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Risk Reduction in the News – Response from the NLN Medical Advisory Committee
2012 Conference featured in Oncology Times
Clinical Trials - Patient Participation
NLN Position Papers: Risk Reduction, Risk Reduction Summary, Diagnosis and Treatment, Exercise, Training, Breast Cancer-Related Lymphedema, Supplement BC-Related LE
Q: Where can I look to find articles and references from medical journals?
A: There are a number of resources available to healthcare providers and patients that allow them to search the medical journals (i.e. literature) to find articles. First, there is the medical library. Many institutions, hospitals, academic medical centers and universities have a library that is dedicated to medical literature. Once you are there, you will need to search within a specific medical database to locate the information that you are looking for. Keep in mind that there are thousands of medical journals, so libraries will not be able to carry all of the journals that you are looking for. One of the most popular medical databases in existence is MEDLINE. This is a database provided and kept by the National Library of Medicine. MEDLINE offers the ability to search by entering keywords according to the topic for which you are looking. For example: "Lymphedema." MEDLINE allows you to set limits on what you are searching for. You can limit the search to specific dates, articles written in English and articles written about humans. In addition, MEDLINE allows the user to search for a specific author and/or a specific journal title. MEDLINE can be accessed free of charge in libraries or from your home computer at www.ncbi.nlm.nih.gov/PubMed. Using general terms to search in MEDLINE will result in a high yield of references. Searching multiple related terms using Boolean operators (and, or, not) will help to focus the search. For example: "Lymphedema AND treatment." MEDLINE also offers the option to select references in which you are interested and move them to a text document or a "clipboard." The clipboard is a running list of all articles that the user has specifically selected. This makes it extremely easy to search the database and compile numerous articles using different search terms.
Another available database is found through the Cochrane Library. The Cochrane Library database focuses on reviews of controlled trials of therapeutic interventions. You can search with keywords as well as Medical Subject Heading (MeSH) terms. There is a fee associated with the use of this database. You can find information at www.updateusa.com/cochrane.htm.
Yet another database is "Best Evidence." Best Evidence catalogues articles that meet a high standard of science in their methods and are clinically relevant. This is a much smaller database because it is quite exclusive in its selection criteria. There is a fee associated with Best Evidence, as well. More information can be found at www.acponline.org/catalog/electronic/ best-evidence.htm.
There are a number of databases that exist and enable thorough literature searches. The aforementioned are both highly visible and highly scrutinized and, in turn, provide medical literature that is of an elevated standard. These sites may not be the best place for a user to find general information about a disease or condition.
Once an article reference is located in a database, the next issue is how to obtain a full text copy of the article. The databases will provide the user with a citation for the reference and an abstract of the article. Occasionally, full text articles can be retrieved through a link provided with the abstract. However, the majority of journal articles will need to be purchased. Your medical library may have the journal available for review. If not, many libraries can offer services that will obtain a full text article.
Q: How do I know that the information that I get from a medical website is reliable?
A: While there are a number of well-intentioned websites that offer information in a medical capacity, the consumers must take it upon themselves to look with more scrutiny at a site to determine if the information provided is legitimate. There are some specific things that can be sought out on a web page to give the user a better idea of the authenticity of the medical information provided. First, a site will typically provide a statement as to whether or not the information provided is from a medical source. It is important to look for references to journal articles or other prominent sources (i.e. The American Cancer Society). Most sites will offer the disclaimer that their information should not take the place of seeing a physician, or does not replace your doctors advice.
Another indicator may be the advertisements that are displayed on the site. If they are from well-known reputable companies, it is likely that the site offers higher-quality information. Look to the bottom of the page for a display that states when the page was last revised or updated. Beware of a site that sells products with claims that are "too-good-to-be-true."
Look for websites of nationally and internationally known organizations, professional organizations and/or societies and major medical centers. These institutions will likely have information to offer from a medical standpoint that is reliable, but they also will provide links to additional sites of equal value. The National Institutes of Health has a very comprehensive web page with a wide variety of medical information at www.nih.gov. It enables you to link to the various institutes and offers a PDQ information page with excellent basic information about numerous medical conditions. MD Consult is another general medical web page designed primarily for healthcare providers. It offers extensive information about various conditions, medical clinical trials, medications and current published research; www.mdconsult.com is the web site, however, membership does carry a fee unless your institution is a participating member.
Please address questions to: Editor c/o NLN, 116 New Montgomery Street, Suite 235, San Francisco, CA 94105 or e-mail: nln@lymphnet.org. Deadlines for submissions (for the following issue) are: Feb 15, May 15, Aug 15, Nov 15.
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