project. All politicians wanted to have one universal eHealth portal for Europe... I don´t think we will succeed without more commerical interests by one of the major players. Web2.0 technologies will give us new options of social networking with easier access to localized information (about experts, self-help groups...) in our local area. But we will need someone to show the right direction. I go for Google Medicine... Competing interests: co-author of a medical and psychological portal (web4health.info) without commercial interests |
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Jayanth Paraki, Consultant India, Paraki
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Please contribute to this humanitarian cause......read this document carefully... While existing representations of the biomedical domain may be sufficient for information retrieval[PC2] purposes, the organization of knowledge in these representations is generally not suitable for reasoning by computers. Reasoning by computers requires the principled, consistent organization usually provided by ontologies. Read the full document at http://www.ontologystream.com/beads/healthInformatics/home.htm Dr Jayanth G Paraki Competing interests: None declared |
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Yu-Chuan Li, Professor, Graduate Institute of Medical Informatics, Taipei Medical University 250 Wu-Hsin Street, Taipei, Taiwan, Min-Huei Hsu
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Internet has changed the world. Powerful search tools like Google helped to change it even more. In addition to Google¡¦s powerful search function, Google Answers (answers.google.com/answers/) lets people bring up their questions on the Internet with a self-set reward price, and people from all over the world can answer the questions with pre-agreed fees. Similar services can be part of the ¡§Google Medicine¡¨ suggested by the editorial; this may potentially improve the financial mechanism as well as the quality and accessibility to consumer-oriented health information on the Internet. On the other hand, since Google is a commercial-orient business, we should be watching closely on how context-sensitive advertising programs like Google Ad (www.google.com/ads/) will influence consumers¡¦ behavior. The editorial also stated that a powerful tool like Google would help bring benefits to developing countries, which is true only on the assumption that the country has a proper information infrastructure. The digital divide among nations is conspicuous in the current world; the most powerful information tool may create even more divide and unfairness on medical services. Competing interests: None declared |
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Ellen C G Grant, physician and gynaecologist Kingston-upon-Thames, KT2 7JU, UK
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I agree with Dr Steve Hickey that there is a problem in the reporting of Nutritional Medicine in my experience as a founder member of the British Society for Ecological Medicine (formerly British Society for Allergy, Environmental and Nutritional Medicine) and a member of the International Editorial Board of the Journal of Nutritional and Environmental Medicine. Dr Hickey thinks Google Science will help to readdress this journalistic nutritional imbalance. However, I do not find Google Scholar very useful as far as my own publications are concerned. If I ask for grant ec. at www.pubmed.gov, 61 publications, most of which are mine, appear. When I insert grant ec. into the search box of Google Scholar 623,000 citations appear. I suppose it is remarkable that four of mine appear in the first 3 pages listing 30 of thesd 623,000 publications. “ec grant” brings up 1,300, while “grant ec” brings up 351. The solution would have been to keep my unusual maiden name but it is a bit late now as it is nearly 50 years since I was married. Competing interests: None declared |
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Kumara Mendis, Senior Lecturer School of Rural Health, University of Sydney, Dubbo, NSW 2830, Australia
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There is no doubt this is the Google era. In the glory of Google’s repeated technological and financial success sometimes we may tend to get confused regarding our objectives. The quality of medical and health information on the Internet is extremely variable. The need in this era of information overload is a science search engine to weed out the scientific content from the vastness of the World Wide Web. According to the respective web sites: ‘Google Scholar provides a simple way to broadly search for scholarly literature’ and ‘Scirus is the most comprehensive science-specific search engine on the Internet’. If we are considering ‘a one stop shop’ for a scientific search engine for medicine, I prefer and rely on Scirus for a number of reasons. 1) Even though the basic search interface is simple, it has a few options. 2) Initial results are displayed in three categories: Journal results, preferred web results and other web results. One can even request one of the three categories. 3) The sidebar on the initial results page further allows you to refine your search by clicking on the word or phrase you want. It then performs a combined search with the Boolean operator ‘AND’ 4) The advance search options gives you added control over the information types, content sources (both journal & web) and subject areas. 5) Ranking by relevancy or date is also possible. 6) The ability to save, email or export (RSS or text format) is another bonus option which is somewhat similar to PubMed. A noteworthy difference between the two engines is the lower number of citations from PubMed retrieved by GS when compared to Scirus. Search both Google scholar(GS) http://scholar.google.com/ and Scirus http://www.scirus.com for a current topic of interest to most doctors – e.g. “Metabolic syndrome”. GS retrieved 301000 web links if you forgot to include the phrase in inverted commas but will reduced the number of links to 16,900 if you do so. The results page gives no further options for the basic search. Scirus gave a total of 45,268 links (whether the inverted commas are included or not) displaying a breakdown of 8,025 journal results 1,409 preferred web results and 35,834 other web results. Even in the basic search interface there is an option for requesting ‘exact phrase’ if you want to. When you use Google scholar the next time, do try Scirus and see the difference - http://www.extranet.elsevier.com/listman/BMN/none.htm Although I love Google, I relay and prefer Scirus when the need is for a scientific search about medical search over the Internet. However neither are alternatives to the gold standards such as PubMed, Embase and Cochrane. Kumara Mendis - kmendis@med.usyd.edu.au Competing interests: None declared |
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Kate M Bradley, Librarian Bellevue Community College 98007
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The anecdote related in this editorial was amusing and thought- provoking. What concerns me is the young resident's apparent assumption that Google in and of itself had done his/her work for him. In reality, the retrieval of the information depended entirely upon another physician's having written up, clearly and accurately, the signs and symptoms of the condition being diagnosed. No past human judgment, no written record of that judgment, no accurate retrieval. Thanks very much. Competing interests: None declared |
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Svend O. Mortensen, Consultant, Urological dept. Herlev Hospital, 2730 Herlev, Denmark
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Google and Google Scholar is doing very good at guessing what you seek inspite of spelling mistakes ("Did you mean ..."), but may still fail, once in a while, especially in names: seeking "Parkinson's" in Google Classic yielded 11.800.000 hits today, whereas "Parkinsons" gave 129.000. Google Scholar didn't differentiate, but gave 3440 hits when asked of "Creutzfeldt-Jakob" but only 160 at "Creutzfeldt-Jacob". Other than person's names, Scholar found 9080 "periaqueductal grey"-s and 3120 "periaqueductal gray"-s. Google Classic yielded 151.000 for both, but did not make any note of the difference in spelling. Google Scholar did not note the difference either but came up with 9080 for "grey" and 3120 for "gray". Will someone please program a Soundex (code for putting sound-a-likes right) for searching the Internet? Svend Mortensen, MD, DSciMed. Competing interests: None declared |
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Ann R. Viera, Librarian Pendergrass AG-VET MED Library A-113 VTH University of Tennessee, Knoxville TN 37996-4541
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There IS a gold-standard source for common medcial questions--Medline plus at medlineplus.gov. It is available so far in English and Spanish. Also, for the students, professors and staff at the veterinary college here at the University of Tennessee, the article by Henderson (Google Scholar: a source for clinicians? Canadian Medical Association Journal 2005 172:1549-50) is the assessment of Google in medicine I recommend. (Giustini cited it.) I also recommend reading librarian Rita Vine's blog Sitelines on the use of Google in Medicine -- see for example: http://www.workingfaster.com/sitelines/archives/2005_06.html#000319 Competing interests: None declared |
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Joseph Britto, CEO & Co-founder Isabel Healthcare Inc, 1254 Lamplighter Way, Reston, VA 20194, Sanjay Pai MD
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We are aware of several ingenious physicians who, when faced with a diagnostic conundrum, have resorted to entering clinical features into Google, thus using Google as a diagnosis decision support system (DDSS). The obvious downside of searching Google, a key word search engine that uses Boolean logic, is that one has to wade through several thousand ‘noisy’ documents of varying quality looking for likely diagnoses. Newer web-based DDSS’s [www.isabelhealthcare.com]are designed to instantly remind physicians in their workflow, of reasonable, relevant diagnoses, for a set of clinical features entered. DDSS rather than replacing physicians can be an invaluable aid in the diagnosis process. DDSS’s enable the classic paradigm of history taking, examination and construction of a safe differential diagnosis by assisting with the ‘telephone directory stage’ – the reconciliation of a patient’s data sets with the data sets that we are expected to carry in our mind. However, DDSS are only useful if we take thorough histories from patients and make conscientious physical examinations and assessments. William Osler might not be turning in his grave. Osler did also say “Everywhere the old order changes and happy they who can change with it” Competing interests: Joseph Britto MD is a co-founder and holds a remunerated position as CEO of Isabel Diagnosis Reminder and Knowledge Mobilizing System. Sanjay Pai MD holds a non-remunerated position as Editorial board member of Isabel Diagnosis Reminder and Knowledge Mobilizing System. |
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Robert J Shaw, Economic Adviser Dept of Health LS2 7UE
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Ellen Grant suggests that Google Scholar is not particularly good at finding her own articles, and says that a search for ec grant delivers 623,000 results. Can I suggest that she tries using Google Scholar's author search when she is trying to do this? A search for author:ec author:grant generates a mere 267 results. Competing interests: None declared |
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todd feinman, md cedars sinai hospital, 90048
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There is a company called Doctor Evidence (www.doctorevidence.com) that has already passed google and google scholar. Dr E is the only company in the world, so far, that is indexing articles that contain relevant outcome data about any test or treatment. Their technologies and services only find and deliver evidence/literature (published and unpublished) that answer a focused "framed" question. Doctor Evidence is already being used by patients, doctors, attorneys, policy makers all over the world. Competing interests:
I am president and founder of Doctor Evidence. I am also a share holder in this corporation. However, my response to the google article will not influence my position or value of my shares. |
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Gordon John Brooks MBChB, PhD (Med Informatics, Lond.), Systems Designer and Medical Practitioner EMIS Knowledge Based SystemsArtillery House, Fort Fareham, Fareham, Hampshire PO14 1AH
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For the
last 14 years, I have been employed by the now market leading provider of UK
primary care electronic record systems to oversee the stepwise evolution of an
integrated knowledge, diagnostic and other point of care clinician support
system called Mentor (www.webmentorlibrary.com).
My department also supplies referentially coherent free, high quality, peer
reviewed evidence based guidance and support for patients (www.patient.co.uk) as well as a link from
this website to online consultation booking. So a patient can refer to quality
assured health information before booking an appointment to visit a healthcare
professional who also has consistent appropriately focused support and advice
available during the consultation. The clinician may end the consultation by
providing further information directly to the patient or by recommending further
reading on the compatible and trusted online source. The The
reference documents we supply refer and link to key evidence and consensus sources
(where available on the Internet) as well as to searches, so provide a way for
clinical users to validate content, find guidelines, evidence or conduct
further research. Underlying everything is a weighted knowledge network of
clinical connections between diseases, symptoms, complications, tests, treatments
etc painstakingly authored and logically inherited to help ensure clinical
users are supplied with the correct high quality information at the medically
appropriate moment. In other words, we strive to supply both suitable content
and efficient, contextually appropriate, searches. So what has
all this to do with Google, you might well ask? After
reading the BMJ Editorial’s tale of front line Google
use -> ' "I entered the salient features into Google,
and the diagnosis popped right up". The attending doctor was taken aback
by the Google diagnosis "Are we physicians no
longer needed?" Is an observer who can accurately select the findings to
be entered in a Google search all we need for a
diagnosis to appear - as if by magic? ' - I ran a
few Google searches to test the attending doctor’s
hypothesis: GOOGLE
SEARCH ONE: “RIGHT ILIAC FOSSA PAIN AND GUARDING” – ie features of suspected Appendicitis Google
brought up the following results on its first page:
I compared
this with our Very Common: rotavirus; gastroenteritis Common: acute appendicitis; diverticulitis;
traveller’s diarrhoea; mesenteric adenitis; salmonella gastroenteritis; pelvic inflammatory disease;
tuberculosis. Etc… So, in this
case Google’s results partially reflect the
clinically generated, research based, diagnostic metadata picked up from
trawling our medical search engine. But lets
take-> GOOGLE
SEARCH TWO: “POLYURIA DYSURIA” – perhaps symptoms of a UTI? This brings
up the following entries on the Google’s first page
of results:
I compared
this with our Common: urinary tract infection; including childhood urinary tract
infection; honeymoon cystitis; recurrent urinary tract infection;
urinary tract infection in pregnancy. Uncommon: acute pyelonephritis; chronic pyelonephritis; renal tuberculosis. Etc… In this
case, Google’s results reflect the metadata and words
of the documents its algorithms have chosen to display. They are, at best,
misleading if used for differential or knowledge support for this clinical
problem. But of
course, I used straight Google in these simple tests
as indeed many health professionals and patients do, perhaps because of
the their experience using Google for retrieving all
sorts of information about holidays; trivia; where to eat out; answers to
crossword puzzles; personal research; locating specialist bulletin boards and so
on. A case of ‘use something you know’? Anyway, to complete the experiment, I fed the ‘beta’ specialist Google Scholar the same searches after adjusting the settings to deliver results in English only. GOOGLE SCHOLAR SEARCH ONE: “RIGHT ILIAC FOSSA PAIN AND GUARDING” This Scholar search brought up articles about GOOGLE SCHOLAR SEARCH TWO: “POLYURIA DYSURIA” The ‘polyuria dysuria’ Scholar search gives an equally bad first page of results as straight Google:
So what is going on? Both Google and Google Scholar are running searches on data automatically extracted from the text and metadata of articles appearing on the Internet. It is well known that Google applies closely guarded automatic site selection and grading criteria when determining which links to content will be included in its search engine database and therefore available to appear the Google results. However, it is clear that stricter site selection criteria have been used in construction of the Scholar search engine. For example, all the high quality content we supply to NHS health professionals and patients, available through Google, has arbitrarily been excluded from Google Scholar’s database. A general explanation about Google Scholar’s selection criteria applied can be found in the online help files: “Google Scholar provides a simple way to
broadly search for scholarly literature. From one place, you can search across
many disciplines and sources: peer-reviewed papers, theses, books, abstracts
and articles, from academic publishers, professional societies, preprint
repositories, universities and other scholarly organizations. Google Scholar helps you identify the most relevant
research across the world of scholarly research.” As can an explanation of the process of Scholar search result ranking: Google Scholar orders your
search results by relevance. As with Google web search,
the most useful references appear at the top of the page. Google
ranking technology considers the full text of each article, the author, the
publication in which the article appeared, and how often the piece has been
cited in other scholarly literature. We have seen from my ‘Search One’ examples above, that when using high quality text and metadata, both Google and Scholar can indeed produce relevant results. But these results appear to be present because of the efforts of the high quality source owners, rather than any Google magic. This is confirmed by Google and Google Scholar’s inability to produce appropriate results when its automatic indexing processes chose to include less relevant articles, as shown in the ‘Search Two’ examples. Google owns no content and its
search algorithms work on data scavenged from content rich sites of all types
and quality. Traditionally, the relationship between Google
and the sites it trawls has been commercially symbiotic, because Google search result presence
grants source content owners the chance of recovering authoring outlay through advertising
revenue. Indeed there is now a whole spin-off business in paying to try and get
your content mentioned in Google. Google provides an excellent and appealing search
facility that I and many millions regularly use for finding all sorts of
information. But just because the brand is an increasingly popular household
name, doesn’t mean we should be seduced into believing its algorithms are any
use whatsoever for generating appropriate solutions to medical queries, as we
have seen from the examples above. And if this is the case, we should be wary
of the clinical impact of automated non-medical proprietary selection and display
algorithms used by middleman sites, such as Google and Google Scholar, to determine what content from what sources health professionals and patients encouraged to hit the friendly search button
will see. Competing interests: Head of development for Web Mentor Library and Patient UK. |
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P Vivekananda-Schmidt, Lecturer Academic Unit of Medical Education, Sheffield University, S10 2GB, Professor Nigel Bax, Professor of Medical Education and Director of Teaching
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A recent editorial(1) in this journal discusses the impact of Google on access to medical knowledge and emphasises the increased access to ‘freely available digital information’ it provides. However, how freely available is such information in reality? Whilst resources available through Google maybe used by an individual for personal study without constraint the use of such material by a teacher for the benefit of their students is fraught with potential difficulties. The Internet offers many potentially valuable resources to support medical teaching.(2) Many lecturers access and use material from the web to support their teaching, as well as uploading such material into virtual learning environments. The UK Patent Office recommends treating Internet materials in the same way as materials from other media (e.g., art work, music recording or video) for copyright purposes.(3) Copyright is an unregistered right protecting the ownership of intellectual material that can be fixed through any medium3 and breaches to copyright can result in significant financial liability to institutions. Guidelines for good practice from JISC for use of materials from the internet include obtaining written consent from the owner and providing acknowledgement.(4) A Google search was performed to determine the extent to which websites that might be accessed for teaching purposes stated the terms of use of their material. Three searches were conducted, one for each of the following terms: ‘Endocrine System’, ‘Musculoskeletal System’ and the ‘Cardiovascular System’. Only sites which had an educational affiliation (secondary or tertiary education) and/or suitable author specification (qualification as a physician or non-clinical specialisation) in the respective physiological systems were visited. Sites provided by pharmaceutical companies or private healthcare providers were not included. The data below is from the first 50 websites visited in each category that met the above criteria and are grouped according to the nature of the information provided as regards copyright. Approximately 90% of sites were universities.
Only a minority of the websites specified the terms of use for users. The UK patent office advises that when the limits of use of internet material are not specified and the content is judged to be legal it may be assumed that an ‘Implied License’ exists.(5) The use of this licence is influenced by the Patent Office’s comment ‘You will only be able to argue that you have an implied licence where all the circumstances suggest that the copyright owner expected you to use his or her copyright material in the way you are going to use it, even though this was never discussed and has not been written down anywhere’. This is all rather confusing and not the sort of thing a busy lecturer takes account of as they prepare their talk. Even if a lecturer safely negotiates their way through these regulations it is then unclear as to whether the lecture may be uploaded onto a Virtual learning Environment.(6) These issues potentially limit the benefits of Internet materials for education and compromise the fundamental ethos of the Internet of making knowledge more accessible and easier to disseminate. It would be helpful if educational institutions agreed how best to share their teaching resources. The editorial suggested that we build ‘Google Medicine’. A Google medicine free from restrictions on copyright and to which all may contribute would be a welcome advance in education and healthcare. Reference List (1) Giustini D. How Google is changing medicine. BMJ 2005; 331(7531):1487-1488. (2) Candler CS, Uijtdehaage SHJ, Dennis SE. Introducing HEAL: The Health Education Assets Library. Academic Medicine 2003; 78(3):249-253. (3) The UK Patent Office. What is Copyright? The UK Patent Office [ 2004 Available from: URL:http://www.patent.gov.uk/copy/definition.htm (4) JISC Legal Information. Good practice related to use of internet material. JISC [ 2005 (5) The UK Patent Office. copyright/implied copyright license. The UK Patent Office [ 2005 Available from: URL:http://www.intellectual- property.gov.uk/faq/copyright/implied_copy_license.htm (6) The UK Patent Office. faq/copyright/exceptions for education. The UK Patent Office [ 2005 Available from: URL:http://www.intellectual- property.gov.uk/faq/copyright/ex_education.htm P.Vivekananda-Schmidt, Lecturer in Medical Education
Professor Nigel Bax, Professor of Medical Education and Director of Teaching Academic Unit of Medical Education, Firth House, School of Medicine and Biomedical Sciences, University of Sheffield, S10 2GB. Competing interests: None declared. Competing interests: None declared |
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Paul G Champion, N/A Southall UB2 4UP
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Finding information that you can copy and pass around (although some restrictions may still apply, such as quoting the original source) is made a lot easier with the Creative Commons search page(1). It would be nice, if those who can bring it to the attention of the right people, can encourage them to publish their organisation's material under the Creative Commons licence (2) and thus make it clear under what conditions their work may be used. Creative Commons is a non-profit organisation. It offers flexible copyright licenses for creative works, which can be downloaded as HTML code and pasted into the web page, making it open access References: (2) Creative Commons Main Page. Http://creativecommons.org (accessed 02 Mar 2006). Competing interests: None declared |
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James Holding, Research Fellow, Centre for Anaesthesia University College Hospital London NW1 2BU, Michael V. Holmes
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EDITOR – Giustini described how Google has become the most powerful influence in searching the internet . In a recent observational study on the labour ward at University College Hospital, London, we found that 33% of pregnant women used the internet as a source of information about labour pain relief. This is a change from the results of a previous study conducted five years ago in Liverpool, in which the internet had been used by less than 3% of parturitants . We wondered what expectant mothers would find on “Googling your treatment”1. It is known that, when searching for health information, patients tend only to look at the first few links after their search, and very few of them later remember from which websites they retrieved information or by whom the sites were created . We feared that the one third of pregnant women using the internet were accessing information that was inaccurate and potentially misleading their labour analgesia choices. We performed a search at the main Google UK site (not Google Scholar) using “labour pain relief” as our criterion. The search provided “about 3,300,000 results”, of which we examined the top ten. Six were written by or had direct contribution from a doctor, two were articles in peer-reviewed journals, one was by a midwife and one was a commercial website selling TENS machines. All of the non-commercial websites were informative and of high quality, providing balanced information. We considered the information to be anaesthetist-friendly, and we were reassured by our investigation. In our internet-savvy society, we suggest that health care providers Google their particular topic in order to discover what kind of information their patients are finding. A cautionary note: as search engines continuously update the pages to which they link and their ranking, we advise regularly repeating the search to keep up with the dynamic flux of the interweb. 1. Giustini D. How Google is changing medicine. BMJ 2005; 331: 1487–1488. (24 Dec) 2. Barclay P M. Book Review: www.painfreebirthing.com. BJA 2003; 90(6): 816 3. Eysenbach G. Köhler C. How do consumers search for and appraise health information on the world wide web? Qualitative study using focus groups, usability tests, and in-depth interviews. BMJ 2002; 324: 573 – 577. (9 Mar) Competing interests: None declared |
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Richard H. Riley, Anaesthetist Royal Perth Hospital
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Dear Sir The editorial by Dean Giustini (BMJ 2005; 331:1487-8) highlights the current and potential usefulness of the search engine Google. Last week I was amused when a trainee surgeon performed a Google search from the computer in the operating theatre prior to performing an examination under anaesthesia in a patient I had just anaesthetised. When I asked why he had not commenced scrubbing he said that he was searching for information on "anal mapping" that was requested by an imunologist but he was unclear about. Remarkably, he was able to locate a description of the technique from a trusted source almost instantly. Clearly, for hospitals with internet access, Google can be a serious, rapid alternative to locating a knowledgable senior doctor or a medical textbook! Richard H Riley Anaesthetist Royal Perth Hospital Perth, WA 6000 Australia Email: richard.riley@health.wa.gov.au Competing interests: None declared |
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Dean Giustini, UBC biomedical branch librarian Vancouver BC V6G1Z2, Dean Giustini
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Dear Google,
UBC Health Library wiki administrator Competing interests: None declared |
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Phillip J. Colquitt, Technician/RN Independent Comment
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I’m reading you on the ward computer, on which I have access to the BMJ Online. Accessing any hyperlinks you provide is another matter. None of the links at the bottom of your letter are accessible. Denied. So much for the mighty web. Further, University of Queensland[UQ]Library just sent a broadcast letter[on paper] to me and other hospital staff indicating that our access to UQ databases is over, and our previous UQ library membership has new terms, with very limited access. For example, Web of Science is no longer. Sounds to me like librarian rage. Competing interests: None declared |
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