bims-librar Biomed News
on Biomedical librarianship
Issue of 2019–11–17
seventeen papers selected by
Thomas Krichel, Open Library Society



  1. Acad Psychiatry. 2019 Nov 13.
       OBJECTIVE: During psychiatric rotation, clerkship students must learn the clinical skill of recording an accurate Mental Status Examination (MSE). The authors built a video e-library consisting of 23 authentic patient videos that were accessible on a secure website during the rotation period, aimed at assisting students' acquisition of MSE skills.
    METHODS: The authors conducted a prospective case comparison study investigating the impact of the video e-library as "add-on" intervention, on acquisition of MSE skills, as measured by a test consisting of three videos with adjoining forced choice questionnaires. Eighty-five clerkship students had instructions and access to the video e-library whereas 82 did not. A group of clinicians, unfamiliar with the video e-library, was also subjected to the new MSE skills test and they served as a reference group. Outcome was defined as scores of MSE skills measured by the purpose made MSE skills test and entailed evaluation questions on the students' use of the e-library.
    RESULTS: The MSE skill test score differed between the three groups, and the clinicians scored higher than both student groups (clinicians mean score (M) 12.6; p < 0.001). However, the students with video access scored higher compared to students without access (M 10.7 versus M 9.9, p = 0.04). The e-library was appreciated by the students as helpful (83.6%) and they used it not only for practicing the MSE but also for observation of interviewing techniques.
    CONCLUSION: The e-library with video vignettes of authentic patients strengthens MSE skills as "add-on" to the psychiatric rotation, and evaluations by the students were positive.
    Keywords:  Blended learning; Clerkship; Clinical decision-making; Digital; Psychiatry
    DOI:  https://doi.org/10.1007/s40596-019-01130-x
  2. Wellcome Open Res. 2019 ;4 148
      Background: Exaggerations in health news were previously found to strongly associate with similar exaggerations in press releases. Moreover, such press release exaggerations did not appear to attract more news. Methods: Here we tested the replicability of these findings in a new cohort of news and press releases based on research in UK universities in 2014 and 2015. Press releases and news were compared to their associated peer-reviewed articles to define exaggeration in advice, causal claims and human inference from non-human studies. Results: We found that the association between news and press releases did not replicate for advice exaggeration, while this association did replicate for causal claims and human inference from non-human studies. There was no evidence for higher news uptake for exaggerated press releases, consistent with previous results. Base exaggeration rates were lower for human inference from non-human studies, possibly reflecting the Concordat on Openness on Animal Research in the UK. Conclusions: Overall, the picture remains that the strength of news statements is normally associated with the strength of press release statements, and without evidence that exaggerated statements get significantly more news.
    Keywords:  hype; media; science communication
    DOI:  https://doi.org/10.12688/wellcomeopenres.15486.1
  3. Reg Anesth Pain Med. 2019 Nov 11. pii: rapm-2019-100835. [Epub ahead of print]
      The regional anesthesia community regularly uses social media for advocacy and education. Well-known leaders in the field are willing to share their opinions with colleagues in a public forum. Some visionaries predict that the influence of social media will soon transcend that of the traditional academic journal. While physicians support the use of social media, an trend may exist toward anecdotal information. Does a lack of online regulation along with a bias towards self-promotion cloud meaningful discussion? In order to avoid the pitfalls of social media, thoughtful communication will help regional anesthesiologists promote their subspecialty. Mindful dialog, promotion of academic journals, and professional etiquette will help maintain a collegial environment.
    Keywords:  education; pain medicine; regional anesthesia
    DOI:  https://doi.org/10.1136/rapm-2019-100835
  4. Niger J Clin Pract. 2019 Nov;22(11): 1467-1474
       Objective: This study aimed to identify the frequency and goals of Internet usage to access health-related information among primary health care service clients.
    Methods: The study was conducted in a primary health care centre with a sample of 788 adults. The data were collected through a questionnaire developed by the researchers.
    Results: The results showed that 81% (n = 640) of the participants used the Internet. All Internet user participants reported that they used the Internet to access health-related information. Of the participants, 67% reported that they used the Internet primarily to obtain information about diseases with 94% reporting that they found the online information reliable and 92% reported that they did not confirm the information they obtained online. The frequency of Internet use to obtain health-related information increased with increase in the level of education of participants. Participants with higher education found the online information to be more reliable and comprehensible. The results showed that while the use of Internet to obtain health-related information was high, the information presented online was not always checked for accuracy.
    Conclusion: Hence, provision of current and evidence-based information on health-related websites is crucial to preserve community health care.
    Keywords:  Health-related information; health research; internet; use of Internet
    DOI:  https://doi.org/10.4103/njcp.njcp_319_18
  5. J Med Internet Res. 2019 Nov 13. 21(11): e13687
       BACKGROUND: Health researchers are increasingly using social media in a professional capacity, and the applications of social media for health researchers are vast. However, there is currently no published evidence synthesis of the ways in which health researchers use social media professionally, and uncertainty remains as to how best to harness its potential.
    OBJECTIVE: This scoping review aimed to explore how social media is used by health researchers professionally, as reported in the literature.
    METHODS: The scoping review methodology guided by Arksey and O'Malley and Levac et al was used. Comprehensive searches based on the concepts of health research and social media were conducted in MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, and Web of Science databases, with no limitations applied. Articles were screened at the title and abstract level and at full text by two reviewers. One reviewer extracted data that were analyzed descriptively to map the available evidence.
    RESULTS: A total of 8359 articles were screened at the title and abstract level, of which 719 were also assessed at full text for eligibility. The 414 articles identified for inclusion were published in 278 different journals. Studies originated from 31 different countries, with the most prevalent being the United States (52.7% [218/414]). The health discipline of the first authors varied, with medicine (33.3% [138/414]) being the most common. A third of the articles covered health generally, with 61 health-specific topics. Papers used a range of social media platforms (mean 1.33 [SD 0.7]). A quarter of the articles screened reported on social media use for participant recruitment (25.1% [104/414]), followed by practical ways to use social media (15.5% [64/414]), and use of social media for content analysis research (13.3% [55/414]). Articles were categorized as celebratory (ie, opportunities for engagement, 72.2% [299/414]), contingent (ie, opportunities and possible limitations, 22.7% [94/414]) and concerned (ie, potentially harmful, 5.1% [21/414]).
    CONCLUSIONS: Health researchers are increasingly publishing on their use of social media for a range of professional purposes. Although most of the sentiment around the use of social media in health research was celebratory, the uses of social media varied widely. Future research is needed to support health researchers to optimize their social media use.
    Keywords:  health; review; social media
    DOI:  https://doi.org/10.2196/13687
  6. J Pediatr Orthop B. 2019 Nov 12.
      Idiopathic clubfoot is the most common congenital anomaly of the lower extremity. YouTube has emerged as an important source of health-related information for patients and families. Parents seek information about clubfoot on YouTube. However, the quality of these videos remains unknown. Therefore, we decided to evaluate the quality of YouTube videos about clubfoot. We searched YouTube for clubfoot videos using appropriate keywords. English language videos with more than 10 000 views were included. Three fellowship trained pediatric orthopedic surgeons independently assessed the videos and classified them into corporate, hospital, education and private. The quality of information was assessed using the Modified DISCERN and JAMA benchmark scores. The search yielded 12 060 videos of which 42 were analyzed. There were 9 (21%) videos from corporate organizations, 12 (29%) from hospitals, 3 (7%) from educational organizations and 18 (43%) by private individuals. The mean Modified DISCERN score was 2.1 ± 1.07 (range 0.3-4) and mean JAMA benchmark score was 0.9 ± 0.65 (range 0-2). Educational videos had highest mean Modified DISCERN score (3.1 ± 0.85) and private videos, the least (1.43 ± 1). This difference was statistically significant (P = 0.004). Hospital videos had highest mean JAMA benchmark score of 1.3 ± 0.6 as compared with private videos which had the least mean score of 0.5 ± 0.6. This difference was also statistically significant (P = 0.001). The results of our study indicate that the quality of information on idiopathic clubfoot on YouTube needs improvement. Videos from educational and hospital sources should be preferred over private sources.
    DOI:  https://doi.org/10.1097/BPB.0000000000000694
  7. J Med Internet Res. 2019 Nov 11. 21(11): e11125
       BACKGROUND: The internet continues to offer new forms of support for health decision making. Government, charity, and commercial websites increasingly offer a platform for shared personal health experiences, and these are just some of the opportunities that have arisen in a largely unregulated arena. Understanding how people trust and act on this information has always been an important issue and remains so, particularly as the design practices of health websites continue to evolve and raise further concerns regarding their trustworthiness.
    OBJECTIVE: The aim of this study was to identify the key factors influencing US and UK citizens' trust and intention to act on advice found on health websites and to understand the role of patient experiences.
    METHODS: A total of 1123 users took part in an online survey (625 from the United States and 498 from the United Kingdom). They were asked to recall their previous visit to a health website. The online survey consisted of an updated general Web trust questionnaire to account for personal experiences plus questions assessing key factors associated with trust in health websites (information corroboration and coping perception) and intention to act. We performed principal component analysis (PCA), then explored the relationship between the factor structure and outcomes by testing the fit to the sampled data using structural equation modeling (SEM). We also explored the model fit across US and UK populations.
    RESULTS: PCA of the general Web trust questionnaire revealed 4 trust factors: (1) personal experiences, (2) credibility and impartiality, (3) privacy, and (4) familiarity. In the final SEM model, trust was found to have a significant direct effect on intention to act (beta=.59; P<.001), and of the trust factors, only credibility and impartiality had a significant direct effect on trust (beta=.79; P<.001). The impact of personal experiences on trust was mediated through information corroboration (beta=.06; P=.04). Variables specific to electronic health (eHealth; information corroboration and coping) were found to substantially improve the model fit, and differences in information corroboration were found between US and UK samples. The final model accounting for all factors achieved a good fit (goodness-of-fit index [0.95], adjusted goodness-of-fit index [0.93], root mean square error of approximation [0.50], and comparative fit index [0.98]) and explained 65% of the variance in trust and 41% of the variance in intention to act.
    CONCLUSIONS: Credibility and impartiality continue to be key predictors of trust in eHealth websites. Websites with patient experiences can positively influence trust but only if users first corroborate the information through other sources. The need for corroboration was weaker in the United Kingdom, where website familiarity reduced the need to check information elsewhere. These findings are discussed in relation to existing trust models, patient experiences, and health literacy.
    Keywords:  eHealth; patient experiences; trust
    DOI:  https://doi.org/10.2196/11125
  8. Postgrad Med J. 2019 Nov 15. pii: postgradmedj-2019-137201. [Epub ahead of print]
      
    Keywords:  general medicine (see internal medicine); information technology; medical education & training; medical journalism; public health; world wide web technology
    DOI:  https://doi.org/10.1136/postgradmedj-2019-137201
  9. J Med Internet Res. 2019 Nov 11. 21(11): e12278
       BACKGROUND: Little is known about the exact process of how patients search for medical information on the internet and what they retrieve. There is especially a paucity of literature on browsing for information on minor ailments, a term used for harmless diseases that are very common in the general population and thus have a significant impact on health care.
    OBJECTIVE: This vignette-based experimental study aimed to explore what kind of Web-based search strategies are applied and how search strategies, demographic characteristics, and the quality of the visited websites relate to finding the right diagnosis. Additional goals were to describe how searching on the Web influences one's perception of the severity of the potential diagnosis and whether or not the participants would discuss the information they found on the internet with their doctors.
    METHODS: Out of 1372 survey participants, 355 were randomly sampled, and 155 of them were recruited and assigned to one of four clinical scenarios. Each search term they used was classified as one of three search strategies: (1) hypothesis testing, (2) narrowing within the general hypothesis area, and (3) symptom exploration. The quality of the websites used was determined by using the DISCERN instrument. To compare the diagnostic accuracy of the participants before and after the internet search, a McNemar test was used. Chi-square tests were used to describe which factors are related to the chosen search strategy. A multivariate binary logistic regression model was constructed to predict which factors are related to finding a sound diagnosis after searching the internet for health information.
    RESULTS: Most participants (65.8%, 102/155) used the symptom exploration strategy. However, this depends on the assigned scenario (P<.001) and the self-estimated severity score of the symptoms before the internet search (P=.001). A significant relation was found between choosing an accurate diagnosis and age (odds ratio [OR] 0.94, 95% CI 0.90 to 0.98) and the clinical scenario, as well as the use of high-quality websites (OR 7.49, 95% CI 1.85 to 30.26). Browsing the internet did not lead to a statistically significant change in participants' beliefs about the severity of the condition (McNemar test, P=.85). Most participants (65%) shared their retrieved information with their physician and most of them (75%) received a positive response.
    CONCLUSIONS: Our findings suggest that most patients use a symptom-based approach; however, if patients expect the potential diagnosis to be severe, they tend to use a hypothesis verification strategy more often and are therefore prone to certain forms of bias. In addition, self-diagnosing accuracy is related to younger age, the symptom scenario, and the use of high-quality websites. We should find ways to guide patients toward search strategies and websites that may more likely lead to accurate decision making.
    Keywords:  adult; consumer health information; diagnosis; humans; information seeking behaviour; internet
    DOI:  https://doi.org/10.2196/12278
  10. Vet Rec. 2019 Nov 16. 185(19): 606
      This month, a horse owner discusses the problem of identifying what online information to trust.
    DOI:  https://doi.org/10.1136/vr.l6528
  11. Malays J Med Sci. 2019 Sep;26(5): 1-5
      The rise of dubious medical practice and anti-vaccination groups in Malaysia suggests that the public needs to be equipped with the scientific literacy skills to navigate the healthcare landscape. Additionally, the overall result of the Programme for International Student Assessment (PISA) 2009+ for Malaysia suggests that the national scientific literacy levels of 16-year-old Malaysian students to be below the international and the Organisation for Economic Co-operation and Development (OECD) average. Consequently, the Higher Order Thinking Skills (HOTS) was introduced to form part of the national English language evaluation in 2013 to encourage creative and critical thinking. In this editorial piece, I describe a youth-led intervention that may be more effective at increasing scientific literacy to combat pseudoscience in Malaysian youth especially in bridging the education inequality gap in Malaysia.
    Keywords:  Malaysia; critical thinking; education; health advocacy; health literacy; misinformation
    DOI:  https://doi.org/10.21315/mjms2019.26.5.1
  12. Mhealth. 2019 ;5 46
       Background: Pregnant women use the Internet and social networking sites to meet a variety of pregnancy-related needs as well as to help make decisions regarding their pregnancy and/or parenting. Knowing more about the current landscape of social networking sites as it relates to pregnancy can inform future work that wants to leverage social media for education or support.
    Methods: Across a 7-day period, we conducted a content analysis of 4 Facebook pregnancy-related groups and 4 Instagram pregnancy-related channels. The posts were coded based on the nature, content, and purpose of each post as well as the number of likes, shares, and comments for each. After establishing inter-rater reliability, univariate statistics were used to describe the nature, characteristics, and popularity of the posts for each group or channel. We then used logistic regressions to predict which characteristics were associated with being popular or unpopular with users.
    Results: There were 288 eligible posts within the 7-day window. Only a small proportion of the large (182,000 to 2,527,712) amount of followers responded with likes or comments (comments: mean =0.02%, SD =0.04%; likes: mean =0.36%, SD =0.89%). Facebook posts tended to give more general pregnancy-related information or opportunities for personal sharing while Instagram posts often had emotional support themes or posts meant to make pregnancy relatable. Popular posts tended to try to make pregnancy more relatable (OR =4.21, P<0.01) or offer emotional support (OR =4.62, P<0.01), while unpopular posts tended to provide general pregnancy-related information (OR= 2.17, P<0.05).
    Conclusions: In general, there were clear characteristics that differentiated the two social networking site posts that garner user attention or not. This can inform how to provide health information and social support via social media to maximize its influence. This work suggests which features are desirable for followers and can help those interested in leveraging Instagram and Facebook to provide pregnancy-related health information.
    Keywords:  Pregnancy; health information; social media; social support
    DOI:  https://doi.org/10.21037/mhealth.2019.09.09
  13. JMIR Med Inform. 2019 Nov 13. 7(4): e14850
       BACKGROUND: Named entity recognition (NER) is a key step in clinical natural language processing (NLP). Traditionally, rule-based systems leverage prior knowledge to define rules to identify named entities. Recently, deep learning-based NER systems have become more and more popular. Contextualized word embedding, as a new type of representation of the word, has been proposed to dynamically capture word sense using context information and has proven successful in many deep learning-based systems in either general domain or medical domain. However, there are very few studies that investigate the effects of combining multiple contextualized embeddings and prior knowledge on the clinical NER task.
    OBJECTIVE: This study aims to improve the performance of NER in clinical text by combining multiple contextual embeddings and prior knowledge.
    METHODS: In this study, we investigate the effects of combining multiple contextualized word embeddings with classic word embedding in deep neural networks to predict named entities in clinical text. We also investigate whether using a semantic lexicon could further improve the performance of the clinical NER system.
    RESULTS: By combining contextualized embeddings such as ELMo and Flair, our system achieves the F-1 score of 87.30% when only training based on a portion of the 2010 Informatics for Integrating Biology and the Bedside NER task dataset. After incorporating the medical lexicon into the word embedding, the F-1 score was further increased to 87.44%. Another finding was that our system still could achieve an F-1 score of 85.36% when the size of the training data was reduced to 40%.
    CONCLUSIONS: Combined contextualized embedding could be beneficial for the clinical NER task. Moreover, the semantic lexicon could be used to further improve the performance of the clinical NER system.
    Keywords:  contextualized word embedding; deep learning; named entity recognition; natural language processing; prior knowledge; semantic embedding
    DOI:  https://doi.org/10.2196/14850
  14. Int J Med Inform. 2019 Nov 01. pii: S1386-5056(19)30818-4. [Epub ahead of print]133 104009
       INTRODUCTION: Research in family medicine is necessary to improve the quality of care. The number of publications in general medicine remains low. Databases from Electronic Medical Records can increase the number of these publications. These data must be coded to be used pertinently. The objective of this study was to assess the quality of semantic annotation by a multi-terminological concept extractor within a corpus of family medicine consultations.
    METHOD: Consultation data in French from 25 general practitioners were automatically annotated using 28 different terminologies. The data extracted were classified into three groups: reasons for consulting, observations and consultation results. The first evaluation led to a correction phase of the tool which led to a second evaluation. For each evaluation, the precision, recall and F-measure were quantified. Then, the inter- and intra-terminological coverage of each terminology was assessed.
    RESULTS: Nearly 15,000 automatic annotations were manually evaluated. The mean values for the second evaluation of precision, recall and F-measure were 0.85, 0.83 and 0.84 respectively. The most common terminologies used were SNOMED CT, SNOMED 3.5 and NClt. The terminologies with the best intra-terminological coverage were ICPC-2, DRC and CISMeF Meta-Terms.
    CONCLUSION: A multi-terminological concepts extractor can be used for the automatic annotation of consultation data in family medicine. Integrating such a tool into general practitioners' business software would be a solution to the lack of routine coding. Developing the use of a single terminology specific to family medicine could improve coding, facilitate semantic interoperability and the communication of relevant information.
    Keywords:  Automatic annotation; Clinical coding; Databases; Electronic medical records; Family medicine
    DOI:  https://doi.org/10.1016/j.ijmedinf.2019.104009
  15. J Hum Lact. 2019 Nov 11. 890334419883203
       BACKGROUND: Human milk expression, primarily by pump, is practiced by the majority of breastfeeding mothers in affluent countries. Existing literature is focused on determining prevalence and duration rates and the factors behind this trend. There is less research exploring mothers' perspectives and experiences related to expression.
    RESEARCH AIM: To gather the experiential wisdom of mothers with a focus on their information needs and sources related to human milk expression.
    METHODS: Audiotaped interviews were conducted with 35 mothers of infants, aged birth to 24 months, who had expressed milk at least once in western Canada. This study was guided by interpretive description, an applied qualitative research approach.
    RESULTS: Registered nurses and international board-certified lactation consultants were the most common sources of information, with Internet, friends/family, and other mothers also important. Inconsistent expression advice was confusing for participants, and many reported health care providers did not address all their expression learning needs. Desired topic areas included practical advice on how to express, determining expression frequency/timing/duration, milk storage guidelines, the influence of expression on milk supply, product information, and general support/encouragement.
    CONCLUSIONS: Assessment of expression learning needs should be part of routine lactation support at each encounter. Nonjudgmental, factual guidance will assist mothers in making evidence-informed decisions related to expression practices that are consistent with their unique breastfeeding goals. This should be supplemented by reputable online resources that provide timely and accurate information as well as efforts to connect mothers with peer support groups.
    Keywords:  breast pump; breastfeeding practices; human milk expression; lactation counseling; qualitative methods
    DOI:  https://doi.org/10.1177/0890334419883203
  16. Health Info Libr J. 2019 Nov 11.
       BACKGROUND: Cancer is a leading cause of death around the world and often is a chronic long term disease. This calls for an expanded workforce to include non-traditional health care providers.
    OBJECTIVE: To determine effectiveness of a cancer information training project with clergy from selected rural Appalachian areas to improve comfort and willingness to work as part of the cancer health care team.
    METHODS: Clergy were trained in the consumer health database of the National Library of Medicine MedlinePlus.gov. Exercises were required that were done using an iPad tablet with an online curriculum. They were also taught how to do a population health assessment of their particular area and develop a health ministry for their church.
    RESULTS: Three key elements were confirmed that would enable replication of the pilot: access to medlineplus, programmed learning modules using mobile technology such as iPads, and staff support including librarians and medical staff. With these key elements, the cancer project is potentially replicable with other groups beyond clergy.
    CONCLUSION: Knowledge about population health, built on new awareness and topical health knowledge, and using new skills to identify relevant information and library resources, could open minds and enhance community support for preventive and medical interventions.
    Keywords:  United States of America (USA); access to information; collaboration; computer-assisted instruction; consumer health information; health education; information skills; public health
    DOI:  https://doi.org/10.1111/hir.12275
  17. Int J Med Inform. 2019 Oct 19. pii: S1386-5056(18)30728-7. [Epub ahead of print]133 104000
       PURPOSE: To evaluate quality and readability of online information on dental treatment for snoring and obstructive sleep apnea.
    METHODS: An Internet search was done using three engines (Bing, Google, and Yahoo) with the combination of terms, "snoring sleep apnea dental treatment". The first 100 sites from the search of each engine were screened. Subject sites were evaluated with Health on the Net(HON) criteria, Journal of American Medical Association(JAMA) benchmarks, DISCERN, Ensuring Quality Information for Patients(EQIP), Flesch-Kincaid Grade level and Flesch Reading Ease(FRE) score.
    RESULTS: One hundred and thirty websites were evaluated. The HON, DISCERN, EQIP, and FRE score were each 39.4%, 47.3%, 49.7%, and 51.6% of the maximum possible score, respectively. According to JAMA benchmarks fewer than 50% of the sites displayed attribution and currency. There was only one site displaying the HON seal. HON score, DISCERN score and EQIP score showed significant inter-correlation.
    CONCLUSION: Based on this study, the current quality and readability of searchable websites on dental treatment for snoring and sleep apnea are low and poorly maintained on average. Clinicians should be able to evaluate and give accurate online information on this issue to patients.
    Keywords:  Obstructive sleep apnea; Online information; Quality; Readability; Snoring
    DOI:  https://doi.org/10.1016/j.ijmedinf.2019.104000