"House Calls on the House"-- Free MEDLARS

by Claire Hamasu

Vice President Albert Gore, in a momentous yet playful press conference, announced free access to the National Library of Medicine's MEDLINE database using the World Wide Web. On June 26, 1997 many dignitaries including Donald Lindberg, Director of the National Library of Medicine, Senator Arlen Specter (R) PA, representatives from the Medical Library Association, and rep-resentatives from journals that have full-text links to MEDLINE gathered in the Dirksen Senate Office Building to witness the event. One of the speakers that morning, Senator Thomas Harkin (D) IA, described the change from fee to free as making available "house calls on the house".

With helpful prompts from David Lipman Director of the National Center for Biotechnology (NCBI) the Vice President demonstrated the usefulness of MEDLINE by performing three searches on PubMed.

While playing a pick-up game of basketball, the Vice President had ruptured his achilles tendon. The first search looked for recommendations on treating this condition.

Search strategy used: Achilles repair casting

As the father of four children, Vice President Gore was very familiar with recurring ear infections. His next search pulled up a surprising reference recommending that children chew Xylitol chewing gum as a way of preventing ear infections.

Search strategy used: Prevention otitis recurrent

The last search was an example of an unsophisticated searcher entering search strategies in natural language. It also illustrated that intelligent systems can interpret natural language statements and produce results, but they may not be the best results for answering the question. The topic was the efficacy of flu shots. Vice President Gore typed in "Should I get a flu shot?" PubMed retrieved many articles but it was difficult to find one that spoke to the selected subject. Following instructions from Mr. Lipman, a revised search statement retrieved citations enumerating the cost benefits of an immunized work force and advising flu shots as one of the best prevention actions that the elderly can take against influenza.

Search strategy used: effectiveness influenza vaccine

The two Web sites providing free access to the National Library of Medicine databases are Internet Grateful Med (http://igm.nlm.nih.gov) and PubMed (http://www.ncbi.nlm.nih.gov/PubMed). The chart below can be used to determine which interface to use for your search question. (See Latitudes page 5 for more information on searching PubMed) IGM searchers who want to use the Loansome Doc feature must still have a MEDLARS id code/password. Online Services Applications for code/password are available from PSRML or you can download it from ftp://nlmpubs.nlm.nih.gov/nlminfo/agreements/userid.txt


                      Internet Grateful Med          PubMed                 
                                                                            

Databases:            MEDLINE, PREMEDLINE,           PREMEDLINE, MEDLINE    
                      OLDMEDLINE, SDILINE,           searched as one        
                      HealthSTAR AIDSLINE,           database               
                      AIDSDRUGS, AIDSTRIALS,                                
                      DIRLINE, HISTLINE, HSRPROJ                            

Search Levels:        One (However, command          Three -  Basic,        
                      language search override       Advanced, Clinical     
                      exists)                                               

Document Delivery:    Loansome Doc (fee may be       Links to about 30      
                      charged)                       online journals (fee   
                                                     may be charged)        

Other Links:          Images from the History of     Bibliography of        
                      Medicine, Agency for Health    related articles       
                      Care Policy and Research                              
                      Clinical Practice Guidelines                          



Latitudes, September/October 1997 -- Vol. 6, Number 5