Other developments set out in The New NHS include a revised national Information Management and Technology Strategy which will address "providing knowledge about health, illness and best treatment practice to the public through the Internet and emerging public access media"; the launch in 2000 of NHS Direct, a 24 hour nurse staffed national helpline; funding from the National Lottery for a network of local Healthy Living Centres; and development of a number of Health Action Zones where agencies will work together to tackle health inequalities.

Work begins in March 1998 to bring these various patient partnership, IT and telecommunications initiatives together into a single Public Information Strategy. As professional advisers to the NHS the authors (BG and VH) are active in developing this strategy nationally. On a local level we are looking forward to library and information services forming part of new Healthy Living Centres and developing multi-agency health information plans within the context of Health Action Zones.

Friday 26 June Room A 10.30

Remote Access to a Library and Information Resource for Primary Health Care Professionals

Accès à Distance à une Bibliothèque et aux Ressources d'Information pour les Praticiens

Andre Tomlin

Institute of Health Sciences Library, Oxford, UK

 

The aim of the Prise project (Primary Care Sharing the Evidence) is to monitor the effect of providing remote access to a library and information resource for all primary health care professionals, and to explore howfar the information needs of primary health care teams are satisfied by the service provided.

In the course of the project we have:

+ Set up of an electronic link providing access to a wide variety of resources including Medline, The Cochrane Library, Best Evidence and the Internet

+ Provided IT support for use of this link in connecting to the library resource

+ Provided a structured training programme based on the principles of CASPfew (Critical Appraisal Skills for Purchasers Finding the Evidence Workshops)

+ Provided library service support for project participants

+ Evaluated the information and ongoing training needs of the PHCT

The project which is managed by the Health Care Libraries Unit and supported by the Anglia and Oxford R&D Directorate, covers the four counties of Berkshire, Buckinghamshire, Northamptonshire and Oxfordshire. In all, 8 general practices and 4 general dental practices have been involved.

The computer links which have been set up have been complemented by on-site training for members of the practice and by telephone, fax and email advice and support. Because we believed that the delivery of information andtraining to the health professional should be as close to the place of practice as possible.

Preliminary findings clearly demonstrate the challenges and opportunities that exist for library and information service provision to a comparatively under-served group of health professionals. Library services play an important part in helping primary health care professionals deal with information overload. The project also seeks to inform the development of library services so that they may better meet the unique information requirements of this user group.

Friday 26 June Room A 11.00

Internet, Intranet and the Electronic Newsstand

Internet, Intranet et le Kiosque Électronique

Moreno Curti, A. Gelmetti, M. Rettani, C. Carrà, A. Gorini, G. Gabutti, A. Zeccato, C. Tinelli, C. Klersy

Direzione Scientifica - Policlinico S.Matteo, Pavia, Italy

 

Purpose of this study has been to show how, in a complex hospital setting, bibliographic information accessible on the Internet can be fitted into local activated services (Intranet).

The increasing availability on the Internet of bibliographic information that are, however, often limited to the bibliographic reference, with no free access to the full-text document, has brought us to the idea of combining both Internet and Intranet contribution. Actually, retrieving full-text documents from the Internet frequently depends on the economic possibilities of the single user. Intranet allows for everyone to check for journals at hand, to page through their indexes, and to fill in and send the request for a copy of the scientific paper of interest to the Scientific Documentation Service (SDS) of the Hospital.

In order to integrate the view from the Internet with that from the Intranet, the request form appears as a frame within the same web page, where the information retrieved from the outside web are displayed. In case a particular SDS periodical is not to be found on the Internet, the system allows to scan the indexes of each number of the available journal and to publish them on the Intranet; they will appear within web pages integrated with the request form. The SDS subsequently decides on the strategy for full text retrieval: from the subscribed periodicals; from full text journals accessible through a password; from national or international document delivery services.

In this way, an 'electronical newsstand' is set up, on which the single user may have a look, from its own computer, to the updated contents of its preferred journals; select the scientific papers of interest; fill in and send the request form for the full text document, which he will within short time receive on his desk, by means of the internal mail.

This service does in no way want to replace biomedical data-banks, but integrate them through a different modality of interrogating them. It will not answer the request of whom is searching bibliography by means of keywords. It rather will substitute the old-style newsstand display in the library, from which the user pages through the more recent issues, looks for new findings, chooses and then orders the articles to be read. Unlike the traditional newsstand display, the Electronic Newsstand may be consulted 24 hours a day and directly from one's own computer.

Le but de ce travail est de montrer comment l'information bibliographique accessible sur Internet peut être insérée dans les services activés localement d'Intranet, dans une réalité hospitalière complexe.

La disponibilité toujours plus grande sur Internet d'informations bibliographiques, qui sont toutefois souvent limitées à la simple référence bibliographique, sans accès libre au texte intégral, nous a ammenés à l'idée de combiner les apports d'Internet et d'Intranet. De fait, récupérer des documents intégraux sur Internet dépend souvent des possibilités économiques des usagers.

Intranet permet à chacun de contrôler les revues à disposition, de parcourir leur table des matières et de remplir et envoyer les formulaires de requête d'un article scientifique d'intérêt au Service de Documentation Scientifique (SDS) de l'Hôpital. Afin d'intégrer les images d'Internet avec celles d'Intranet, le formulaire apparaît en quadre sur la même page web que l'information récupérée à l'extérieur. Dans le cas où une revue du SDS n'aurait pas son correspondant sur Internet, le système permet de passer au scanner la table des matières de chaque numéro de la revue, afin de publier celle-ci sur Intranet. Elle apparaîtra à l'intérieur de pages web intégrées avec le formulaire de requête.

Le SDS décidera ensuite de la stratégie pour récupérer le texte intégral: à partir des revues scientifiques en abonnement, à partir de journaux à texte intégral accessibles par mot-clef, à travers les services nationaux et internationaux de récupération de documents.

Ainsi faisant un véritable kiosque électronique est mis en place, que l'usager peut consulter, à partir de son propre ordinateur, pour se mettre à jour sur le contenu de ses revues préférées, pour sélectionner les articles qui l'intéressent, pour remplir et envoyer le formulaire de requête de texte intégral. Il recevra celui-ci dans les plus brefs délais sur son bureau, à travers la poste intérieure.

Ce service ne veut aucunement remplacer les banques de données biomédicales, mais bien les intégrer par une modalité d'interrogation différente. Il ne répondra pas aux exigences de celui qui recherche une bibliographie par mots-clef. Plutôt il remplacera le kiosque "ancienne manière" de la bibliothèque, où l'utilisateur feuilletait les numéros les plus récents des revues scientifiques, recherchait les nouveautés, choisissait et coman dait les articles à lire. Contrairement au kiosque traditionnel, le kiosque élecronique peut être consulté 24 heures sur 24, directement de son propre ordinateur.

Friday 26 June Room A 11.30

Les Avantages et les Menaces pour l'Organisation du Système d'Information dans le domaine Médico-Pharmaceutique à l'Époque des Nouvelles Technologies

Anna Maria Uryga

Université Jagiellonne de Cracovie, Bibliothèque Médicale, Krakow, Poland

 

La Bibliothèque Médicale de l'Université Jagiellonne est la plus ancienne des bibliothèques en ce domaine en Pologne. L'unité organisationellement indépendante des facultés de médecine et de pharmacie (Collegium Medicum) est l'élement constituant de la bibliothèque nationale dont les missions sont le service, la pédagogie et la recherche.

Depuis 1984, la Bibliothèque Médicale fonctionne dans un nouveau bâtiment, qui est éloignée de plus de 10-20 km du centre universitaire et du centre hospitalier universitaire. Le système d'information de notre bibliothèque, comprenant bibliothèque centrale comme un centre logistique et 70 unités associées dans le cadre du C.H.U., présente beaucoup d'éléments de dysfonctionnement. Notre bibliothèque est quand même un pôle documentaire principal en médecine de l'université tant pour les étudiants que pour les enseignants, les chercheurs et pour les professionels de la santé dans la région. En considérant la distance qui sépare la bibliothèque de la vie universitaire et hospitalière, on peut constater que ce modèle concret exprime un besoin de developper l'idée de la bibliothèque virtuelle et sans limite à l'avenir.

Les objectifs de la restructuration à atteindre à court et moyen terme sont les suivants:

- optimisation de l'accès à l'information par:

* L'accés à distance via la réseau de Campus aux catalogues de la bibliothèques et aux banques de      données la poursuite de l'effort de formation des utilisateurs à la recherche documentaire.

* La connexion par fibre optique aux réseaux nationaux (NASK) et internationaux (Internet).

* L'organisation des services d'information et de la documentation spécialisée.

- développement méthodique des collections et restructuration des activités par l'exploitation exacte des locaux (achèvement de l'extension) et leur modernisation doit être composée dans la logique du project d'automatisation de la Bibliothèque.

- intensification du rôle coordinateur du service commun de la documentation de l'université de Cracovie en domaine de la mèdecine, par une politique plus affirmée de coopération avec les autres structures documentaires;

- participation active au projet d'informatisation des bibliothèques piloté par le services interétablissements de coopération documentaire;

- mise en place d'un véritable système d'évaluation des services offerts par la Bibliothèque

Après deux ans de déroulement du projet de la restructuration du système des bibliothèques et d'information du Collegium Medicum de l'Université Jagiellonne, nous présenterons un premier bilan, indiquant les points positifs, les difficultés rencontrées et les prospectives. Le but de notre présentation n'est seulement de montrer cette situation concréte, où se trouve notre bibliothèque. Il s'agit également par une meilleure connaissance des conditions, de tous les dispositifs et moyens d'information, de développer la coopération en matière d'information entre les institutions polonaises et étrangères.

Friday 26 June Room B 10.30

How Virtual is Scientific Publishing?

Hans E. Roosendaal

Elsevier Science, Amsterdam, NL

 

This presentation gives an analysis of the transformation of the familiar scientific information value chain into a scientific communication value network . Developments in research and academia call for new ways of knowledge management which in turn has consequences for the scientific communication market.

The scientific communication market is described in terms of four forces representing the actors, content, accessibility and applicability, and their interplay. Scientific communication is described in terms of its four main functions: registration, awareness, certification and archive. These forces and functions allow to analyze the developments in the market and allow to discuss the transformation from paper-based system to communication in an electronic environment.

The developments in research are seen to further the already existing autonomous development of a 'unified archive', lead us to review certification policies to include elements external to research and lead us to consider new structures for communication and publications.

In particular, when we consider communication during research as well, the need to review the structure and organisation of the market becomes evident.

Friday 26 June Room B 11.00

Net-Knitting: the Library Paradigm and the New Environment

Derek Law, Tony McSean

King's College Londen and British Medical Association, London, UK

 

The access versus collection debate has been gaining in importance for at least 50 years. It is surfacing again in different clothing as we have enough experience of how the Internet does work to allow us to begin asking how it should work. In theory the Internet abolishes the concept of distance but with networks running at the speed of their slowest link the practical reality is much more complex. Libraries need to exploit interlocking Internet/Intranet environments, with metropolitan/regional networks entering the picture also.

The paper examines initiatives in Japan, the USA and Europe and puts forward the suggestion that the accepted function of a library is an almost perfect paradigm of the emerging shape of electron ic scholarly communication.

The paper suggests a framework for decisions between local and remote acccess to information resources, new forms of library working to take account of library/ publishing/ computing convergence, and a shift in the place of librarians from the end of the information distribution process to the beginning.

Finally the paper suggests a timetable for the process by which experimentation in new forms of communication will become practical, paperless reality.

Friday 26 June Room B 11.30

Citation Analysis of the Veterinary Literature: a Tool to Understanding Changing Scientific Communication

Tom Roper

Royal College of Veterinary Surgeons Wellcome Library, London, UK

 

Citation analysis is a powerful bibliometric tool, but one infrequently applied to the veterinary literature: only one major study has been performed in recent years, and that confined itself to citation analysis as a tool for journal selection. There has been an increased interest in the area of animal health information, as the links between human and animal health have become the matter of public and media attention.

Using the resources of the RCVS Wellcome Library, one of the leading libraries for the profession, a citation analysis of two recent years (1995-96) of the core English language veterinary journals of interest to European practitioners was carried out in order to determine:

- the extent to which new media of scientific communication are changing the veterinary field

- the relationship between the veterinary literature and the wider biomedical literature

- the core journals and other media in the field

- the extent to which literature in languages other than English is cited

- the extent to which the major online biomedical indexing services cover this increasingly important field

The results have more than purely bibliometric significance, and show how the veterinary literature reflects the social and technological environment, as well as the development of science.

Friday 26 June Room B 12.00

Changing Users' Attitudes towards Information: an Italian Project on Invalid Biomedical Literature

Maria Nardelli, Mariateresa Azzolini, Gabriella Gabutti, Maura Moggia, Fulvia Sirocco

ZENECA S.P.A., ISF Pharmaceuticals, Policlinico San Matteo, Astra Farmaceutici, Azienda Ospedaliera "Ospedale San Martino", Milano, Italy

 

Invalid literature is undoubtedly a problem involving all scientific fields, but it becomes a more ethical and moral matter when related to the biomedical field. In fact recently was demonstrated that information retrieved to satisfy specific clinical questions can be used by physicians in future patient care decisions. Therefore one of the most important commitments for health information professionals should be to make users well aware of the existence of corrected or retracted articles. Both biomedical documentalists and librarians can play an important role in bringing published errata to users' attention, making them more critical readers and stimulating them to verify constantly the validity of the data contained in the literature they usually consult.

Despite the importance of this matter, health information professionals worldwide still can't refer to a codified method to help them reporting correctly invalid literature. With particular reference to librarians, usually they deal with the problem individually in many different ways, according to the organization of their libraries and the attitudes of their users. Even scientific publishers show corrected or retracted articles on their biomedical journals in many different ways, making often difficult for the end-users to retrieve this kind of information. It is slightly easier for health information professionals to have access to published errata consulting the most important biomedical databases, such as Medline or Embase, that report corrections or retractions through several appropriate keywords.

For all the above reasons, at the beginning of 1997 I gathered a small group of italian biomedical librarians interested in developing and starting a common experiment, devoted to identify a useful and functional method to keep users informed on invalid literature. In the project are involved two public libraries and two libraries of pharmaceutical industries, all members of the Italian Association of Health Information Professionals (GIDIF,RBM). The experiment provides a regular exchange of information among the group, the creation of a database for the retrieved errata, and individual interventions to awaken users' interest in the problem stimulating their critical attitude towards health information.

The collection of about 150 corrections or retractions since the beginning of the experiment seems to be a good result that stimulates us to keep on with the project. Now we would like to obtain the contribution and the suggestions of other italian and foreign colleagues, using different and perhaps more efficient methods to retrieve errata and to keep users informed about invalid literature.

Friday 26 June Room C 10.30

Quality Handbook - a Tool for Raising the Efficiency of Library Work

Grete Günther Bjørkenes

Østfold Sentralsykehus, Medisink Bibliotek, Frederikstad, Norway

 

Is our workplaces for the staff or for the users? This question was arisen in "Synopsis" no. 3/97,
(the journal of RBT) by Kirsten Engelstad.

There is no simple answer to that question. As she continued: a good, secure and stimulating workplace is important for the staff, but most workplaces are dependent on customers or a market. The staff of special libraries have become more and more engaged in orientating their activities towards good customer service.

For a long time the librarians were occupied with the internal library systems and co-operation between libraries. The users benefited of course of that efforts, but it was not until the libraries drew their attention to leadership, organization, customer handling, and marketing this become important.

The quality of the service has been more and more the question when librarians meet. In Norway this issue is also one of the main tasks for other organizations, for example the hospital that our library is a part of.

Securing quality and arise the service is what we have aimed at, all the time, but the new way to work, is to document what you do, do what you document and let the user know what they can expect of their libraries. In Norway some libraries have documented their work in special books, and use it as a tool to arise their quality in all fields.To increase the efficiency of the library, was the main goal for the librarians in Østfold Sentralsykehus to start the work with such a handbook, but we discovered soon that this led to better service for the users, better work environment for the staff, greater enthusiasm for the work, and last but not least, a more efficient library as a whole.

It was a great task to start and meant a good deal of work, and when the book was finished, we knew already then that this work will never be finished if you want a tool like this both in daily work, and also in the planning for the future. It has to be revised every year, at last, but the way we have done it, with great stress on the practical work around the procedures and also with mere manuals for special equipments, we realise already now, that we do not want to be without it.

Friday 26 June Room C 11.00

Total Quality Management in Dutch Medical Libraries: 1987-1998

Ronald van Dieën

Sophia Hospital, Medical Library, Zwolle, NL

 

In 1987 the Royal Dutch Society of Medicine (KNMG) in cooperation with the National Hospital Institute (NZi), presented guidelines for medical libraries in general hospitals. Due to the fact that this report was written by doctors instead of librarians, it lacked support by the medical librarians. Because there was no alternative, hospital directors accepted these guidelines and we, the medical librarians, had to work with it.

In 1990 the Librarians of Psychiatric Hospitals (BPZ) rewrote the report from a more practical point of view and updated it. Since then, many activities to improve the quality of medical libraries and medical librarians, found place. Committees on quality care, professional education, guidelines were installed. The last milestone was the acception of quality guidelines concerning medical libraries, in a total quality system for general hospitals called PACE. (PACE can be seen as the Dutch counterpart of the JHACO).

The library of the Sophia Hospital in Zwolle was the first medical library in the Netherlands to take part in a PACE survey and was awarded with a certificate.

Friday 26 June Room C 11.30

The Development of a Strategic Plan for the Scientific Information Provision of a Pharmaceutical Company

Nico W. van Putte

SDG InfoCentre, N.V. Organon, Oss, NL

 

Scientific information in the form of literature and patents is of essential value for an innovative pharmaceutical company like Organon. Such information plays a crucial role in the process of research and development (both in the laboratories and the clinic), in the registration procedure for new products and in the support of products on the market.Increasing competition in the pharmaceutical industry and rapid developments in the area of scientific information have made a pro-active approach with regard to the scientific information provision of a pharmaceutical company more and more desirable. Therefore Organon has developed a vision on the scientific information provision of the company for the near future and has laid down this vision in a strategic plan.

The plan describes the policy of the company with regard to the scientific information provision for the forthcoming five years and the consequences of this policy for the end-users, the information departments and some other departments involved, primarily for the headquarters in Oss in the Netherlands, but also for certain affiliates abroad. The plan is updated annually and is distributed to responsible managers in the organization after approval by the managing director. Implementation is mainly realized by means of operational plans of the information departments in Oss and abroad.

By means of the strategic plan one policy has been realized for the scientific information provision of the whole company. The plan has clarified the responsibilities of the end-users, the information departments and some other departments. Moreover, it stimulates the renovation of the scientific information provision which is vital to the future of the company.

Friday 26 June Room C 12.00

Expanding Information Service to Medical Staff and Students at small and remote Hospitals: a project at a University Library in Norway

Ragnhild E. Lande

University Library of Trondheim, Trondheim, Norway

 

In 1993 the Faculty of Medicine at the University of Trondheim was able to offer a complete undergraduate medical education to 60 students per year, after 18 years where only 3 1/2 years of clinical undergraduate medical education was offered. The new curriculum is based on problem-based learning (PBL). The preclinical and clinical part of the study are totally integrated during the 6 years of study. The number of new students per year was increased by 50% after 4 years, and it will be doubled within few years.

The clinical teaching is now spread over 8 hospitals in the middle part of Norway and, in addition, at the University Hospital. These hospitals are not a part of the University. The smallest of them have had problems in recruiting and keeping specialists in the medical and health science fields for some time. The specialists prefer to work in a professional and scientific environment in larger hospitals with better facilities. All the small hospitals have an inhouse data network but very few PC's with connection to the Internet. Half of them have a smal l one-person medical library.

There is a close relation between problem-based learning on the one hand and the library service on the other. It is also important for clinical practice to be able to retrieve relevant information and to be kept informed on the state of medical science. Therefore the University and the hospital authorities are planning a project which will start in the autumn of 1997. The aim is to make the Medical Library and Information Centre at the University into a power centre for these hospitals, so that the staff and the PBL students working there can have good access to information resources and find relevant literature for their daily work.

The paper will give an overview of the needs, the offers and the practical problems.

Friday 26 June Room D 10.30

Informational Infrastructure of a Public Health 'Library' of the (near) Future

Klaus Prätor

Landesinstitut für den öffentlichen Gesundheitsdienst, Bielefeld, Germany

 

The following considerations are based on experiences with the SOMED bibliographic database and library for public health maintained by the State Institute for Public Health NW, enriched by the results of two EU-supported studies on information systems within the fields of public health and environmental medicine. Of course a future library will extend its scope to different forms of electronic information. This will not be a merely technical change but also - and more important - a conceptual change. Technical means will trigger new forms of document organisation and document reference, as exemplified by hypertext and hypermedia, which combined with networking offer tremendous opportunities for information handling. These opportunities can only be exploited, if accompanied by an appropriate conceptual framework for integrating workplaces, network and information sources.

The suggested infrastructure is characterized by heavy use of meta-information, a new word covering as well traditional as recent concepts. Meta-information can roughly be class ified as automatic vs. intellectual by the intended use by computers or human beings. To enable retrieval and handling of a multitude of documents as well as the orientation within them, different forms of meta-information are needed: mainly referential, structural and semantic one.

The reported solutions are not restricted to a conceptual level but cover also the level of software engineering. With integration of information as a main goal of meta-information the integration of meta-information itself forms an important topic in this respect.

Friday 26 June Room D 11.00

The Story of the Dutch Working Group for Automation and Centralization of Catalogues of Hospital Libraries: Learning from too much Success

Marjan van Wegen

St Lucas Andreas Hospital, Amsterdam, NL

 

In 1984, a number of small medical libraries initiated a project to reach a common goal: the automation of their work and centralisation of their catalogues. These libraries primarily wanted to join forces in order to improve efficiency and enhance the quality of their library services. This collaboration resulted in the creation of the Central Catalogue of Hospital Libraries (CCZ-system) which also is an integral part of the National Automated Catalogue System (NCC). These libraries not only enabled the CCZ-system financially. They also made a joint effort to create a common thesaurus of medical Dutch headings and to complete a Dutch translation of the National Library of Congress Classification. The project proved to be a huge success - in ten years' time over 60 hospital libraries have become participants in the CCZ-system which now contains 84,000 titles. But this success led to more activities than the CCZ-group could manage.

Years ago, this collaboration had started as just a working group within the Biomedical Section of the Dutch Medical Libraries Association (BMI). Over the years however, this working group has evolved into a more or less independent BMI-section that concerns itself with the many aspects of maintaining and improving a professional standard in medical library services. This ultimately resulted in to biannual meetings focusing on subjects relevant to medical library work, such as: 'Working with electronic journals', 'Using the Internet', and 'Security measures in small hospital libraries'. These meetings are also open to employees of hospital libraries that do not actively feed titles into the CCZ-system.

The task of both maintaining and extending a thesaurus and a classification system, and organising biannual meetings for hospital libraries turns out to be unmanageable. This is why the CCZ-group will probably return to its initial task of creating and maintaining catalogues within the central catalogue of hospital libraries. The organisation of seminars will be delegated to the BMI. This also implies that hospital libraries cannot be part of the CCZ-system, unless they contribute to it.

The tradition of co-operation among libraries in The Netherlands has in the case of CCZ-group almost become too much of a success - it has certainly led to greater professionalism of a number of small (hospital) libraries, but at the same time this collaboration has become too large to manage. Therefore, it is vital that collaborations as these remain manageable and keep a clear order of priorities and also establish well-defined relations with similar collaborations.

Friday 26 June Room D 11.30

On the Role of Vernacular Medical Vocabularies in the Context of a Virtual Medical Library

Päivi Pekkarinen

National Library of Health Sciences, Helsinki, Finland

 

The paper explores the potential of vernacular medical vocabularies in the organization, structure and function of a virtual medical library. It is argued that they add to the awareness building and knowledge empowering of medical and health information users. For this purpose, a virtual medical library is defined as a computer-based, telecommunication-connected, domain-specific information system providing services as any conventional library does. Yet, its collection of documents, being continuously built and individually confugured by the user, expands beyond any single library collection. From the management point of view it may be seen as a cooperative of information professionals and information users; it is a continuous interactive process.

Regarded as a formal structure, a virtual /medical/ library contains documents, their relations and attributes attached to them.

Two types of documents may be distinguished by the data they contain

(1) documents as such, consisting of texts and images as well as multimedia

(2) metadocuments, consisting metadata used for the representation and retrieval of documents.

Documents produced by the information user may be considered as a microstructure; documents supported by the information professional may be considered as a macrostructure. The microstructure calls for the local, the macrostructure calls for the global. For the medical and health information user the virtual medical library is an opportunity to create meanings using his/her vernacular language, produce microstructures, and make them publicly accessible through macrostructures.

Two major domains manifested in the documents of the virtual library may be distinguished: expert knowledge domain and every day life domain. These lead to two requirements for the macrostructure of the virtual library: the capability to accommodate expert concepts and expressions (terminology) as well as popular concepts and expressions (terminology).

It is suggested that the primary tool for managing and maintaining the cooperative and interactive process of the virtual medical library is a user-interface-interlinked metathesaurus (cf. UMLS) linking a variety of vernacular medical vocabularies. Essential to the thesaurus is its transparency: the information professional-built relations between terms and concepts are continuously evaluated by the information user on the basis of their meaning: how well the information professional-built facets correspond to those used by the information user to structure his /her thinking.

Friday 26 June Room D 12.00

Equal Access, Simple Access: National Database Agreements in Norway

Elisabet h Akre

Norwegian Library Association, Section for Medicine and Health, Oslo, Norway

 

In the last few years the development of network technology has revolutionized the access to information and knowledge resources.

The demand for life-long learning and continuous updating of professional knowledge and competence is increasing. A major goal for libraries must be to contribute to equal and simple access to quality-controlled information sources for their users. Consortium agreements are one way of obtaining this.

The Norwegian National Office for Research Documentation, Academic and Special Libraries (RBT) entered into national license agreements for use of 9 databases from OCLC and ISI in 1996. These databases did not cover medical and health topics, and the access was restricted to academic institutions.

In the light of life-long learning and demands for continuous professional updating, it is of vital importance that access to quality-controlled information sources is not only available to students and academic staff but also to medical and health personnel working in non-teaching hospitals and other settings. The Norwegian authorities confirm this by their plans of a national technological 'health network'. The network is meant to be ready by the year 2000.In February 1997 the Norwegian Library Association. Section for Medicine and Health (SMH) asked RBT to contribute to national agreements for health databases such as Medline, Embase, Cinahl and others. The agreements should allow access for both academic and non-academic institutions in the health field.

A cooperation project between RBT and SMH was started, and in the period from May to September 1997 a pilot project has been going on, testing health databases from OCLC, OVID and Silver Platter. Test institutions have been both academic and non-academic institutions. The test results are now being evaluated and the next step will be to enter into negotiations. The aim is to have agreements ready by the beginning of 1998.

However, this summer a new revolutionary player has entered the arena - the NLM Free Medline. How will this affect the present and future situation? Is this the beginning of a new era when all health information will be accessible free of charge? Will paid licence agreements become unnecessary or will they have to include services supplementary to bibliographic services, such as full text documents, document delivery and others to be competitive?

The paper will focus on the role of consortium agreements as intermediary in the delivery of good information sources, as well as the economic and technical advantages of such agreements. The Norwegian experiences will be described, in particular the SMH/RBT health database project, with an updating of the project and of the situation regarding free or paid health information on the Internet by June 1998.

Friday 26 June Room A 15.15

Systematic Reviews depend on Systematic Literature Searches

Les Revues Systématiques dépendant de Recherches Systématiques de Publications

Hugh Brazier

Royal College of Surgeons in Ireland, Dublin, Ireland

 

Well designed systematic reviews and meta-analyses make important contributions to medical knowledge, and for many years the production of such reviews has been recognised as a key component in evidence-based medicine. The validity of a review depends on many factors, including - crucially - the methods employed to identify the research studies used in the analysis.

There are several published guidelines on the systematic review process, and much advice on how to carry out the literature search, with many authors stressing the need for high quality search methods which must be explicitly described in the review paper. But in practice how well do systematic reviewers and meta-analysts carry out their literature searches, and how clearly do they report the methods they have used?

This paper presents the results of a study of 154 meta-analyses and systematic reviews published in seven leading medical journals from 1985 to 1997. A search of Medline was specified in almost all papers, but less than half mentioned any o ther bibliographic database, and only just over half stated that they searched for unpublished material. The majority gave some indication of search terms used, but only one in ten included an adequate description of the search strategy. Publication bias was referred to in a third of the reviews, but only one in eight acknowledged the possibility that the search strategy employed might have missed relevant published literature. There was no evidence of any change over the twelve-year period.

This study raises concerns both about the quality of reports of search methods, and about the quality of the searches themselves. Many published systematic reviews and meta-analyses still appear to be based on poorly executed and inadequately documented searches. As medical librarians we have a duty to educate our clinical colleagues and improve the quality of the systematic review process.

Friday 26 June Room A 15.45

Assessment of Information Needs in Public Health in Germany - Results of a Nationwide Survey

Estimation des Besoins en Information dans la Santé Publique en Allemagne, Résultats d'une Enquête à l'Échelon National

Anke Scheiber, Rüdiger Schneemann, R. Wischer

Technische Universität Berlin, Institut für Gesundheitswissenschaften, Berlin, Germany

 

After a period of silent activity, public health as a scientific field has re-established itself in Germany over the last few years. Since Public Health in Germany is a new (or renewed), multidisciplinary area, there is no well established informational infrastructure to offer researchers, as well as other experts, an overview of current research activities and recently published literature. Therefore, a preliminary study based at the Institute for Health Sciences at the Technical University Berlin is assessing the informational needs in public health research and practice. The objectives of the study are to develop a design for a supplementary documentation about Public Health projects in Germany and to identify the benefits of new Internet online procedures for public health practice and research.

Also a survey about the experience with online databases and demands for specific information resources was conducted during August 1996 in order to analyse the extent of problems experienced with information retrieval. A questionnaire was developed and sent to 585 key persons. The response rate was 38% (n=217). Although scientific journals and other literature were the most preferred information resources (nearly 100% used them), about two-thirds of the responders were using databases for their research, and about 29% of them used the Internet to access the databases. A third of the responders were dissatisfied with the information output in general, and 35% complained about the quality of databases' counselling services. About 73% reported missing specialised databases (e.g. those containing epidemiological data). Due to the fact that it is very difficult to find qualified partners for cooperation and research experts, a forthcoming database about ongoing Public Health projects was supported by 70% of the responders.

The main conclusions of the survey findings are:

(a) there is a serious demand for information filtering and information supply in Public Health in Germany;

(b) as other investigations showed as well, some of the ''missed'' databases do already exist, but are obviously not well known or accessible, thus indicating a need of promoting information resources;

(c) although some of the responders have had access to the Internet, only very few of them were using email or the world wide web to find and exchange information.

The knowledge of how to use and customise online services should be developed by special training programmes.

Friday 26 June Room A 16.15

European Union Contribution to an International Register of Controlled Trials: The Importance of Collaboration throughout Europe

Contribution de l'Union Européenne à un Registre International d'Essais Contrôlés: l'Importance de la Coopération dans l'Europe Entière

Carol Lefebvre

UK Cochrane Centre, Oxford, UK

 

Randomized trials involving sufficient numbers of patients are essential to distinguish reliably between important effects of many forms of health care and the effects of biases or the play of chance. It has been shown repeatedly that if systematic reviews of randomized controlled trials (RCTs), updated periodically, had been made from the beginning of series of related trials, reliable treatment recommendations could have been made available earlier, and resources for research could have been used more efficiently. For systematic reviews to be reliable, they must be based on as high a proportion of the relevant evidence as possible. Searches of major bibliographic databases such as Medline and Embase have been shown to miss on average 50% of the studies in a number of clinical areas, and many important European journals, especially those not published in English, are not indexed in the major databases.

In November 1994 the European Union funded a contract under the BIOMED Programme, to identify reports of trials from general healthcare journals published in Europe. As this contract draws to an end, 13,000 reports of trials are now identifiable as trials in the Cochrane Controlled Trials Register (CCTR), which were not identifiable as trials in Medline before this contract. I am currently at the contract negotiation stage to extend this contract for a further three-year period, in order to be able to search specialized general healthcare journals published throughout the European Union. It is expected that this contract will commence early in 1998.

Our colleagues within the BIOMED contract who are responsible for searching German-language journals have made an important discovery as a result of their work. Under the contract, they searched five leading general healthcare journals published in German-speaking Europe. They compared studies reported in these five German speaking journals with reports by the same authors in English-language journals, to see if there were any differences in the characteristics between those articles published in English and those articles published in German. They found that only 35% of the German-language articles reported significant differences between the study and controlled groups. Conversely, 62% of the English-language articles reported significant differences between the study and control groups. This led our colleagues to conclude that authors are more likely to publish RCTs in an English-language journal if the results are statistically significant. E nglish-language bias may therefore be introduced in reviews and meta-analysis if they include only trials reported in English. It is therefore crucial that reports of trials published throughout Europe are identified and made available to those who are preparing systematic reviews and meta-analyses.

Friday 26 June Room A 16.45

Guidelines to Adapt the General Principles of the Non-statistical Meta-analysis Method to Specific Fields of Biomedical Research: the Example of Molecular Oncology.

Application des Principes de la Méta-analyse Non-statistique pour une Revue Critique de la Recherche Biomédicale en Oncologie Moléculaire

Françoise Pasleau, C. Delvenne, Nadine Cielniaszek

University of Liège, Liège, Belgium

 

In most circumstances, considerable time lags before results from biomedical research are integrated in general medical practice are inevitable. Several economic, technical factors and educational orientation are responsible for this gap. Effective information management at the institutional level, could provide clinicians the means to adopt new perspectives. At present, the link between basic research and clinical application relies upon the motivation of individuals to develop new skills in literature retrieval and analysis and yet their occupational responsabilities inhibit this endeavour. Academic librarians, educated and trained in information and biomedical sciences, have a role in providing physicians with current and readily applicable knowledge from the critical analysis of the literature.

The Faculty of Medicine Library is developing a research programme to design an updated and comprehensive picture of the diagnostic and prognostic biological markers in the field of human prostate cancer. The final product is envisioned as a database accessible on the web that will integrate bibliographic analyses and results from prospective and retrospective studies conducted at the University of Liège. As this product is designed to have a direct impact on clinical decision making and patient care, it should guarantee thoroughness, relevancy and objectivity and not become yet another narrative review of the literature.

Over the last decade, there has been a movement towards using statistical meta-analyses to synthesize literature. This method has proven to be useful when similar strategies are used to produce similar quantitative outcomes that can be merged for statistical analysis.¹ Even though studies in cancer research assess the same model, they are often too fragmented or heterogeneous in their design, methods and instrumentation. Approaches have been developed to conduct non-statistical meta-analysis of such publications.²

Quantitative and qualitative meta-analyses are based on common principles which are largely discussed in the literature. They are related to model development, literature coding, rating references for quality and annotating and synthesizing high quality references. In practice, these basic principles require translation into actual instructions adapted to every domain of biomedical research. Variable definition is a very critical step that governs the quality of subsequent analyses. Specific examples provided illustrate the guidelines acquired from our experience.

Il s'écoule souvent un intervalle de temps fort long avant que les nouveaux concepts issus de la recherche biomédicale soient intégrés dans la pratique médicale courante.

Les raisons de cette situation sont autant d'ordre économique et technique que culturel.

Actuellement, les liens entre la recherche fondamentale et la médecine clinique ne peuvent exister que sur base d'initiatives individuelles et les médecins concernés doivent investir une partie de leur temps dans l'apprentissage des techniques de recherche et d'analyse de la littérature.

Une gestion professionnelle de l'information au niveau d'une institution telle qu'un hôpital universitaire devrait par contre inciter davantage de cliniciens à utiliser les ressources de la littérature issue de la recherche biomédicale.

C'est pourquoi la Bibliothèque de la Faculté de Médecine de l'Université de Liège propose, à titre expérimental, de créer un prototype de site web consacré à l'étude des marqueurs pronostiques et diagnostiques du cancer de la prostate. Des scientifiques, spécialisés en sciences biomédicales et formés aux techniques de gestion documentaire, fourniront à l'intention des médecins spécialistes et/ou généralistes, voire des patients eux-mêmes, une analyse critique de la littérature en relation directe avec les activités cliniques de l'institution.

Notre objectif étant de fournir aux médecins des informations susceptibles d'être utilisées comme bases de décision clinique, notre responsabilité se trouve engagée vis à vis des patients.

Nous devrons donc définir une stratégie qui garantisse à la fois l'exhaustivité et la pertinence de l'information traitée et l'objectivité des analyses présentées. Sur base des principes de la méta-analyse,^1,2 nous avons conçu un protocole en cinq étapes comprenant: la définition à priori des objectifs, la recherche non biaisée d'information, la définition de critères de sélection des études, l'extraction et la synthèse des données.

La difficulté consistera à traduire ces principes en une série de consignes pratiques et techniques et d'en dégager des lignes de conduite générales qui permettront d'étendre cette approche à n'importe quel domaine de la médecine.

1. D'Agostino RB, Weintraub M. Meta-analysis: a method for synthesizing research. Clin Pharmacol Ther 1995;58:605-616

2. Bland CJ, Meurer LN, Maldonado G. A systematic approach to conducting a non-statistical meta-analysis of research literature. Acad Med 1995;70:642-653

Friday 26 June Room B 15.15

The Provision of Information for R&D Units at the County Councils in Sweden

Lotta Haglund

Spri Library and Research Report Bank, Stockholm, Sweden

 

The purpose of this study is to investigate how the staff at the research and development (R&D) units at Swedish county councils manage their information needs. I also wanted to see if their information seeking habits differ from the habits of researchers working in traditional research environments, i.e. universities.

Chantal Lheureux-Prévot, Virginie Halley des Fontaines

Centre de Documentation en Santé Publique - CHU St Antoine, Paris, France

 

Lorsqu'une bibliothèque ou un centre de documentation ouvre un site web, il souhaite valoriser ses ressources documentaires et entrer en contact avec de nouveaux usagers. Mais comment connaître l'impact réel des informations transmises et les attentes des utilisateurs?

Le dialogue entre le lecteur et le professionnel de l'information est un instrument privilégié du travail documentaire qui permet de cerner les demandes. Il fait place à une communication à sens unique, au mieux à une communication hachée et très parcellaire au gré des messages électroniques.

Soucieux d'évaluer l'intérêt suscité par le site web mis en place par le Centre de Documentation et de connaître le degré de satisfaction des utilisateurs, nous avons testé une grille d'évaluation et des outils statistiques adaptés. La grille d'évaluation comprend quatre critères: connaissance, lisibilité, motif(s) d'accès et utilisation du site. Les questions sont insérées dans la structure du site et apparaissent lors des chargements de certaines pages. Les outils statistiques permettent d'affiner certaines données, par exemple l'origine géographique des connexions ou les pages les plus consultées.

La combinaison de ces informations doit contribuer à l'adaptation du site aux besoins et attentes des utilisateurs.

When a library or documentation centre provides information on the web it is done in order to bring their resources in contact with new users. But how can we know what the real impact of the information is and to what extend it is used?

The dialogue between end-user and information professional is particularly suited to investigate such effects.

To investigate and evaluate the interest and end-user satisfaction of our web site and we have used an evaluation matrix and adopted some statistical methods.

The evaluation matrix consisted of: awareness, readability, reasons for consulting and usage of the site. The questions are incorporated in the structure of the site and are presented on the screen when viewing of the pages. The statistical methods allow downloading of certain data, such as the geographical origin of the connection and the pages consulted.

The combination of these data will contribute to the adaptation of the site to the information needs and behaviour of the users.

Saturday 27 June Room A 10.00

Old and New Media in Human Anatomy

Ancients et Nouveaux Médias en Anatomie Humaine

Berend Hillen

Dept. of Functional Anatomy, Medical Faculty, Utrecht University, Utrecht, NL

 

Anatomists have always been interested in new technologies to teach and to convey images. Early examples are, of course, the printings of the wood cuts in Vesalius great atlas! In fact, one may question if Vesalius would have been considered the founder of modern anatomy if Leonardo da Vinci had published his dissections. The requirements of an anatomical image are that 1: it should be objective and 2: it should represent the three dimensional relations properly. It is clear that in print it is, for various reasons, hard to satisfy both requirements. Depending on the anatomical technique only one or the other can be met, for instance dissection is 3-D but not objective, cross-sections are objective but only 2-D.

With modern electronic media it is possible to work out ways to meet both conditions in a better way than in printing. Technological development of imaging modalities (CT and MRI), anatomical cross-section techniques (heavy duty microtomes), informatics (powerful workstations and image processing software) and multi media platforms (CD-I, CD-ROM) all influence anatomy as a discipline and open new ways and possibilities for studying anatomy and dissiminate anatomical knowledge. In this project all these innovations have been put together, resulting in the prod uction of a Interactive Compact Disc. A large number of cross-sections, at very small intervals, was recorded directly from the surface of an anatomical specimen in the cryomicrotome with a videocamera, digitized and stored in a computer. The recording interval was identical to the size of the pixels in the acquisition (75 micrometer). Therefore, it was possible to calculate the two perpendicular cross-sections with the same resolution. On the CD platform, it is possible to manipulate with these series of cross-sections interactively. Among the features are orthogonal manipulations at specific tissue locations and a video animation of the cross-sections. Both enhance the insight in 3D relations of the 2D cross-sections. Especially the video animation, where the original third dimension is replaced by time, appears to be an attractive and useful tool for demonstrating 3D topographical relations. Other features of the interaction are the identification of the structures, either directly from the displayed section or by means of an index and changing the image modality (Anatomy, CT, MR) of the cross-sections and relating cross-sections to 3D reconstruction of specific elements (sinuses, skeleton) of the region. Considering the teaching value of such a production, it must be kept in mind that the applied techniques do not allow for a reduction of the complexity of the topographical relations. Therefore, its place in the medical curriculum is limited and teacher-dependent. On the other hand in postgraduate training, where insight in the details and the complexity is prerequisite, this is a powerful tool.

Saturday 27 June Room B 9.00

New Challenges and Roles for Library Staff in Response to Changes to the Biomedical Curricula in U.K. Universities

Michelle Wake, Linda Lisgarten

Library and Information Service, School of Pharmacy, University of London, London, UK

 

The Library of The School of Pharmacy serves an independent biomedical college of the University of London. Two main undergraduate courses are taught at the School; a Master of Pharmacy degree and a Bachelor of Science in Toxicology and Pharmacology. A large number of postgraduate courses, full and part-time, are also provided for. Research is also undertaken on the highest level, as the School's reputation is of international repute. The Library is central to all the School's activities.

Rapid changes in the content and execution of the undergraduate courses at the School have had a profound effect on the Library over the past three years, with two major curriculum reviews having been implemented.

The biggest impact on the Library so far has been an increase in teaching methods which are similar to problem based learning (PBL). This has led to a great increase in the use of electronic sources and printed stock by students. Issue Desk transactions alone jumped from 8,000 in the Autumn term of 1995 to 16,500 in the Autumn term of 1996. PBL students do use the Library differently to those using traditional learning methods. More time must be spent teaching information retrieval and Library staff must learn new skills and take on a teaching role. Predictably the budget and staffing levels have not been able to expand at the same rate.

The presentation will deal not only with the changes and associated challenges but also with the way the Library services have responded and have been proactive to the needs of the new curriculum and new directions in biomedical education. The success of the Library in meeting these challenges is crucial to the success of the institution in achieving its strategic objectives.

Donner RS, Bickley H. Problem based learning: an assessment of its feasibility and cost. Hum Pathol 1990;21:881-885

Buckton G, Bates IP. A problem-based learning approach to pharmaceutical education. Int Pharm J 1991;5:7-13

Student centred learning and its implementaion at Strathclyde school of pharmacy. Pharm J 1996;256:127-131

Eldredge JD. A problem-based learning curriculumin in transition: the emerging role of the library. Bull Med Libr Assoc 1993;81:310-315

Schilling K, Ginn DS, Mickelson P, Roth LH. Integration of information-seeking skills and activities into a problem-based curriculum. Bull Med Libr Assoc 1995;83:176-183

Marshall JG, Fitzgerald D, Busby L, Heaton G. A study of library use in problem-based and traditional medical curricula. Bull Med Libr Assoc 1993;81:299-305

Saturday 27 June Room B 9.30

Introducing Evidence-based Practice: the Library's Role in Teaching First Year Medical Students about Critical Information Tools

Keir Reavie

Vera P. Shiffman Medical Library, Wayne State University, Detroit, USA

 

The Shiffman Medical Library of Wayne State University plays an integral part in the mandatory first year Evidence-based Medicine course in the School of Medicine. The library conducts lectures, demonstrations and hands-on training, teaching medical students to access and use essential evidence-based practice information resources.

The course is two and a half weeks long. Students receive an assignment of four questions in the first class. Each question is best answered by four different information sources:

1) A textbook;

2) The journal literature, accessible using the Medline database;

3) A structured review of a single research study, found in publications like the ACP Journal Club, and;

4) A meta-analysis of the literature available in the Cochrane Database of Systematic Reviews.

In the first week of classes students can attend optional hands-on training facilitated by librarians within the library's computer labs. The training provides students with the background to efficiently use resources needed to complete their assignments. Medline and the Cochrane Databases are available via a network within the library and the School of Medicine. Other resources required for completion of the assignment are available on the Internet, or in print form within the library. The students take the opportunity during the hands-on training to utilize the expertise of medical librarians for assistance and to work on the assignment. A resource on the world wide web (WWW) designed to guide students in using networked-based evidence-based p ractice resources is accessible at any time using assigned passwords. Librarians are available outside hands-on training sessions to help students with the assignment. A team composed of a librarian and a physician presents a lecture that includes interactive demonstrations of the variety of information resources available to assist with evidence-based practice, including resources not needed to complete the assignment.

Attendance at the optional hands-on training and the access frequency for the WWW resource are recorded and compared to elucidate student's preferences for learning this material--personalized one-on-one, or group training, or web-based training on their own time. An online questionnaire is used to assess student's reactions to using the web resource, and to deduce its utility for learning and doing the assignments. Evaluations from previous Evidence-based Medicine courses, which did not include assignments, hands-on training, or a web resource, are compared with current course evaluations to gather data on the impact of the new course design.

Saturday 27 June Room B 10.00

Enduser-Education at the Karolinska Institute Library in Sweden

Christine Wickman

MIC-KIBIC, Karolinska Institute, Stockholm, Sweden

 

The Karolinska Institute Library and Information Center (KIBIC) is the Swedish National Resource Library for Medicine, Dentistry and Nursing Resarch as well as the Karolinska Institute Library in Sweden. The Karolinska Institute is the only Medical University in Sweden.

The MIC as a department of KIBIC and as a database host is very experienced in running courses for end-users and intermediaries. Teaching how to search information in biomedical databases, planning and running tailor-made courses for companies, institutions and medical libraries are included in our education programme. The introduction of problem-based learning in the curriculum for students in medicine and biomedicine changed our teaching priorities a lot. Students and teachers at the Karolinska Institute became a main end-user group.

The planning a nd administration of courses as well as teaching rather huge student groups each term demand a lot of resources both in time and personnel/staff. In this oral presentation I would like to focus on our experiences on building up curriculum-integrated education courses and finding new ways in teaching end-users how to find their own information. The importance of Internet and the world wide web as a tool and an aid for information seeking will be discussed.

What will be the future for librarians and information specialists as teachers?

Will search programmes becoming so user-friendly and self instructive that no teaching efforts will be needed?

Is distance-learning going to be the solution?

How important is the personal contact when teachers and pupils/students are coming together in courses?

Saturday 27 June Room C 9.00

Education for Health Sciences Librarians: Past, Present and Future Possibilities

Linda C. Smith

GSLIS, Univ. of Illinois at Urbana-Champaign, Champaign, Illinois, USA

 

Education for health sciences librarians in North America has been influenced by schools of library and information science (LIS), the Medical Library Association (MLA), and the National Library of Medicine (NLM).

This paper will provide an overview of education for health sciences librarianship by considering its development, current status, and possible future evolution.

Technologies for distance learning now make possible educational programs that cross national boundaries. Because health sciences librarians place a strong emphasis on lifelong learning, the paper will consider post-master's programs (e.g., internships) and continuing education as well as the first degree in LIS.

Another distinguishing cha racteristic of health sciences librarianship is the potential role of the professional association in providing a credentialing program for its members, as exemplified by MLA's Academy of Health Information Professionals (AHIP). Required knowledge and skills identified in Platform for Change, MLA's educational policy statement, encompass the health sciences environment and information policies, management of information services, health sciences information services, health sciences resource management, information systems and technology, instruction support systems, and research, analysis and interpretation.

Over the past two years with support from NLM planning grants, much attention has been directed toward future directions for education and training of health sciences librarians, including consideration of emerging roles and the role of computing and communications technologies in enhancing educational programs. In particular it is important to identify which means are most effective in achieving desired educational outcomes.

Implications of the findings of these planning grants for international collaboration in educational programs will be explored.

Saturday 27 June Room C 9.30

Becoming ADEPT: Teaching Evidence Based Medicine to Librarians using Distance Learning

Alison Hicks, Andrew Booth

School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK

 

'Becoming ADEPT: Applying Diagnosis Etiology Prognosis & Therapy methodological filters' is a continuing education programme for health librarians devised by the School of Health and Related Research (ScHARR), University of Sheffield, for South Thames Regional Library Service. Forty librarians received a programme combining elements of workshop exercises and distance-learning techniques to equip them to support Evidence Based Medicine (EBM).

This programme has three essential features: it employs the same techniques used to teach EBM to health professionals (eg. scenarios, focusing questions & critical appraisal), it harnesses the published re search findings on Medline retrieval from the Health Information Research Unit at McMaster University, Canada, and it goes beyond information retrieval to provide an insight into basic features of research design and interpretation.

Existing heavy demands on practicing health librarians, differing levels of resources and different levels of experience and competence placed a requirement for modules that were concise, accessible and self-sustaining. Modules were designed to take no more than two hours, to present realistic scenarios and to supply supporting materials. They were also centred on a common technology, Medline. A group feedback technique was used thus enabling shared learning, rather than merely depending on the external facilitators. Five modules (Therapy, Diagnosis, Reviews, Prognosis and Etiology (combined), and Guidelines and Economic Evaluations (combined) were delivered over the period March-October 1997. Three of these modules were handled via Distance Learning and two via workshops. Each module had learning objectives, exercises and an evaluation form.

This presentation will review both qualitative and quantitative data assembled during the training programme and will draw conclusions of practical benefit to those involved in either distance learning or EBM.

Saturday 27 June Room C 10.00

Getting Evidence to the Bedside - the Role of the Clinical Librarian

Anne Lusher

Cairns Library, University of Oxford, Oxford, UK

 

The Cairns Library, University of Oxford, is actively involved in the Oxford Consortium for Getting Evidence to the Bedside, a collaborative group which is investigating strategies for optimising access to evidence-based resources at the point of need i.e. ward or unit.

One of the group's pilot projects involves the attachment of a librarian to the Clinical Service of a medical team comprising 4 final year medical students, 2 house officers, a senior house officer, 2 specialist registrars, 1 clinical epidemiologist and a consultant. The attachment was for one month in September 1997 and will continue fo r a further month in April 1998.

The evidence-based resources are made available to the team on a number of computer terminals in key clinical areas (linked to the Internet, medical texts and various biomedical databases), on an 'evidence cart' (containing summary critical appraisals, CD-based Medline, Best Evidence, projector and printing facilities) and hand-held touch-screen computers (containing a subset of the above). The librarian attends ward-based post-take rounds, team rounds and student teaching rounds where the presentation, evaluation, clinical course and management of patients are discussed, clinical problems identified, clinical questions formulated and evidence sought immediately.

The primary objective of the 'clinical librarian' is to support patient-centred, self-directed, problem-based learning at the bedside by

(1) initiating immediate literature searches in response to clinical problems and educational requirements;

(2) advising how to identify highly specific patient-related evidence using advanced search strategies and methodologic filters;

(3) providing rapid access to articles or other reference material on a same-day or next-day basis.

The specific objectives of the project are to assist the clinical team in

(1) answering clinical questions arising from individual patient-centred problems;

(2) fulfilling educational prescriptions for presentations at weekly meetings;

(3) searching effectively Medline and secondary sources of critically appraised evidence;

(4) accessing the full text of articles and other reference material identified as useful.

The clinical service attachment offers an exciting and unique opportunity for librarians to gain a first-hand view of activities and information needs of medical students and doctors in training in a clinical setting and to measure the impact of close cooperation between the information specialist and the clinical team on therapeutic or diagnostic decision-making in direct patient care.

Saturday 27 June Room D 9.00

Consumer Health Information -- Developments in the USA

Donna Flake, John Rader

Coastal Area Health Education Center Library, Wilmington, North Carolina, USA

 

We as health professionals, are seeking ways to improve the health status of our communities. In ever growing numbers, consumers have started to take responsibility for their own health status by paying attention to nutrition, exercise, and general wellness. We are seeing consumer health information in ever growing quantities, in popular magazines, on television, in videotape format, in drug stores, in voluntary health agencies, and particularly through the Internet.

This paper will examine the great emphasis being placed on sources of consumer health information in the United States today. The consumer health information new emphasis of the National Library of Medicine and the Medical Library Association will be enumerated. Additionally, brief descriptions of three of the most outstanding consumer health libraries in the United States will be given.

The paper will also provide a description of an exciting new consumer health library in Wilmington, North Carolina, scheduled to open in Spring 1998. This library will be one of the largest and best funded in the United States. This library will be a department within the Wellness Division of New Hanover Regional Medical Center, the local large teaching hospital. The idea for creating this library was the joint project of a multifaceted group of people, including librarians from the Health Sciences Library at Coastal Area Health Education Center, librarians from the public library, wellness educators, university employees, and health educators from the community health department. All of these agencies will continue to support the library in the future.

The library will be located in the shopping center across the street from the medical center. It will be open five and a half days a week, staffed by a librarian and a library assistant, and will include electronic reference sources, s uch as Infotrac Health Reference Center on CD-ROM, Internet interactive CD-ROMs, and Medline. A circulating collection of books as well as videotapes, periodicals, and pamphlets will also be available. Once the library has been fully established, an add on project will be a traveling wellness van.

Saturday 27 June Room D 9.30

The Internet and Consumer Health Information: Implications for Social Qquality

Robert Kiley, Sally Hernando

Wellcome Trust, London, UK

 

"More than a third of all Internet searches are performed for health-related information" states Dr Harold Varmus, Director of the National Institutes of Health, USA, in the New York Times, 27 June 1997.

In recognition of the growing use of the Internet for health information the NIH have developed two freely available resources for consumers world wide:

Healthfinder: http://www.healthfinder.gov

and PubMed: http://www.ncbi.nlm.nih.gov/PubMed/

These sites are already proving to be popular with librarians and researchers internationally, who are finding barriers to information falling every day.

The NIH claims that members of the public can also benefit, citing the example of the Virginia couple whose 6-month search of the medical literature resulted in treatment for their son's rare inherited disease - the story of the film "Lorenzo's oil".

But is it realistic to expect that all but a tiny minority of health care consumers can use these resources effectively?

And, by legitimising the use of WANs for delivery of health information, do we risk creating an even wider gap in quality of care available to the world's rich and poor?

This paper will investigate these issues, and look at some ways in which librarians can help consumers to make sense of the vast amount of electronic information which is now, as least nominally, only a keystroke away. It will review current initiatives in the UK, and discuss the Wellcome Trust Information Service as a resource for the general public in biomedical science and health care.

Saturday 27 June Room D 10.00

Access to Consumer Health Information: a Development Model

Jennifer MacDougall

Library Association of Ireland, Dublin, Ireland

 

The Consumer Health Information Research Project, initiated in September 1996 by the Library Association of Ireland and funded by the Irish Department of Health from the National Lottery, is investigating the provision of healthcare information to the public by government and the voluntary sector in the Republic of Ireland. The study is examining the feasibility of a coordinated dissemination policy and a consumer health information (CHI) service for Ireland. The role of healthcare practitioners, the Department of Health, the Health Boards, pharmacists, medical and public libraries, national, local and voluntary organisations are examined in increasing access to this, the fastest growing area of healthcare information.

The research follows a recent study, Information for Health (Jennifer MacDougall, Library Association of Ireland, 1995) which identified increasing public demand for health information which was often unavailable or difficult to access. Other important studies in Ireland have also revealed a need for increased access to CHI sources. For example, the recent Department of Health publication "A Plan for Women's Health (1997)" identified the central problem for women as one of accessing appropriate, relevant and timely information on health and related areas for themselves and their families. The Plan has pledged to take cognisance of the outcome of the CHI Research Project in planning future action.

Within this context, the research methodology has so far involved: meetings with over 60 organisations invol ved in the provision of healthcare information to the public; study visits to fourteen established CHI services in the UK; extensive background research and literature searching; a case study of the Wexford area; the development of a database of national and local CHI resources.

Areas of the investigation include access to CHI, communications, awareness, types of information, and quality assurance.

The vast range of information collected overall is now being assessed and collated and will be presented in a report at the begining of 1998. The full findings and recommendations for the development of CHI in Ireland will be reported at EAHIL'98. It is expected that the results of the research will have relevance in many countries throughout Europe.

Saturday 27 June Room A 11.00

The National Library of Medicine: future plans for international access to its information resources

Lois Ann Colaianni

National Library of Medicine, Bethesda, Maryland, USA

 

The National Library of Medicine (NLM) in the United States provides a number of information resources useful to health sciences librarians and information professionals. Modern telecommunications make these resources accessible from all over the world.

This talk will highlight current developments in these resources, describe plans for the near future, and discuss how these changes may affect the roles of health sciences librarians and information professionals in the future.

Saturday 27 June Room A 11.25

EMBASE and full text: a common future?

Wubbo Tempel

Elsevier Science Secondary Publishing Division, Amsterdam, NL

 

Elsevier Science is publisher of 1100 primary scientific journals, a number of secondary services, of which Embase will be the best known to the EAHIL audience, and a number of specialty databases such as MDL, Beilstein, F-D-C, BioMedNet and ChemWeb.

The publisher's responsibilities in general are to add value for authors, subscribers and readers, to stay ahead of the technology curve (i.e. print-to-online is no longer sufficient, and the interneet raises users' expectations), to contribute to scholarly communication and to enhance access and functionality.

With its broad product base (and Lexis-Nexis technology available), Elsevier Science is uniquely positioned to produce the value-add, integrated services that the user community presently demands.

Example: ScienceDirect - designed with the end user in mind. It offers the full text, plus an abstracting and indexing layer as a navigational and research aid. The "full" Embase and other databases can be consulted for those users who want to use the full functionality of these databases.

Second example: Elsevier Electronic Subscriptions - which offers the electronic version of the full text of Elsevier Science journals for local implementation. If so desired, the EES package can be accessed through ScienceServer software, which can comprise Embase or other databases as a companion file and as such, as a linked navigational tool.

Saturday 27 June Room A 11.50

Linking Publications and References

Arnoud de Kemp

Sales, Marketing & Corporate Development, Springer Verlag, Berlin-Heidelberg, Germany

 

Visionaries of different backgrounds have been working on the idea of an invisible and unlimited library (Borges, Bush, Nelson, Gerfield, Eco, Negroponte, etc.). Due to high speed networks, powerful computers, new kinds of document formats, new ways for descriptions, links, and indexing, it is now becoming possible to start building the electronic medical and health science library of the future. There are several interesting projects and first information services. Arnoud de Kemp has been involved in electronic publishing from its origins. He will give an overview of developments, look into the problem of formats, present push technologies and focus on the big challenge of linking publications and references, for instance with the Document Object Identifier (DOI).

Saturday 27 June Room A 12.15

The Reenchantment of the Library

Bas Savenije

University Library Utrecht

 

Libraries have introduced a great many rules and procedures you need to familiarize yourself with, if you wat to make use of the services. These rules are needed because of the manner in which libraries have solved the problems related to the explosion of information: the access to information has been rationalized in a one-sided way.

The future library's challenge is to bring its content to live. What matters is not what you search, rather what you want to create, i.e. the extra value that comes into being as soon as various information sources come together. With the help of information technology it will become possible to browse through information as though you were strolling among bookshelves in a multidimensional fashion. Thus, the connection with man's creativity can be restored: the reenchantment of the library.

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