Personal computer access to MEDLINE: an introduction

Journal of Family Practice, April, 1991 by M. Lee Chambliss

Physicians can personally search MEDLINE to answer clinical questions or to update their knowledge base. The components required, each of which is discussed in the text, are a personal computer, a communications software program, a modem, the literature database, and an information vendor. Physicians can assemble and use these components with a minimum of expense and computer knowledge.

For the novice searcher who does not want to make a large initial investment, obtaining a low-cost personal computer and using an information vendor such as GRATEFUL MED or PaperChase may be the most suitable alternative. For searchers without access to a medical library or for more experienced searchers, an information vendor such as BRS, MEDIS, or DIALOG may be more appropriate.

Key words. MEDLARS-MEDLINE Information System; decision making, computer-assisted; diagnosis, computer-assisted. J Fam Pract 1991; 32:414-419.

Recent publications state the value of personal computer access to the medical literature and recommend this system as an effective way to answer clinical questions and to further medical education. [1-4] Personal computers give physicians rapid and easy access to more than 700,000 journal citations in the National Library of Medicine as well as much other useful medical information. Physicians who use personal computers but are unfamiliar with computer literature searching can access valuable information after only 1 to 2 hours of reviewing the operating instructions. Several articles explaining the methods involved and the different systems available were written in the mid-1980s, but major changes have occurred since that time. There is a paucity of recent articles that evaluate and compare all of the current systems. This article (1) explains the advantages of personal computer access to the medical literature, (2) gives information on different available components, (3) discusses information vendors in detail and reviews available comparison studies, and (4) gives suggestions as to which components may be most appropriate for different individuals.

Why Search?

Physicians use personal computers and communications technology in two main ways. First, specific information is generated with literature searches. In 3 to 4 minutes and for $2 to $5, a personal computer can scan the entire literature base of the National Library of Medicine and produce a list of relevant journal citations and their abstracts. A search may be designed to look for a specific author, article title, or medical subject. The number of citations generated for a medical subject may be limited by using qualifiers. For example, if one were looking for information on orthostatic hypotension, one could easily limit the search to retrieve only review articles about drug therapy for adults that were written in the last 2 years.

Second, a technique known as Selective Dissemination of Information (SDI) helps physicians with the never-ending task of staying abreast of the latest medical literature. The SDI technique entails designing a literature search on a specific topic and running it regularly to retrieve the most recent information on that subject. [5] For example, if a large portion of a practice were devoted to treating diabetes, one could design a search to produce relevant articles on the management of diabetes. Performing this search regularly (every month, quarter, or year, depending on one's reading habits) would generate a list with abstracts of the most current literature on that topic. This search could be restricted further to produce only articles that appear in preselected accessible journals.

Medical librarians perform both literature and SDI searches for physicians. There are, however, several advantages to searching the medical literature personally. First, personal searching may be more precise because it is often difficult for a physician to communicate to a librarian the exact nature of the information he or she is seeking. In performing a search individually, a physician incorporates his or her specific questions and medical knowledge into the search. This process often results in more pertinent data. [6] Second, personal searching is more timely and convenient. Results are obtained when and where they are needed: in the office, in the hospital, or at home. If they do not produce the desired results, searches can be modified immediately rather than having to wait 24 hours to discover from the librarian that the search must be repeated. Physicians' ability to search the medical literature, however, does not supplant the need for trained medical librarians. Librarians provide invaluable assistance in designing complex literature searches, and are expert consultants when personal searches do not produce the desired results.

The Components

The componenets necessary to perform personal literature searches are a personal computer, a modem, a communications software program, a medical database, and an information vendor.