bims-librar Biomed news
on Biomedical librarianship
Issue of 2019‒03‒03
twenty-one papers selected by
Thomas Krichel
Open Library Society

  1. Health Info Libr J. 2019 Mar;36(1): 1-3
    Grant MJ.
      Maria Grant reflects on her ten years as Editor-in-Chief of the Health Information and Libraries Journal, her vision to enhance the quality and reach of the journal, and working with prospective authors in the health library sector to increase confidence in recognising and communicating the value of the work being undertaken.
    Keywords:  journals; library and information sector; publishers and publishing
  2. J Am Med Inform Assoc. 2019 Feb 26. pii: ocy189. [Epub ahead of print]
    Pesaranghader A, Matwin S, Sokolova M, Pesaranghader A.
      OBJECTIVE: In biomedicine, there is a wealth of information hidden in unstructured narratives such as research articles and clinical reports. To exploit these data properly, a word sense disambiguation (WSD) algorithm prevents downstream difficulties in the natural language processing applications pipeline. Supervised WSD algorithms largely outperform un- or semisupervised and knowledge-based methods; however, they train 1 separate classifier for each ambiguous term, necessitating a large number of expert-labeled training data, an unattainable goal in medical informatics. To alleviate this need, a single model that shares statistical strength across all instances and scales well with the vocabulary size is desirable.MATERIALS AND METHODS: Built on recent advances in deep learning, our deepBioWSD model leverages 1 single bidirectional long short-term memory network that makes sense prediction for any ambiguous term. In the model, first, the Unified Medical Language System sense embeddings will be computed using their text definitions; and then, after initializing the network with these embeddings, it will be trained on all (available) training data collectively. This method also considers a novel technique for automatic collection of training data from PubMed to (pre)train the network in an unsupervised manner.
    RESULTS: We use the MSH WSD dataset to compare WSD algorithms, with macro and micro accuracies employed as evaluation metrics. deepBioWSD outperforms existing models in biomedical text WSD by achieving the state-of-the-art performance of 96.82% for macro accuracy.
    CONCLUSIONS: Apart from the disambiguation improvement and unsupervised training, deepBioWSD depends on considerably less number of expert-labeled data as it learns the target and the context terms jointly. These merit deepBioWSD to be conveniently deployable in real-time biomedical applications.
    Keywords:  bidirectional long short-term memory network; biomedical text mining; deep neural networks; word sense disambiguation; zero-shot learning
  3. Health Info Libr J. 2019 Mar;36(1): 101-105
    Pizzarelli S, Cammarano RR, Sampaolo L, Della Seta M.
      In this article, guest writers from the Istituto Superiore di Sanità in Italy, the leading scientific technical body of the Italian National Health Service present a historic case study considering the role and evolution of the information specialists at their institution over a twenty year period. The paper places a particular emphasis on the initiatives undertaken in consumer health information and health literacy promotion, in order to improve public health in Italy. Areas covered include the development of online health information provision, early strategies to support the improvement of health literacy, and national projects and collaborations. H.S.
    Keywords:  consumer health information; health literacy; information dissemination; information services; libraries; medical
  4. AMIA Annu Symp Proc. 2018 ;2018 368-376
    Demner-Fushman D, Mork JG, Rogers WJ, Shooshan SE, Rodriguez L, Aronson AR.
      Medication doses, one of the determining factors in medication safety and effectiveness, are present in the literature, but only in free-text form. We set out to determine if the systems developed for extracting drug prescription information from clinical text would yield comparable results on scientific literature and if sequence-to-sequence learning with neural networks could improve over the current state-of-the-art. We developed a collection of 694 PubMed Central documents annotated with drug dose information using the i2b2 schema. We found that less than half of the drug doses are present in the MEDLINE/PubMed abstracts, and full-text is needed to identify the other half. We identified the differences in the scope and formatting of drug dose information in the literature and clinical text, which require developing new dose extraction approaches. Finally, we achieved 83.9% recall, 87.2% precision and 85.5% F1 score in extracting complete drug prescription information from the literature.
  5. Semin Nucl Med. 2019 Mar;pii: S0001-2998(18)30098-9. [Epub ahead of print]49(2): 105-114
    Wilson M, Moher D.
      In the early 1970s, when Seminars in Nuclear Medicine started publication, little was known about the quality of reporting in biomedical journals. Senior scholars were invited to become scientific editors of journals based on their research credibility and stature. Their knowledge of journalology (publication science) was not assessed. Similarly, while the use of peer review was gaining momentum, there was limited guidance on the tasks and expectations of peer reviewing. Almost 50 years later, the evidence base regarding the quality of reporting is vast. This paper highlights some of this evidence including that relevant to imaging and nuclear medicine research. In biomedical publications, there is a crisis in reproducibility; high prevalence rates of reporting biases, such as selective outcome reporting; spin; low registration rates of research protocols; and endemic poor reporting of research across biomedicine. These issues and some more immediate solutions are also discussed in the paper. The use of reporting guidelines has been shown to be associated with better reporting of clinical trials and other research articles. The use of audit and feedback tools is likely to provide an important gauge about the functions of biomedical journals. Finally, the push to better equip scientific editors and peer reviewers is taking a more concerted effort.
  6. Am J Otolaryngol. 2019 Feb 18. pii: S0196-0709(18)31045-7. [Epub ahead of print]
    Unsal AA, Dubal PM, Pfaff JA, Friedel ME, Eloy JA, Kountakis SE.
      OBJECTIVE: Variation in weather patterns is often cited as a risk factor for epistaxis although robust studies investigating specific climate factors are lacking. As society is increasingly utilizing the Internet to learn more about their medical conditions, we explore whether Internet search activity related to epistaxis is influenced by fluctuations in climate.METHODS: Internet search activity for epistaxis-related search terms during 2012-2017 were extracted from Google Trends and localized to six highly populated cities in the US: New York, New York; Los Angeles, California; Chicago, Illinois; Houston, Texas; Philadelphia, Pennsylvania; and Atlanta, Georgia. Data were compared to local average monthly climate data from the National Centers for Environmental Information for the same time period.
    RESULTS: Spearmen correlations (r) were statistically strongest for dew point temperature (rNewYork = -0.82; rPhiladelphia = -0.74; rChicago = -0.65; rAtlanta = -0.49, rLosAngeles = -0.3). This was followed closely by relative humidity (rNewYork = -0.63; rPhiladelphia = -0.57; rLosAngeles = -0.44; rAtlanta = -0.42; rHouston = -0.40) and average temperature (rNewYork = -0.8; rPhiladelphia = -0.72; rChicago = -0.62; rAtlanta = -0.45). Overall, correlations were most significant and predictable for cities with the greatest seasonal climate shifts (New York, Philadelphia, and Chicago). The weakest environmental factor was barometric pressure, which was found to be moderately positive in Atlanta (rbarometric = 0.31), Philadelphia (rbarometric = 0.30) and New York (rbarometric = 0.27).
    CONCLUSIONS: Google Trends data for epistaxis-related search activity responds closely to climate patterns in most cities studied, thus underscoring the potential utility of Internet search activity data as a resource for epidemiologic study and for the identification of at risk populations.
    Keywords:  Barometric pressure; Dew point; Dew point temperature; Epistaxis; Google; Google Trends; Humidity; Nosebleed; Temperature; Weather
  7. Health Info Libr J. 2019 Mar;36(1): 96-100
    Madge OL, Robu I.
      This article is part of a series in this regular feature which looks at new directions in health science libraries. This article provides an updated overview of medical libraries in Romania, with a focus on the academic libraries which function under the patronage of medical schools. Information was collected through a survey questionnaire sent out to Romanian academic medical libraries in March 2017. The responses provide an overall picture of the state of Romanian medical libraries, highlighting the main trends and areas in which progress is evident, as well as the problems confronting these libraries. J.M.
    Keywords:  Libraries, academic; libraries, medical; library administration
  8. Trends Cardiovasc Med. 2019 Feb 14. pii: S1050-1738(19)30010-6. [Epub ahead of print]
    Farouk S, Sparks MA.
    Keywords:  Education; Peer review; Social media; Twitter
  9. J Prev Interv Community. 2019 Jan-Mar;47(1):47(1): 5-13
    Basch CH, Ethan D, Cadorett V, Kollia B, Clark A.
      Community water fluoridation has been deemed one of the greatest public health achievements, yet it remains a controversial topic. As those who are concerned about the benefits and safety of community water fluoridation are likely to turn to the Internet to find information, it is important to know the ease with which a person can read popular materials online. The aim of this study was to assess the readability levels of pro- and anti-fluoride articles on the Internet. Using a highly-recommended readability site, the first 100 articles garnered from websites in a Google were analyzed for a multitude of scores on popular readability tests. Of the 100 articles analyzed, 71 were deemed to be pro-fluoride, and 29 were anti-fluoride. Anti-fluoride materials were more readable across all scores when compared to the pro-fluoride materials. It is critical for consumers to be aware of the credibility of the health information they are reading and to be educated on how to determine if a website or source is reliable, especially when information is conflicting. It is also critical that health associations and other websites devoted to public health promotion develop and provide more accessible health information in terms of readability.
    Keywords:  Dental health; fluoride; information; readability
  10. Am J Health Behav. 2019 Mar 01. 43(2): 437-448
    Shi W.
      Objectives: Given the prevalence of stress among young adults and its impact on overall health, it is important to understand how college students respond to stress and stress management messages and which factors influence subsequent health information engagement. Methods: In the current study, I used an experimental design to test whether the variables of risk percep tion, response efficacy, and source credibility can exert an impact on a convenient sample of undergraduate students at a large Midwestern public university in the health context of stress and stress management. Results: Both risk perception and response efficacy were positively associated with health information seeking and negatively associated with health information avoiding, but only risk perception had a strong and statistically significant influence on information engagement. I found no statistically significant interaction between risk perception and response efficacy or moderating effects of source credibility. Conclusions: This study provides empirical support for the claim that stress-related risk perception can influence young adults' information engagement significantly. Health communication strategists addressing the issue of stress among college students should consider eliciting risk perception.
  11. AMIA Annu Symp Proc. 2018 ;2018 1036-1045
    Turner AM, Osterhage KP, Taylor JO, Hartzler AL, Demiris G.
      Older adults are the largest consumers of healthcare. As part of a broader study of personal health information management (PHIM), we interviewed older adults in King County, Washington, and their involved family and friends (FF), regarding health information (HI) sources they seek and utilize. Analysis of interview transcripts revealed four main themes: 1) older adults and FF consider healthcare providers the foundational source of HI; 2) older adults utilize FF for seeking, sharing, and interpreting HI, while FF serve as surrogate seekers and experience-based experts; 3) online searching is common for older adults and FF, but confidence in assessing the quality of online HI is often lacking; 4) a smorgasbord approach is frequently utilized by older adults and FF for gathering and clarifying HI. Design considerations include: facilitating access to quality provider-vetted HI, incorporating older adults and FF in the design process, and creating shared spaces for communication of HI among older adults, FF, and providers.
  12. BMJ Evid Based Med. 2019 Feb 25. pii: bmjebm-2018-111109. [Epub ahead of print]
    Bareket R, Schonberg MA, Schonmann Y.
      The last decades saw remarkable change in the way healthcare professionals generate and consume medical knowledge. Information management technologies have evolved considerably, yet medical publications continue to use a referencing system that has changed very little since the turn of the 20th century. Research suggests that up to one in five referenced claims quotes the original text inaccurately. Many authors, perhaps inadvertently, contribute to this process by citing non-primary data and amplifying the errors of their predecessors. Erroneous claims are propagated, accumulate into false belief systems and generate inaccurate knowledge. Updating the referencing system to provide additional information to support each referenced claim (eg, the location of the referenced statement in the original text and the nature of that text) could, perhaps, address this cycle of inaccuracy. We believe such changes in the referencing system would prompt authors to rigorously verify referenced claims and provide readers with context to inform a critical evaluation of the text. We detail our proposal for changes in the notations used for referencing, as well as in the information provided within reference lists. We also discuss some barriers and solutions to the adoption of our proposal.
    Keywords:  medical journalism
  13. Confl Health. 2019 ;13 4
    Flaherty MG, Roberts LF.
      Donor and agency priorities are influenced by a variety of political, social, and media-related forces that can have a profound impact on response and resource provision. We have attempted to assess how well internet searches articulate the span of violent death rates for five current "crisis" settings. In three graduate classes (2 public health, 1 information science) at US universities, during a four month period in 2017-2018, we asked approximately 60 graduate students to conduct an internet search to determine which of five countries had the highest and lowest "violence specific mortality rate": Venezuela, Syria, Yemen, Central African Republic (CAR), or Mali. Students were divided into groups of three, and within each group explored this question by three approaches. Many graduate students in all groups could not determine the relative rates, especially which country had the lowest violence specific mortality rate. Of the 34 searches that identified a highest violent death rate country, 27.5 (81%) concluded it was Venezuela, followed by Syria (4.5; 13%), Mali (1; 3%) and CAR (1; 3%). Of the 26 searches that identified a least violent death rate 21.5 (83%) reported either CAR or Mali, followed by Yemen (2.5; 10%) and Syria (2; 8%). Aside from lack of data on CAR and Mali, students were perplexed about whether to include suicides or executions in the measure. This resulted in almost half of all inquiries unable to estimate a highest and lowest rate among these five countries. Where conclusions were drawn, it is likely the internet drew students to the opposite conclusion from reality. There are several reasons for this discordance, such as differing categories of violent deaths as defined by the World Health Organization, and search engine algorithms. It is probable, however, that larger issues of connectivity of individual societies with each other and the outside world are playing a profound role in the deceptive results found in this exercise. This insight emphasizes the internet's under-reporting in the world's most poor and remote locations, and highlights the importance of primary data collection and reporting in such settings.
    Keywords:  Humanitarian injustice; Internet searching; Violent death rate
  14. PLoS One. 2019 ;14(2): e0211919
    Viguera-Guerra I, Ruano J, Aguilar-Luque M, Gay-Mimbrera J, Montilla A, Fernández-Rueda JL, Fernández-Chaichio J, Sanz-Cabanillas JL, Gómez-Arias PJ, Vélez García-Nieto A, Gómez-Garcia F, Isla-Tejera B.
      This research-on-research study describes efforts to develop non-Cochrane systematic reviews (SRs) by analyzing demographical and time-course collaborations between international institutions using protocols registered in the International Prospective Register of Systematic Reviews (PROSPERO) or published in scientific journals. We have published an a priori protocol to develop this study. Protocols published in scientific journals were searched using the MEDLINE and Embase databases; the query terms "Systematic review" [Title] AND "protocol" [Title] were searched from February 2011 to December 2017. Protocols registered at PROSPERO during the same period were obtained by web scraping all non-Cochrane records with a Python script. After excluding protocols that had a fulfillment or duplication rate of less than 90%, they were classified as published "only in PROSPERO", "only in journals", or in "journals and PROSPERO". Results of data and metadata extraction using text mining processes were curated by two reviewers. These Datasets and R scripts are freely available to facilitate reproducibility. We obtained 20,814 protocols of non-Cochrane SRs. While "unique protocols" by reviewers' institutions from 60 countries were the most frequent, a median of 6 (2-150) institutions from 130 different countries were involved in the preparation of "collaborative protocols". The highest Ranked countries involved in overall protocol production were the UK, the U.S., Australia, Brazil, China, Canada, the Netherlands, Germany, and Italy. Most protocols were registered only in PROSPERO. However, the number of protocols published in scientific journals (924) or in both PROSPERO and journals (807) has increased over the last three years. Syst Rev and BMJ Open published more than half of the total protocols. While the more productive countries were involved in "unique" and "collaborative protocols", less productive countries only participated in "collaborative protocols" that were mainly published in PROSPERO. Our results suggest that, although most countries were involved in solitary production of protocols for non-Cochrane SRs during the study period, it would be useful to develop new strategies to promote international collaborations, especially with less productive countries.
  15. J Neurosci Res. 2019 Feb 27.
    Lopez-Castroman J, Moulahi B, Azé J, Bringay S, Deninotti J, Guillaume S, Baca-Garcia E.
      Attention about the risks of online social networks (SNs) has been called upon reports describing their use to express emotional distress and suicidal ideation or plans. On the Internet, cyberbullying, suicide pacts, Internet addiction, and "extreme" communities seem to increase suicidal behavior (SB). In this study, the scientific literature about SBs and SNs was narratively reviewed. Some authors focus on detecting at-risk populations through data mining, identification of risks factors, and web activity patterns. Others describe prevention practices on the Internet, such as websites, screening, and applications. Targeted interventions through SNs are also contemplated when suicidal ideation is present. Multiple predictive models should be defined, implemented, tested, and combined in order to deal with the risk of SB through an effective decision support system. This endeavor might require a reorganization of care for SNs users presenting suicidal ideation.
    Keywords:  mood disorders; natural language processing; social networks; suicidal behavior
  16. Semin Nucl Med. 2019 Mar;pii: S0001-2998(18)30097-7. [Epub ahead of print]49(2): 121-135
    McInnes MDF, Lim CS, van der Pol CB, Salameh JP, McGrath TA, Frank RA.
      Suboptimal reporting in the publication of imaging research studies is a growing concern. Deficient and incomplete reporting prevents the evaluation of the validity, replicability, and the overall quality of the research. Reporting guidelines are checklists designed to guide researchers about the minimum information to be provided in research studies to allow for adequate quality appraisal and to assess generalizability. They are a powerful tool to allow key stakeholders such as journal editors, peer reviewers, funding agencies, and readers to better identify robust health research. The Enhancing the QUAlity and Transparency of Health Research Network is an international initiative that attempts to improve the reporting practices of a variety of health research study designs by providing the resources required to develop, disseminate, and implement reporting guidelines. In this review, we elaborate on the impact of good reporting on imaging research, and the different types of guidelines relevant for the various study designs applicable in imaging research.
  17. Female Pelvic Med Reconstr Surg. 2019 Mar/Apr;25(2):25(2): 120-124
    Kadam-Halani PK, Lee DD, Sammel MD, Arya LA, Andy UU.
      OBJECTIVE: The aim of this study was to assess the quality of information available through the Internet for a variety of search terms for fecal incontinence (FI).METHODS: Using the Google search engine, searches were performed for 4 terms: "bowel control problem," "accidental bowel leakage," "fecal incontinence," and "leaking stool." The DISCERN quality analysis tool and JAMA benchmark criteria were implemented by 2 independent reviewers to evaluate the first 20 search results for each term. To determine if 1 term provided higher-quality information, mean DISCERN and JAMA criteria scores as well as Web site category were compared using analysis of variance and Pearson χ tests.
    RESULTS: Mean DISCERN scores for all terms fell in the middle range of possible scores. DISCERN questions addressing risks of treatment options, effects of treatment on quality of life, and gaps in knowledge/differences in expert opinion had the lowest scores across all search terms (range of scores, 1.1-1.7/5). JAMA criteria on authorship and attribution were most frequently missing on average in 48 of 80 and 42 of 80 Web sites, respectively. There were significant differences in mean DISCERN scores among the terms, with "fecal incontinence" yielding the highest mean score. The term "accidental bowel leakage" yielded the highest number of marketing Web sites, whereas "leaking stool" had the highest proportion of social Web sites.
    CONCLUSIONS: The quality of available information about FI on the Internet is variable, and key components are often missing. The term "fecal incontinence" yielded the highest quality information of all search terms.
  18. J Educ Health Promot. 2019 ;8 2
    Bathaei SA, Abolghasem-Gorji H, Delgoshaei B, Khankeh HR.
      INTRODUCTION: Disasters are inescapable phenomena. Once they occur, reliable and objective information becomes vital in sound decision-making to respond. Emergency health evaluation of affected population can be used to gather information about the patterns of access to medical care, basic household needs, and other health needs. The objective of this review was to summarize evidence from scientific studies on the various methods of emergency health evaluation following disasters.MATERIALS AND METHODS: A comprehensive list of studies was provided in May 2017 by an extensive search using PubMed, Web of Sciences, Ovid Medline, ProQuest Research Library, and World Health Organization Library.
    RESULTS: Of the 1592 retrieved articles, 21 articles were included in this review. In a majority of the studies (n = 18), a questionnaire was used and an interview was conducted to collect information, but in three studies, smartphone-based methods were used. Sampling method in most of the studies was cluster sampling in Community Assessment for Public Health Emergency Response method. But in eight studies, random sampling method was used. In a majority of the studies, the demographic status of samples and in 18 studies, the condition of diseases, water, shelters, health, food, mortality rate, and existing medical services were investigated.
    CONCLUSIONS: Although new methods such as social media and smartphones were already investigated in some articles, but these approaches require further investigation since there is a growing need for new methods.
    Keywords:  Disaster; emergency health evaluation; need assessment; new approach
  19. Int J Drug Policy. 2019 Feb 21. pii: S0955-3959(19)30013-1. [Epub ahead of print]
    Lewis N, Sznitman SR.
      BACKGROUND: The legalization of medical and recreational cannabis is a topic of continued debate in countries around the world. It has been suggested that medical cannabis legalization influences cannabis legalization for recreational purposes through increased media attention toward the positive health effects of cannabis. However, the nature of media coverage is likely to vary across mass media and online sources (internet and social media). In addition, effects of information engagement on attitudes may vary depending on whether information was actively sought or obtained incidentally during patterns of regular media use (scanned).METHODS: This study uses data from an online survey of Israeli adults (N = 554) to test the association between information seeking and scanning about medical cannabis (from mass media and online sources) and attitudes toward medical cannabis. Furthermore, we test indirect effects of media engagement on attitudes toward cannabis legalization through medical cannabis attitudes.
    RESULTS: Seeking and scanning for information about medical cannabis from online sources, but not from mass media sources, were associated with positive attitudes toward medical cannabis. Engagement with medical cannabis information from online sources was also indirectly associated with greater support for cannabis legalization, through positive attitudes related to medical cannabis.
    CONCLUSION: The results suggest that one mechanism through which medical cannabis legalization is associated with cannabis legalization for all purposes is public engagement with information about medical cannabis in the media, particularly from the internet and social media channels. As increasingly more jurisdictions are expected to legalize medical cannabis, with resulting increase in media attention, support for recreational cannabis legalization may be expected to grow.
    Keywords:  Cannabis legalization; Information seeking; Medical cannabis; Online survey; Scanning; Social media
  20. Urology. 2019 Feb 25. pii: S0090-4295(19)30205-5. [Epub ahead of print]
    Asafu-Adjei D, Mikkilineni N, Sebesta E, Hyams E.
      OBJECTIVE: To evaluate the quality of web-based information on ablative therapies for prostate cancer METHODS: The two most common search engines (Google and Bing) were queried for the following terms: "prostate cancer" + "HIFU" and "cryotherapy", respectively. The top 50 websites for each were obtained. Websites were characterized and analyzed regarding their accuracy and completeness of information using criteria determined a priori. Academic papers were excluded.RESULTS: Of "HIFU" search results, 17% were advertisements, 13% and 29% were academic and private practice websites, respectively. Erroneous information on oncological efficacy was presented in 15% and 41% of academic and private practice websites, respectively. Criteria for treatment were mentioned in 31% and 66% of academic and private practice websites, respectively. Of "cryotherapy" search results, 18% were advertisements, 15% academic sites, and 11% private practices. Erroneous information was presented in 73% of both academic and private practice websites. Criteria for treatment were mentioned in 27% and 18% of these sites, respectively. 78% and 75% of HIFU and cryotherapy sites, respectively, mentioned general side effects.
    CONCLUSIONS: There is substantial inaccurate and incomplete information on the Internet regarding ablative treatments for prostate cancer from academic and private practice websites. Selection criteria are uncommonly discussed. More attention to accuracy of information is needed to ensure patients are not misled about the data behind these treatments.
    Keywords:  Cryotherapy; HIFU; prostate ablation; prostate cancer; prostate treatment
  21. Dtsch Med Wochenschr. 2019 Mar 01.
    Wangler J, Jansky M.
      BACKGROUND:  It may happen that extensive internet search leads to health anxiety in patients, which solidify in the long term. Dealing with such 'cyberchondria' presents a special challenge for the physician. The study highlights general medical attitudes and experiences with regard to patients who are increasingly searching the Internet for symptoms, illnesses or therapies. Particular emphasis will be given to persons who develop health anxieties due to previous Health information on the Internet. It will be determined which procedures make sense in order to respond appropriately to patients with internet-related health concerns.METHODS AND PARTICIPANTS:  In the course of a written survey, a total of 844 general practitioners and primary care internists in southern Hesse and additionally in the rural districts of Gießen, Marburg-Biedenkopf, Kassel and the city of Kassel were interviewed between April 20 and June 20, 2018.
    RESULTS:  Two-thirds of respondents assume that 15 % or more of their own patients confront them with the results of their own internet search. 73 % see the emergence of internet-related health anxiety as an increasing problem in patient care. Against this background, the respondents predominantly see negative effects caused by online self-information (psychological stability, expectations towards the doctor). Almost one of five doctors (18 %) has already experienced the termination of care relationships due to an extensive internet search by the patient. In order to respond to unsettled or frightened patients, the physicians surveyed rely on a detailed explanation of the diagnosis and/or therapy and recommend certain websites that they consider to be reputable.
    DISCUSSION:  The authors argue that the online information search should be actively discussed in the patient interview in order to prevent possible negative effects on the doctor-patient relationship. Accordingly, it would be worth considering to extend the medical history by the dimension of online self-information.