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How to make the Internet work for you
Hans Pasterkamp, MD, FRCPC1
and Bill Poluha2
Dept. of Pediatrics and Child Health1 and NJMHS Library2
University of Manitoba
Winnipeg, MB
Objectives
at the end of this workshop you should know how to




choose from the range of information resources on
the Internet
use efficient search strategies to retrieve relevant
information
evaluate Internet based information content
incorporate Internet derived information in your
practice
Getting on the Internet
• Computer hardware (PC)
- Intel Pentium, 32 Mb RAM (minimum)
- Modem compatible with Internet Service Provider
- Modem speed min. 28.8 kbps
• Internet Service Provider
- Established company
- Enough modems to avoid busy lines
Needles in Haystacks
“Take a book ...
Remove the cover, remove the title page,
Remove the table of contents, remove the index,
Cut the binding from the spine,
Fling the loose pages that remain so that they scatter about the room ...
Now, find the information you needed from the book.
This is the Internet! “
attributed to Michael Gorman
Dean of Library Services, CSU Fresno
Healthcare Web Sites
• created by and for professions, societies
• about diseases, wellness, healthcare, or
health promotion
• for educational purposes, instruction
• directed at the public, at students, or at
practitioners
Information resources
world wide web
other
• search engines
• pathfinder sites
• subject catalogues
• e-mail
• filters & filing
• file attachments
• listserve (discussion groups)
• find & subscribe
• unsubscribe
• newsgroups
• gopher
• chat
Search strategies
• encyclopedic sites
– e.g. http://www.ncbi.nlm.nih.gov (MedLine, OMIM etc.)
– e.g. http://igm.nlm.nih.gov (Grateful Med - MedLine)
• pathfinder sites
e.g. http://www.med.jhu.edu/peds/neonatology/poi.html
• navigator sites
• free text search
– e.g. http://www.altavista.com
– meta-search engines, e.g., http://www.northernlight.com,
http://www.dogpile.com, http://www.infind.com
– PC-based searchbots, e.g. Copernic‘99
(http://www.copernic.com)
Encyclopedic sites
• cover wide range of health care topics,
providing direction and links
• promise of quality control (but often, the more
inclusive, the less quality)
• convenience of one-stop shopping
Exercise 1 - Encyclopedic Sites
You are the Attending
Pediatrician in a Teaching
Hospital. A 14 year old
girl on the ward has just
been admitted for the 3rd
time this year because of
asthma. The Intern asks if
there is any relevant
information on asthma on
the Internet.
Pathfinder Sites
• cover a single topic well
• sometimes offer content; they always offer
links!
• think of them as bibliographies, guides to
the topic on the web
Exercise 2 - Pathfinder Sites
A mother brings her 5 year
old son for vaccination. He
has CF and she is concerned
about routine vaccinations
since she read about this on
the Internet. She also
wonders about potential use
of ozone and of mullien tea.
She cannot find the web site
of the CCFF.
Navigator Sites
• search engines
– “purpose built” searches of the web with specific queries
– don’t expect precision of bibliographic searches
– advantages & disadvantages (too much or too little, out of context)
• catalogues
– collect & organize sites for browsing
– allow searches of what they have collected
• evaluated sites
– like catalogues, they have a repertoire
– they add extra value in description or approval of some kind
– try hard to locate criteria for each service
Exercise 3 - Free Text Search
A teenage patient with
end-stage CF asks you
about new therapies and
about lung transplantation.
She wants to use this
information in a science
project at school and she
wonders if students could
use the Internet to find
other resources.
Exercise 4 - Subject Catalogue
You have not been involved in the care of children with
rheumatoid disorders for awhile and you wonder about
your knowledge in this area,
Are there any web sites that can test your disease-specific
knowledge? If so, how would you find these sites and
how would you validate their content?
Exercise 5 - Subject Catalogue
A respiratory therapist has
returned from a conference
in Snowbird, USA, and
now wonders about
guidelines to use noninvasive IPPV in CF. Is
there any point in resorting
to the Internet for a search?
Exercise 6 - Listserv
Foster parents of a 4 year
old boy with attention
deficit wonder if you
know ADHD related
Internet resources.
WWW - Critical Appraisal
• how do you know what you can trust?
• how do you evaluate print sources?
– credentials of author
– reputation of publisher
– accuracy of content
– timeliness of information
• apply the same common sense standards to the
WWW
Quality Assessment
• Credibility: Source, Context, Currency, Relevance/Utility, Editorial
Review Process
• Content: Accuracy, Hierarchy of Evidence, Original Sources Stated,
Disclaimer, Omissions Noted
• Disclosure: Purpose of Site, Profiling
• Links: Selection, Architecture, Content, Back Linkages and Descriptions
• Design: Accessibility, Logical Organization, Internal Search Engine
• Interactivity: Mechanism for Feedback, Chat Rooms, Tailoring
• Caveats: Alerts
from: Criteria for Assessing the Quality of Health Information on the Internet
at http://hitiweb.mitretek.org/docs/criteria.html
Case Scenario
A 52 year old mother brings her 9 year old daughter
to you for assessment of Lyme disease. She states
that she has Lyme disease herself and that her
daughter’s problems of cough and wheeze are related
to an intrauterine infection with B. burgdorfferi
How do you find out about possible vertical
transmission of Lyme disease? What could the
mother know and what should you know?
Finding It Again
• save meta-searches
• use bookmarks in web browsers
– “post-process” bookmarks
• use index and search programs on PC and Mac
• bibliography programs (e.g., Reference Manager,
Procite etc.)
• electronic filing cabinet
• catalogue media (disks, CD-ROM, cassettes)
• take it with you (PDA)