How to make the Internet work for you

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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

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Objectivesat 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

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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

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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
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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

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Information resources

• world wide web
• search engines
• pathfinder sites
• subject catalogues

• other
• e-mail
• filters filing
• file attachments
• listserve (discussion groups)
• find subscribe
• unsubscribe
• newsgroups
• gopher
• chat

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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 sitese.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.northernlig
  ht.com, http//www.dogpile.com,
  http//www.infind.com
• PC-based searchbots, e.g. Copernic99
  (http//www.copernic.com)

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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

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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.

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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

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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.

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Navigator Sites

• search engines
• purpose built searches of the web with specific
  queries
• dont 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

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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.

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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?
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Exercise 5 - Subject Catalogue

• A respiratory therapist has returned from a
  conference in Snowbird, USA, and now wonders
  about guidelines to use non-invasive IPPV in CF.
  Is there any point in resorting to the Internet
  for a search?

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Exercise 6 - Listserv

• Foster parents of a 4 year old boy with
  attention deficit wonder if you know ADHD related
  Internet resources.

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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

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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

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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 daughters 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?
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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)