bims-librar Biomed News
on Biomedical librarianship
Issue of 2019–10–13
eightteen papers selected by
Thomas Krichel, Open Library Society



  1. Health Info Libr J. 2019 Oct 08.
       BACKGROUND: Like many health library associations, the Medical Library Association (MLA) developed competencies guiding lifelong learning and competence for medical librarians. Medical librarians should be able to develop skills in identified areas. One MLA indicator of organising resources defines expert skill as the ability to develop classification and metadata schemes for unique collections.
    OBJECTIVES: This manuscript reviews available curricula for selected library programmes in the United States and Canada, along with professional development and informal opportunities for skill development to identify how medical librarians, who are not experts in cataloging or metadata and not employed as cataloging or metadata librarians, can progress in competency.
    METHODS: The authors reviewed library school and continuing education programming around metadata, along with answers from a pre-existing informal poll regarding cataloging and metadata roles in health sciences libraries. Data were collected and examined using descriptive statistics.
    DISCUSSION: Gaps and opportunities for education around organising resources are discussed, including library school courses, formal continuing education opportunities and informal learning (e.g. peer support networks, on-the-job learning).
    CONCLUSION: Education in organising resources should be created throughout the educational journey of librarianship. Continuing educational opportunities in organising resources should be created by professional organisations that expect competency in this area.
    Keywords:  data management; education and training; information storage and retrieval; libraries, medical; library and information professionals; lifelong learning; professional development
    DOI:  https://doi.org/10.1111/hir.12280
  2. Nucleic Acids Res. 2019 Oct 11. pii: gkz899. [Epub ahead of print]
      The National Center for Biotechnology Information (NCBI) provides a large suite of online resources for biological information and data, including the GenBank® nucleic acid sequence database and the PubMed database of citations and abstracts published in life science journals. The Entrez system provides search and retrieval operations for most of these data from 35 distinct databases. The E-utilities serve as the programming interface for the Entrez system. Custom implementations of the BLAST program provide sequence-based searching of many specialized datasets. New resources released in the past year include a new PubMed interface, a sequence database search and a gene orthologs page. Additional resources that were updated in the past year include PMC, Bookshelf, My Bibliography, Assembly, RefSeq, viral genomes, the prokaryotic genome annotation pipeline, Genome Workbench, dbSNP, BLAST, Primer-BLAST, IgBLAST and PubChem. All of these resources can be accessed through the NCBI home page at www.ncbi.nlm.nih.gov.
    DOI:  https://doi.org/10.1093/nar/gkz899
  3. Bioinformatics. 2019 Oct 09. pii: btz756. [Epub ahead of print]
       MOTIVATION: With the rapidly growing biomedical literature, automatically indexing biomedical articles by Medical Subject Heading (MeSH), namely MeSH indexing, has become increasingly important for facilitating hypothesis generation and knowledge discovery. Over the past years, many large-scale MeSH indexing approaches have been proposed, such as Medical Text Indexer (MTI), MeSHLabeler, DeepMeSH and MeSHProbeNet. However, the performance of these methods is hampered by using limited information, i.e. only the title and abstract of biomedical articles.
    RESULTS: We propose FullMeSH, a large-scale MeSH indexing method taking advantage of the recent increase in the availability of full text articles. Compared to DeepMeSH and other state-of-the-art methods, FullMeSH has three novelties: 1) Instead of using a full text as a whole, FullMeSH segments it into several sections with their normalized titles in order to distinguish their contributions to the overall performance. 2) FullMeSH integrates the evidence from different sections in a "learning to rank" framework by combining the sparse and deep semantic representations. 3) FullMeSH trains an Attention-based Convolutional Neural Network (AttentionCNN) for each section, which achieves better performance on infrequent MeSH headings. FullMeSH has been developed and empirically trained on the entire set of 1.4 million full-text articles in the PubMed Central Open Access subset. It achieved a Micro F-measure of 66.76% on a test set of 10,000 articles, which was 3.3% and 6.4% higher than DeepMeSH and MeSHLabeler, respectively. Furthermore, FullMeSH demonstrated an average improvement of 4.7% over DeepMeSH for indexing Check Tags, a set of most frequently indexed MeSH headings.
    SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.
    DOI:  https://doi.org/10.1093/bioinformatics/btz756
  4. Health Info Libr J. 2019 Oct 11.
       BACKGROUND: This paper is the second part of a two phase, sequential mixed method study.
    OBJECTIVES: To get the views of medical librarians in Pakistan regarding information literacy (IL) skills of medical students and how to teach them IL skills.
    METHODS: Structured interviews were conducted with 20 medical librarians in Pakistan. We audio recorded, transcribed all the interviews and performed content analysis and coding of the textual data. We presented the emerging themes with the frequency of their appearance.
    RESULTS: Interviewees agreed that the IL skills of their students were inadequate. Participants suggested that librarians should train students through mandatory IL instruction programmes, designed in coordination with medical faculty. However, workshops/seminars were considered the most effective IL delivery methods for medical faculty and clinicians. The majority of respondents supported the integration of IL instruction into the curriculum as an independent and credit course.
    DISCUSSION: Teaching IL skills to medical students requires proper planning. Therefore, librarians have to prove their place within the curricular structure of the institution and develop understanding of the pedagogy of instruction.
    CONCLUSION: Librarians must collaborate with faculty to train students in advanced information skills. There is a need to integrate IL instruction into the curriculum at all levels.
    Keywords:  Pakistan; competencies; information literacy; information skills; medical students
    DOI:  https://doi.org/10.1111/hir.12279
  5. PLoS Biol. 2019 Oct;17(10): e3000385
      Citation data have remained hidden behind proprietary, restrictive licensing agreements, which raises barriers to entry for analysts wishing to use the data, increases the expense of performing large-scale analyses, and reduces the robustness and reproducibility of the conclusions. For the past several years, the National Institutes of Health (NIH) Office of Portfolio Analysis (OPA) has been aggregating and enhancing citation data that can be shared publicly. Here, we describe the NIH Open Citation Collection (NIH-OCC), a public access database for biomedical research that is made freely available to the community. This dataset, which has been carefully generated from unrestricted data sources such as MedLine, PubMed Central (PMC), and CrossRef, now underlies the citation statistics delivered in the NIH iCite analytic platform. We have also included data from a machine learning pipeline that identifies, extracts, resolves, and disambiguates references from full-text articles available on the internet. Open citation links are available to the public in a major update of iCite (https://icite.od.nih.gov).
    DOI:  https://doi.org/10.1371/journal.pbio.3000385
  6. JMIR Res Protoc. 2019 Oct 09. 8(10): e14889
       BACKGROUND: Deaf American Sign Language (ASL) users often struggle with limited health literacy compared with their hearing peers. However, the mechanisms driving limited health literacy and how this may impact access to and understanding of health information for Deaf individuals have not been determined. Deaf individuals are more likely than hearing individuals to use the internet, yet they continue to report significant barriers to health information. This study presents an opportunity to identify key targets that impact information access for a largely marginalized population.
    OBJECTIVE: This study aims to elucidate the role of information marginalization on health literacy in Deaf ASL users and to better understand the mechanisms of health literacy in this population for the purpose of identifying viable targets for future health literacy interventions.
    METHODS: This is an exploratory mixed methods study to identify predictors and moderators of health literacy in the Deaf population. These predictors of health literacy will be used to inform the second step that qualitatively explains the findings, including how Deaf individuals access and understand Web-based health information. Multiple interviewer- and computer-based instruments underwent translation and adaptation, from English to ASL, to make them accessible for the Deaf participants in our study. A planned sample of 450 Deaf ASL users and 450 hearing native English speakers, aged 18 to 70 years, will be recruited from 3 partnering sites: Rochester, NY; Flint, MI; and Chicago, IL. These individuals will participate in a single data collection visit. A subset of participants (approximately 30) with key characteristics of interest will be invited for a second data collection visit to observe and inquire more about their ability to directly access, navigate, and comprehend Web-based health information. The study will help assess how the ways health literacy and information are visualized may differ between Deaf individuals and hearing individuals. The study will also survey participants' ownership and use of computer and mobile devices and their level of Web-based information use, including health information.
    RESULTS: Adaptation and translation of protocols and instruments have been completed and are now in use for the study. Recruitment is underway and will continue until late 2020. Results from this study will be used to provide a guide on how to structure Web-based health information in a way that maximizes accessibility and improves health literacy for Deaf individuals.
    CONCLUSIONS: The results from this mixed methods proposal will advance what is known about health literacy and health information accessibility for Deaf individuals. This innovative study will generate rich data on how to formulate health information and health literacy interventions more accurately to take advantage of visual learning skills.
    INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/14889.
    Keywords:  consumer health information; deaf; health literacy; hearing loss
    DOI:  https://doi.org/10.2196/14889
  7. JMIR Public Health Surveill. 2019 Oct 08. 5(4): e13212
       BACKGROUND: Heparinoid is a medication prescribed in Japan for skin diseases, such as atopic dermatitis and dry skin. Heparinoid prescription has increased with instances of internet blogs recommending its use as a cosmetic.
    OBJECTIVE: This study aimed to examine the prescription trends in moisturizer use and analyze their association with internet searches.
    METHODS: We used a claims database to identify pharmacy claims of heparinoid-only prescriptions in Japan. Additionally, we used Google Trends to obtain internet search data for the period between October 1, 2007, and September 31, 2017. To analyze the association between heparinoid prescriptions and internet searches, we performed an autoregressive integrated moving average approach for each time series.
    RESULTS: We identified 155,733 patients who had been prescribed heparinoid. The number of prescriptions increased from 2011 onward, and related internet searches increased from 2012 onward. Internet searches were significantly correlated with total heparinoid prescription (correlation coefficient=.25, P=.005). In addition, internet searches were significantly correlated with heparinoid prescription in those aged 20-59 years at -1-month lag in Google Trends (correlation coefficient=.30, P=.001).
    CONCLUSIONS: Google searches related to heparinoid prescriptions showed a seasonal pattern and increased gradually over the preceding several years. Google searches were positively correlated with prescription trends. In addition, in a particular age group (20-59 years), prescriptions increased with the increase in internet searches. These results suggest that people obtained health-related information on the internet and that this affected their behavior and prescription requests.
    Keywords:  Google Trends; heparinoid; infodemiology; internet; moisturizer; time series analysis
    DOI:  https://doi.org/10.2196/13212
  8. J Am Med Inform Assoc. 2019 Oct 12. pii: ocz150. [Epub ahead of print]
       OBJECTIVE: This study focuses on the task of automatically assigning standardized (topical) subject headings to free-text sentences in clinical nursing notes. The underlying motivation is to support nurses when they document patient care by developing a computer system that can assist in incorporating suitable subject headings that reflect the documented topics. Central in this study is performance evaluation of several text classification methods to assess the feasibility of developing such a system.
    MATERIALS AND METHODS: Seven text classification methods are evaluated using a corpus of approximately 0.5 million nursing notes (5.5 million sentences) with 676 unique headings extracted from a Finnish university hospital. Several of these methods are based on artificial neural networks. Evaluation is first done in an automatic manner for all methods, then a manual error analysis is done on a sample.
    RESULTS: We find that a method based on a bidirectional long short-term memory network performs best with an average recall of 0.5435 when allowed to suggest 1 subject heading per sentence and 0.8954 when allowed to suggest 10 subject headings per sentence. However, other methods achieve comparable results. The manual analysis indicates that the predictions are better than what the automatic evaluation suggests.
    CONCLUSIONS: The results indicate that several of the tested methods perform well in suggesting the most appropriate subject headings on sentence level. Thus, we find it feasible to develop a text classification system that can support the use of standardized terminologies and save nurses time and effort on care documentation.
    Keywords:  clinical decision support; electronic health records; natural language processing; nursing documentation; text classification
    DOI:  https://doi.org/10.1093/jamia/ocz150
  9. Health Info Libr J. 2019 Oct 08.
       BACKGROUND: Clinical specialists require access to the most recent and up to date professional information. However, barriers such as insufficient time and lack of necessary information retrieval skills necessitate the presence of clinical informationist (CI) in medical teams.
    OBJECTIVES: This study sought to determine the pre-requisite for CI participation in the grand round.
    METHODS: This was a qualitative study carried out using content analysis approach. Study involved all fellowship students and attending physicians in the department of gastroenterology at Al-Zahra hospital in Isfahan (Iran), who were selected using purposive sampling. Gathered reports were analysed using qualitative content analysis and concept mapping approaches.
    DISCUSSION: To improve the process of CI collaboration with clinical specialists during the educational rounds, it is necessary for CI to have certain pre-requisite skills.
    CONCLUSIONS: By identifying the pre-requisites for CI participation in the grand round and explaining advantages of this participation for clinical specialists, this study proposes a suitable process for implantation of CI participation in grand rounds.
    Keywords:  education and training; health information needs; health professionals; informationist, clinical; libraries, medical
    DOI:  https://doi.org/10.1111/hir.12273
  10. J Am Med Inform Assoc. 2019 Oct 08. pii: ocz152. [Epub ahead of print]
       OBJECTIVE: Consumers increasingly turn to the internet in search of health-related information; and they want their questions answered with short and precise passages, rather than needing to analyze lists of relevant documents returned by search engines and reading each document to find an answer. We aim to answer consumer health questions with information from reliable sources.
    MATERIALS AND METHODS: We combine knowledge-based, traditional machine and deep learning approaches to understand consumers' questions and select the best answers from consumer-oriented sources. We evaluate the end-to-end system and its components on simple questions generated in a pilot development of MedlinePlus Alexa skill, as well as the short and long real-life questions submitted to the National Library of Medicine by consumers.
    RESULTS: Our system achieves 78.7% mean average precision and 87.9% mean reciprocal rank on simple Alexa questions, and 44.5% mean average precision and 51.6% mean reciprocal rank on real-life questions submitted by National Library of Medicine consumers.
    DISCUSSION: The ensemble of deep learning, domain knowledge, and traditional approaches recognizes question type and focus well in the simple questions, but it leaves room for improvement on the real-life consumers' questions. Information retrieval approaches alone are sufficient for finding answers to simple Alexa questions. Answering real-life questions, however, benefits from a combination of information retrieval and inference approaches.
    CONCLUSION: A pilot practical implementation of research needed to help consumers find reliable answers to their health-related questions demonstrates that for most questions the reliable answers exist and can be found automatically with acceptable accuracy.
    Keywords:  artificial intelligence; consumer health questions; deep learning; natural language processing; question answering
    DOI:  https://doi.org/10.1093/jamia/ocz152
  11. Sociol Health Illn. 2019 Oct;41 Suppl 1 65-81
      In an increasingly connected world, information about health can be exchanged at any time, in any location or direction, and is no longer dominated by traditional authoritative sources. We consider the ways information and advice given in consultations by doctors transcends the boundary between the clinic and the home. We explore how information that is widely accessible outside the consultation is transformed by General Practitioners (GPs) into a medical offering. Data comprise 18 consultations identified from 144 consultations between unselected patients and five GPs. We use conversation analytic methods to explore four ways in which GPs used online resources; (i) to check information; (ii) as an explanatory tool; (iii) to provide information for patients for outside the consultation; (iv) to signpost further explanation and self-help. We demonstrate the interactional delicacy with which resources from the Internet are introduced and discussed, developing and extending Nettleton's (2004) idea of 'e-scaped medicine' to argue that Internet resources may be 'recaptured' by GPs, with information transformed and translated into a medical offering so as to maintain the asymmetry between patients and practitioners necessary for the successful functioning of medical practice.
    Keywords:  E-health; Internet; conversation analysis (CA); doctor-patient communication/interaction; general practice
    DOI:  https://doi.org/10.1111/1467-9566.12833
  12. PeerJ. 2019 ;7 e7634
       Background: The use of the internet to satisfy information needs is widespread among cancer patients. Patients' decisions regarding whether to act upon the information they find strongly depend on the trustworthiness of the information and the medium. Patients who are younger, more highly educated and female are more likely to trust online information. The objectives of this systematic review were to examine the extent to which cancer patients trust in cancer-related online information, internet websites as a source of cancer-related information or the internet as a medium of cancer information.
    Methods: A systematic review was conducted using five databases (PROSPERO registration number: CRD42017070190). Studies of any kind were included if they measured cancer patients' trust in online health information. Study quality was assessed using the Research Triangle Institute (RTI) item bank. A narrative synthesis was undertaken to examine the included studies.
    Results: Of the 7,314 citations obtained by the search, seven cross-sectional studies were included in the synthesis. A total of 1,054 patients reported having some or a great deal of trust in online cancer information; 154 patients reported moderately trusting such information; and 833 patients reported having no or little trust in online cancer information, internet websites as a source of cancer-related information or the internet as a medium of cancer-related information. Two of the seven studies reported between group comparisons for the above-stated patient characteristics. The methodological quality of the included studies was diverse.
    Conclusion: The results of the included studies indicates that approximately half of cancer patients appear to trust cancer-specific online information, internet websites as a source of cancer-related information or the internet as an information medium. However, the small number of included studies, high heterogeneity of participants, methods and outcomes calls for further systematic research. It is important to understand that cancer patients do and will increasingly use trusted cancer information websites to search for information concerning their disease. Therefore, physicians and other health care providers should provide more support and advice to these patients.
    Keywords:  Consumer health information; Medical informatics; Systematic review; Telemedicine; Trust
    DOI:  https://doi.org/10.7717/peerj.7634
  13. BMC Med Educ. 2019 Oct 09. 19(1): 367
       BACKGROUND: Information and communications technology (ICT) has been suggested as an important tool for improving global health education and building research capacity in developing countries. However, the existing curricula do not have adequate emphasis on global health research and training. This study was carried out to examine health sciences postgraduates' attitudes and practices regarding curriculum for ICT use in global health research and training in China.
    METHODS: A cross-sectional study was conducted among health sciences postgraduates from six universities in southern China, during December 2016 to March 2017. A self-administered online questionnaire was used to collect data through an online survey platform. Data were analyzed using SPSS for Windows 13.0.
    RESULTS: A total of 1065 participants successfully completed the questionnaires. More than 90% of the students have not had any training about ICT, three quarters have not taken an online course, and 31% of the students do not use ICT in their current research. More than 65% thought that, in an ICT research training curriculum, it was important to learn: ICT utilization related knowledge, ICT research methods/resources, knowledge of databases, ways of data use and acquisition, and informatics search methods (ICT users compared to non-users were more likely to agree to these learning components (all p <  0.05)). Many of the respondents used or planned to use mobile phones (80%), Internet (59%), use computer and WeChat (> 40%), and QQ (a popular chat tool in China) (30%) as ICT tools in research activities. ICT users compared to non-users were more likely to consider using ICT and/or biomedical informatics methods in decision-support or support for information seeking, healthcare delivering, academic research, data gathering, and facilitating collaboration (all p <  0.05).
    CONCLUSIONS: The findings of this study showed that ICT utilization was very important to health sciences postgraduates for their research activities in China, but they lacked ICT-related training. The results suggested the need for specialized curriculum related to ICT use in global health research for health sciences postgraduates in China.
    Keywords:  Global health research; Health sciences students; ICT; Information and communication technology; Training curriculum
    DOI:  https://doi.org/10.1186/s12909-019-1785-6
  14. J Med Internet Res. 2019 Oct 08. 21(10): e14731
       BACKGROUND: Social media platforms play a vital role in the dissemination of health information. However, evidence suggests that a high proportion of Twitter posts (ie, tweets) are not necessarily accurate, and many studies suggest that tweets do not need to be accurate, or at least evidence based, to receive traction. This is a dangerous combination in the sphere of health information.
    OBJECTIVE: The first objective of this study is to examine health-related tweets originating from Saudi Arabia in terms of their accuracy. The second objective is to find factors that relate to the accuracy and dissemination of these tweets, thereby enabling the identification of ways to enhance the dissemination of accurate tweets. The initial findings from this study and methodological improvements will then be employed in a larger-scale study that will address these issues in more detail.
    METHODS: A health lexicon was used to extract health-related tweets using the Twitter application programming interface and the results were further filtered manually. A total of 300 tweets were each labeled by two medical doctors; the doctors agreed that 109 tweets were either accurate or inaccurate. Other measures were taken from these tweets' metadata to see if there was any relationship between the measures and either the accuracy or the dissemination of the tweets. The entire range of this metadata was analyzed using Python, version 3.6.5 (Python Software Foundation), to answer the research questions posed.
    RESULTS: A total of 34 out of 109 tweets (31.2%) in the dataset used in this study were classified as untrustworthy health information. These came mainly from users with a non-health care background and social media accounts that had no corresponding physical (ie, organization) manifestation. Unsurprisingly, we found that traditionally trusted health sources were more likely to tweet accurate health information than other users. Likewise, these provisional results suggest that tweets posted in the morning are more trustworthy than tweets posted at night, possibly corresponding to official and casual posts, respectively. Our results also suggest that the crowd was quite good at identifying trustworthy information sources, as evidenced by the number of times a tweet's author was tagged as favorited by the community.
    CONCLUSIONS: The results indicate some initially surprising factors that might correlate with the accuracy of tweets and their dissemination. For example, the time a tweet was posted correlated with its accuracy, which may reflect a difference between professional (ie, morning) and hobbyist (ie, evening) tweets. More surprisingly, tweets containing a kashida-a decorative element in Arabic writing used to justify the text within lines-were more likely to be disseminated through retweets. These findings will be further assessed using data analysis techniques on a much larger dataset in future work.
    Keywords:  dissemination; health communication; misinformation; new media; social media; trustworthiness
    DOI:  https://doi.org/10.2196/14731
  15. Int J Eat Disord. 2019 Oct 07.
       OBJECTIVE: Evaluate the quality and readability of United Kingdom-based websites on anorexia nervosa.
    METHOD: First-page search results of three search engines (with search term "anorexia nervosa") were consulted. Websites were excluded if they were pro-ana, duplications, advertisements, Wikipedia, nonwritten/video, invalid addresses, non-English, book links, articles/news pages, and discussion forums. Fifteen websites were evaluated on information quality using DISCERN, and on readability using the Flesch Reading Ease (FRE) Scale. Spearman's correlations between quality and readability were calculated.
    RESULTS: DISCERN-scores ranged from 34 to 71 (M = 49.27, SD = 9.16), representing "fair" information quality. FRE-scores ranged from 28 to 64 (M = 42.7, SD = 13.43), representing "difficult" readability. The Royal College of Psychiatrists website (https://www.rcpsych.ac.uk/) received the only "excellent" quality rating and was the only website that met the recommended reading level. The other websites' quality varied, and their reading levels ranged from fairly to very difficult.
    CONCLUSION: Website quality scores varied. Oftentimes, information about treatment risks and benefits was lacking, and texts were too complex. Website quality seals could prove beneficial, and web developers should use quality and readability measures to ensure information accessibility. Future research should utilize DISCERN and FRE to evaluate quality and readability of websites pertaining to other eating disorders too.
    Keywords:  anorexia; anorexia nervosa; comprehension; consumer health information; feeding and eating disorders; health literacy; information dissemination; internet
    DOI:  https://doi.org/10.1002/eat.23173
  16. J Stud Alcohol Drugs. 2019 Sep;80(5): 524-533
       OBJECTIVE: Alcohol use during pregnancy can harm the developing fetus. The exact amount, pattern, and critical period of exposure necessary for harm to occur are unclear, although official guidance often emphasizes precautionary abstention. The impacts on fertility and breastfeeding are also unclear. Information on alcohol and pregnancy is disseminated by the alcohol industry-funded organizations, and there are emerging concerns about its accuracy, suggesting the need for detailed analysis.
    METHOD: Information on alcohol consumption in relation to fertility, pregnancy, and breastfeeding was extracted from the websites of 23 alcohol industry-funded bodies (e.g., Drinkaware [United Kingdom] and DrinkWise [Australia]), and 19 public health organizations (e.g., Health.gov and NHS Choices). Comparative qualitative and quantitative analysis of the framing and completeness of this information was undertaken.
    RESULTS: Alcohol industry-funded organizations were statistically significantly less likely than public health websites to provide information on fetal alcohol spectrum disorder and less likely to advise that no amount of alcohol is safe during pregnancy. They were significantly more likely to emphasize uncertainties and less likely to use direct language (e.g., "don't drink"). Some alcohol industry-funded (and no public health) websites appear to use "alternate causation" arguments, similar to those used by the tobacco industry, to argue for causes of alcohol harms in pregnancy other than alcohol.
    CONCLUSIONS: Alcohol industry-funded websites omit and misrepresent the evidence on key risks of alcohol consumption during pregnancy. This may "nudge" women toward continuing to drink during pregnancy. These findings suggest that alcohol industry-funded bodies may increase risk to pregnant women by disseminating misinformation. The public should be made widely aware of the risks of obtaining health information from alcohol industry-funded sources.
  17. Sociol Health Illn. 2019 Oct;41 Suppl 1 50-64
      Digital media offer citizens novel ways of 'enacting' health and illness, and treatment and care. However, while digital media may so 'empower' citizens, those searching for credible information will be confronted with various, often-conflicting claims that may have 'disempowering' effects. This article uses Gieryn's concept of the 'cultural cartography' to explore the criteria that patients and carers employ in establishing the credibility of information on alleged treatments. Drawing on data from interviews with Australian patients and carers who have travelled or considered travelling abroad for unproven commercial stem cell treatments, the article examines how individuals assess rival sources of epistemic authority - science-based and non-science-based - as they search for credible information. As we argue, in a context where conventional treatment options are perceived to be limited or non-existent - which is likely to be the case with those suffering severe, life-limiting conditions - and the credibility of sources uncertain, matters of opinion and belief are prone to being interpreted as matters of fact, with potentially far-reaching implications for citizens' health. Revealing the mechanisms by which individuals ascribe credibility to health information, we conclude, has become crucial as digital media assume a growing role in health and healthcare and governments encourage citizens to become 'digitally literate'.
    Keywords:  credibility; cultural cartography; digital technology; hope; stem cell tourism; trust
    DOI:  https://doi.org/10.1111/1467-9566.12872