bims-librar Biomed News
on Biomedical librarianship
Issue of 2021–01–17
33 papers selected by
Thomas Krichel, Open Library Society



  1. J Med Libr Assoc. 2021 Jan 01. 109(1): 75-83
       Objective: There are concerns about nonscientific and/or unclear information on the coronavirus disease 2019 (COVID-19) that is available on the Internet. Furthermore, people's ability to understand health information varies and depends on their skills in reading and interpreting information. This study aims to evaluate the readability and creditability of websites with COVID-19-related information.
    Methods: The search terms "coronavirus," "COVID," and "COVID-19" were input into Google. The websites of the first thirty results for each search term were evaluated in terms of their credibility and readability using the Health On the Net Foundation code of conduct (HONcode) and Flesch-Kincaid Grade Level (FKGL), Simple Measure of Gobbledygook (SMOG), Gunning Fog, and Flesch Reading Ease Score (FRE) scales, respectively.
    Results: The readability of COVID-19-related health information on websites was suitable for high school graduates or college students and, thus, was far above the recommended readability level. Most websites that were examined (87.2%) had not been officially certified by HONcode. There was no significant difference in the readability scores of websites with and without HONcode certification.
    Conclusion: These results suggest that organizations should improve the readability of their websites and provide information that more people can understand. This could lead to greater health literacy, less health anxiety, and the provision of better preventive information about the disease.
    DOI:  https://doi.org/10.5195/jmla.2021.1020
  2. J Med Libr Assoc. 2021 Jan 01. 109(1): 107-111
       Background: The Harvey Cushing/John Hay Whitney Medical Library serves a community of over 22,000 individuals primarily from the Yale Schools of Medicine, Public Health, and Nursing and the Yale New Haven Hospital. Though they are geographically close to one another, reaching these disparate populations can be a challenge. Having a clear and thorough communication plan has proved invaluable in transcending communication chasms, especially in recent times of crisis.
    Case Presentation: This article describes the Harvey Cushing/John Hay Whitney Medical Library's methods for communicating and promoting its remote resources and services in response to coronavirus disease 2019 (COVID-19). It details our communication strategies and messages leading up to, and after, the Yale campus was closed and specifies how we pivoted from reaching users inside the library to reaching our audiences remotely.
    Conclusions: Our communication plan has provided the foundation for all of our messaging, be it print or digital media. In recent moments of crisis, it has been especially helpful for planning and executing large scale messaging. Similarly, knowing whom to contact around our organization to promote our message in different and broader ways has been extremely beneficial.
    DOI:  https://doi.org/10.5195/jmla.2021.1003
  3. J Med Libr Assoc. 2021 Jan 01. 109(1): 133-136
      Internet and communication technologies enable the creation of tremendous amounts of textual, graphic, and pictorial information. User-generated content published through personal web pages, blogs, and social media platforms has not only increased the amount of information available, but also expanded its reach. However, this ubiquity of information and empowerment of its creators leads to potentially controversial, futile, and inaccurate content circulating throughout the world. In the case of the COVID-19 pandemic, this can create false hope, fear, anxiety, harm, and confusion amongst information stakeholders. The World Health Organization recently applied the term "infodemic" to the COVID-19 pandemic. This commentary briefly discusses the current infodemic, its potential consequences, and the role of libraries-specifically health sciences, biomedical, and medical libraries-to help counter the COVID-19 infodemic. The discussion also has relevance for infodemics relating to other health and non-health affairs.
    DOI:  https://doi.org/10.5195/jmla.2021.1044
  4. J Med Libr Assoc. 2021 Jan 01. 109(1): 1-12
      Over the years, health sciences librarians have been change agents, leading the charge on issues of importance to the profession and the communities we serve. From its founding in 1898 with the Exchange, the Medical Library Association (MLA) has been dedicated to improving access to health information. In 2003, the Board of Directors published a statement supporting open access to information generated from federally funded scientific and medical research and maintained that having access to timely, relevant, and accurate information is vital to the health of the nation and its education and research programs. At some financial risk, the association made the Journal of the Medical Library Association (JMLA) open access and published the entire archive of JMLA and its predecessor, the Bulletin of the Medical Library Association, in PubMed Central. Nearly two decades later, the promise of open access and open science finally seems to be coming to fruition. In the 2020 Janet Doe Lecture, Chris Shaffer, AHIP, described the ways that MLA has led the profession, standing behind a shared vision and "walking the walk." In challenging listeners to embrace open science, he affirmed that, as leaders in improving access to health sciences information since 1898, medical librarians must work in the open science arena to realize our vision "that quality information is essential for improved health."
    DOI:  https://doi.org/10.5195/jmla.2021.1127
  5. Otol Neurotol. 2021 Feb 01. 42(2): 341-344
       OBJECTIVE: PubMed is the world's largest online collection of biomedical literature citations. A PubMed search (October 11, 2019) using the medical subject heading terms "history" and "mastoidectomy" was conducted. The heading "best matches" listed as first article "A brief history of mastoidectomy," a very relevant free full text. The aim of this study is to validate or not the relevance attributed to this study as the first article listed in best matches.
    METHODOLOGY: All the references of the article mentioned before 1860 were checked, further completed with other original sources, and studied again, with particular attention to their extracted quotes.
    RESULTS: Surprisingly, this article contains many inaccuracies, notably concerning Galen, Lucas van Leyden, Paré, Riolan the Younger, Justus von Berger, Jasser, Dezeimeris, Wilde and Toynbee. This was most certainly related to blind trust of some secondary references.
    CONCLUSION: Never trust secondary references. This article also raises questions on the validity and the relevance of the best matches algorithm in PubMed.
    DOI:  https://doi.org/10.1097/MAO.0000000000002802
  6. J Med Libr Assoc. 2021 Jan 01. 109(1): 90-96
       Background: A request for consumer health information training for public librarians led to the development of a specialized consumer health reference and health literacy training program by professional consumer health librarians from an academic medical center. Professional consumer health librarians created an interactive presentation aimed at improving public librarians' ability to respond to consumer health questions and provide vetted health resources.
    Case Presentation: Building on professional expertise, librarians at Weill Cornell Medicine developed a live class demonstration accompanied by a representative subject LibGuide to support public librarians who assist patrons with health questions. Skills involved in effectively communicating with patrons who are seeking consumer health information include conducting reference interviews, matching patrons' needs with appropriate resources, teaching useful Internet search methods, assessing health information, and understanding health literacy issues. Originally envisioned as two in-person live demonstrations, the team proactively adapted the program to respond to the stay-at-home social-distancing order put in place in response to the coronavirus disease 2019 (COVID-19) pandemic.
    Conclusions: The team successfully led an in-person live training session followed by an adapted online training experience, the latter designed to complete the curricula while complying with city and state orders.
    DOI:  https://doi.org/10.5195/jmla.2021.1014
  7. J Med Libr Assoc. 2021 Jan 01. 109(1): 97-106
       Background: Systematic reviews are comprehensive, robust, inclusive, transparent, and reproducible when bringing together the evidence to answer a research question. Various guidelines provide recommendations on the expertise required to conduct a systematic review, where and how to search for literature, and what should be reported in the published review. However, the finer details of the search results are not typically reported to allow the search methods or search efficiency to be evaluated.
    Case Presentation: This case study presents a search summary table, containing the details of which databases were searched, which supplementary search methods were used, and where the included articles were found. It was developed and published alongside a recent systematic review. This simple format can be used in future systematic reviews to improve search results reporting.
    Conclusions: Publishing a search summary table in all systematic reviews would add to the growing evidence base about information retrieval, which would help in determining which databases to search for which type of review (in terms of either topic or scope), what supplementary search methods are most effective, what type of literature is being included, and where it is found. It would also provide evidence for future searching and search methods research.
    DOI:  https://doi.org/10.5195/jmla.2021.809
  8. J Med Libr Assoc. 2021 Jan 01. 109(1): 23-32
       Objective: This study retroactively investigated the search used in a 2019 review by Hayden et al., one of the first systematic reviews of prognostic factors that was published in the Cochrane Library. The review was designed to address recognized weaknesses in reviews of prognosis by using multiple supplementary search methods in addition to traditional electronic database searching.
    Methods: The authors used four approaches to comprehensively assess aspects of systematic review literature searching for prognostic factor studies: (1) comparison of search recall of broad versus focused electronic search strategies, (2) linking of search methods of origin for eligible studies, (3) analysis of impact of supplementary search methods on meta-analysis conclusions, and (4) analysis of prognosis filter performance.
    Results: The review's focused electronic search strategy resulted in a 91% reduction in recall, compared to a broader version. Had the team relied on the focused search strategy without using supplementary search methods, they would have missed 23 of 58 eligible studies that were indexed in MEDLINE; additionally, the number of included studies in 2 of the review's primary outcome meta-analyses would have changed. Using a broader strategy without supplementary searches would still have missed 5 studies. The prognosis filter used in the review demonstrated the highest sensitivity of any of the filters tested.
    Conclusions: Our study results support recommendations for supplementary search methods made by prominent systematic review methodologists. Leaving out any supplemental search methods would have resulted in missed studies, and these omissions would not have been prevented by using a broader search strategy or any of the other prognosis filters tested.
    DOI:  https://doi.org/10.5195/jmla.2021.939
  9. J Med Libr Assoc. 2021 Jan 01. 109(1): 52-61
       Objective: The objective of this study was to determine the scope of experience, roles, and challenges that librarians face in participating in dental and oral health systematic and scoping reviews to inform outreach efforts to researchers and identify areas for librarian professional development.
    Methods: The authors developed a twenty-three-item survey based on the findings of two recent articles about health sciences librarians' roles and challenges in conducting systematic and scoping reviews. The survey was distributed via electronic mailing lists to librarians who were likely to have participated in conducting dental systematic and scoping reviews.
    Results: While survey respondents reported participating in many dental reviews, they participated more commonly in systematic reviews than in scoping reviews. Also, they worked less commonly on dental and oral health reviews than on non-dental reviews. Librarian roles in dental reviews tended to follow traditional librarian roles: all respondents had participated in planning and information retrieval stages, whereas fewer respondents had participated in screening and assessing articles. The most frequently reported challenges involved the lead reviewer or review team rather than the librarians themselves, with time- and methodology-related challenges being most common.
    Conclusions: Although librarians might not be highly involved in dental and oral health systematic and scoping reviews, more librarian participation in these reviews, either as methodologists or information experts, may improve their reviews' overall quality.
    DOI:  https://doi.org/10.5195/jmla.2021.1031
  10. Inf Syst Front. 2021 Jan 06. 1-15
      Extant literature has increased our understanding of the multifaceted nature of the digital divide, showing that it entails more than access to information and communication resources. Research indicates that digital inequality mirrors to a significant extent offline inequality related to socioeconomic resources. Bridging digital divides is critical for sustainable digitalized societies. Ιn this paper, we present a literature review of Information Systems research on the digital divide within settings with advanced technological infrastructures and economies over the last decade (2010-2020). The review results are organized in a concept matrix mapping contributing factors and measures for crossing the divides. Building on the results, we elaborate a research agenda that proposes [1] extending established models of digital inequalities with new variables and use of theory, [2] critically examining the effects of digital divide interventions, and [3] better linking digital divide research with research on sustainability.
    Supplementary Information: The online version contains supplementary material available at 10.1007/s10796-020-10096-3.
    Keywords:  Digital divide; Digital inequalities; Digitalization; Information systems research; Sustainability
    DOI:  https://doi.org/10.1007/s10796-020-10096-3
  11. Andrology. 2021 Jan 11.
       BACKGROUND: Male factor infertility (MFI) is a common medical condition which requires high quality research to guide clinical practice; however, systematic reviews (SRs) and meta-analyses (MAs) often vary in quality, raising concerns regarding the validity of their results. We sought to perform an objective analysis of SRs and MAs in MFI treatment and management and to report on the quality of published literature.
    METHODS: A comprehensive search in PubMed/MEDLINE and EMBASE was used to identify relevant publications. Primary search terms were male infertility, male sterility, and male subfertility. Two authors independently performed searches, screened citations for eligibility, extracted data for analysis, and graded methodological quality using the validated AMSTAR (A Measurement Tool to Assess Systematic Reviews) instrument, a validated tool used in the critical appraisal of SRs/MAs.
    RESULTS: 27 publications met inclusion criteria and were included in the analysis. Mean AMSTAR score (± SD) among all publications was 7.4 (1.9) out of 11, reflecting "fair to good" quality. Non-pharmacological medical treatment for MFI was the most commonly assessed intervention (n=13, 48.1%). No publications met all AMSTAR criteria. While the number of SRs/MAs has increased over time (p=0.037), the quality of publications has not significantly changed (p=0.72). SRs/MAs of the Cochrane Library had higher AMSTAR score than non-Cochrane SRs/MAs (8.5 vs 6.3, p=0.002).
    CONCLUSIONS: The methodological quality of SRs/MAs should be assessed to ensure high-quality evidence for clinical practice guidelines in MFI treatment and management. This review highlights a need for increased effort to publish high-quality studies in MFI treatment and management.
    Keywords:  male infertility; male subfertility; quality; rigor; systematic reviews
    DOI:  https://doi.org/10.1111/andr.12972
  12. J Med Libr Assoc. 2021 Jan 01. 109(1): 62-67
       Objective: Reproducibility of systemic reviews (SRs) can be hindered by the presence of citation bias. Citation bias may occur when authors of SRs conduct hand-searches of included study reference lists to identify additional studies. Such a practice may lead to exaggerated SR summary effects. The purpose of this paper is to examine the prevalence of hand-searching reference lists in otolaryngology SRs.
    Methods: The authors searched for systematic reviews published in eight clinical otolaryngology journals using the Cochrane Library and PubMed, with the date parameter of January 1, 2008, to December 31, 2017. Two independent authors worked separately to extract data from each SR for the following elements: whether reference lists were hand-searched, other kinds of supplemental searching, PRISMA adherence, and funding source. Following extraction, the investigators met to review discrepancies and achieve consensus.
    Results: A total of 539 systemic reviews, 502 from clinical journals and 37 from the Cochrane library, were identified. Of those SRs, 72.4% (390/539) hand-searched reference lists, including 97.3% (36/37) of Cochrane reviews. For 228 (58.5%) of the SRs that hand-searched reference lists, no other supplemental search (e.g., search of trial registries) was conducted.
    Conclusions: These findings indicate that hand-searching reference lists is a common practice in otolaryngology SRs. Moreover, a majority of studies at risk of citation bias did not attempt to mitigate the bias by conducting additional supplemental searches. The implication is that summary effects in otolaryngology systematic reviews may be biased toward statistically significant findings.
    DOI:  https://doi.org/10.5195/jmla.2021.736
  13. J Med Libr Assoc. 2021 Jan 01. 109(1): 126-132
      The Medical Library Association's InSight Initiative provides an open and collaborative environment for library and industry partners to discuss vexing problems and find solutions to better serve their users. The initiative's fifth summit, continuing work from the previous summit, focused on understanding how users discover and access information in the clinical environment. During the summit, participants were divided into working groups and encouraged to create a tangible product as a result of their discussions. At the end of the summit, participants established a framework for understanding users' pain points, discussed possible solutions to those points, and received feedback on their work from an End User Advisory Board comprising physicians, clinical researchers, and clinical faculty in biomedicine. In addition to the pain point framework, participants are developing MLA InSight Initiative Learning content with modules to educate librarians and publishers about critical aspects of user behavior. The 2020 Insight Initiative Fall Forum will serve as a virtual home for constructive dialogue between health sciences librarians and publishers on improving discovery and access to information.
    DOI:  https://doi.org/10.5195/jmla.2021.1051
  14. J Med Libr Assoc. 2021 Jan 01. 109(1): 120-125
       Background: Starting in the 1990s, health care providers began prescribing opioids to patients as pain relievers, believing they were safe. However, many patients became addicted to these pills. In 2017, the US Department of Health and Human Services declared a public health emergency to fight the opioid epidemic. This crisis was prevalent in East Tennessee, where many residents were prescribed opioids.
    Case Presentation: Librarians at an academic medical center library in East Tennessee analyzed the health information requests related to pain, mental health, and addiction over the last fifteen years. We reviewed the pattern of requests related to these topics, the counties requesting this information, and the impact that these hospital policies had on these requests.
    Conclusions: From 2005 to 2014, there were few requests about mental health, pain, and substance abuse. However, once the library moved into the hospital and there was an increase in awareness of opioid addiction, requests on those topics increased. Most of the requests were about pain, with the height occurring in 2017, during which year the public health emergency to fight the epidemic was declared. Additionally, 2017 was the year the hospital implemented visitor limitations for patients with infections associated with intravenous drug use, which might explain the drastic drop in substance abuse information requests in 2018. Future outreach will target counties that have a high opioid prescription rate.
    DOI:  https://doi.org/10.5195/jmla.2021.1015
  15. J Med Libr Assoc. 2021 Jan 01. 109(1): 112-119
       Background: Despite a strong research presence in Lancashire Teaching Hospitals National Health Service (NHS) Foundation Trust (LTHTR), allied health professionals from the organization are underrepresented in developing and publicizing research that is inspired by day-to-day clinical practice and staff experiences. Two LTHTR departments, Library and Knowledge Services (LKS) and Research and Innovation (R&I), came together to enable a group of staff to develop the knowledge and skills that they needed to access information and create new "home grown" research.
    Case Presentation: A clinical librarian and an academic research nurse created a research engagement program in the diagnostic radiography department at LTHTR, which included the development, delivery, and evaluation of 6 workshops. Sixteen individuals took part in these workshops, and data were collected on library usage, self-efficacy in information literacy, and research output before and after their delivery. Library membership increased by 50% among diagnostic radiography staff, literature search requests from this department increased by 133%, and all participants who attended at least 1 workshop reported an increased Information Literacy Self Efficacy Scale (ILSES) score. An increase in research activity and outputs was also attributed to the program.
    Conclusions: This project has resulted in a set of freely available workshop plans and support resources that can be customized for other health care professionals and has won several awards for its innovative use of departmental collaboration. Through the evaluation of the program from workshop attendees and non-attenders, we have identified impacts, outputs, and barriers to engagement in order to continue to deliver this content to other departments and embed a home grown research culture at LTHTR.
    DOI:  https://doi.org/10.5195/jmla.2021.842
  16. J Med Libr Assoc. 2021 Jan 01. 109(1): 33-43
       Objectives: Access to high-quality information improves the quality of patient care, but lack of time and sufficient skills in information seeking can prevent access to information by clinicians. To solve this problem, clinical informationists can provide high-quality, filtered information for clinical team members. This study identified the core competencies that clinical informationists need to effectively fulfill their roles on clinical teams.
    Methods: Participants were selected purposefully from clinicians and medical librarians. Data were collected through semi-structured interviews and analyzed using qualitative content analysis.
    Results: The authors identified six competencies-communication, research, education and training, domain knowledge, information services, and technology-which together were used to develop a "CREDIT" model of core competencies for clinical informationists.
    Conclusions: The CREDIT model can be used as criteria for evaluating the performance of clinical informationists as well as for developing and assessing clinical informationist educational programs and curriculums.
    DOI:  https://doi.org/10.5195/jmla.2021.1065
  17. J Biomed Inform. 2021 Jan 12. pii: S1532-0464(21)00013-7. [Epub ahead of print] 103684
       INTRODUCTION: Concept normalization is the task of linking terms from textual medical documents to their concept in terminologies such as the UMLS®. Traditional approaches to this problem depend heavily on the coverage of available resources, which poses a problem for languages other than English.
    OBJECTIVE: We present a system for concept normalization in French. We consider textual mentions already extracted and labeled by a named entity recognition system, and we classify these mentions with a UMLS concept unique identifier. We take advantage of the multilingual nature of available terminologies and embedding models to improve concept normalization in French without translation nor direct supervision.
    MATERIALS AND METHODS: We consider the task as a highly-multiclass classification problem. The terms are encoded with contextualized embeddings and classified via cosine similarity and softmax. A first step uses a subset of the terminology to finetune the embeddings and train the model. A second step adds the entire target terminology, and the model is trained further with hard negative selection and softmax sampling.
    RESULTS: On two corpora from the Quaero FrenchMed benchmark, we show that our approach can lead to good results even with no labeled data at all; and that it outperforms existing supervised methods with labeled data.
    DISCUSSION: Training the system with both French and English terms improves by a large margin the performance of the system on a French benchmark, regardless of the way the embeddings were pretrained (French, English, multilingual). Our distantly supervised method can be applied to any kind of documents or medical domain, as it does not require any concept-labeled documents.
    CONCLUSION: These experiments pave the way for simpler and more effective multilingual approaches to processing medical texts in languages other than English.
    Keywords:  Information Extraction; Medical concept normalization; Multilingual representation; Natural Language Processing
    DOI:  https://doi.org/10.1016/j.jbi.2021.103684
  18. J Cheminform. 2020 Sep 21. 12(1): 57
       BACKGROUND: Named Entity Linking systems are a powerful aid to the manual curation of digital libraries, which is getting increasingly costly and inefficient due to the information overload. Models based on the Personalized PageRank (PPR) algorithm are one of the state-of-the-art approaches, but these have low performance when the disambiguation graphs are sparse.
    FINDINGS: This work proposes a Named Entity Linking framework designated by Relation Extraction for Entity Linking (REEL) that uses automatically extracted relations to overcome this limitation. Our method builds a disambiguation graph, where the nodes are the ontology candidates for the entities and the edges are added according to the relations established in the text, which the method extracts automatically. The PPR algorithm and the information content of each ontology are then applied to choose the candidate for each entity that maximises the coherence of the disambiguation graph. We evaluated the method on three gold standards: the subset of the CRAFT corpus with ChEBI annotations (CRAFT-ChEBI), the subset of the BC5CDR corpus with disease annotations from the MEDIC vocabulary (BC5CDR-Diseases) and the subset with chemical annotations from the CTD-Chemical vocabulary (BC5CDR-Chemicals). The F1-Score achieved by REEL was 85.8%, 80.9% and 90.3% in these gold standards, respectively, outperforming baseline approaches.
    CONCLUSIONS: We demonstrated that RE tools can improve Named Entity Linking by capturing semantic information expressed in text missing in Knowledge Bases and use it to improve the disambiguation graph of Named Entity Linking models. REEL can be adapted to any text mining pipeline and potentially to any domain, as long as there is an ontology or other knowledge Base available.
    Keywords:  Named Entity Linking; Ontologies; PageRank; Relation extraction; Text mining
    DOI:  https://doi.org/10.1186/s13321-020-00461-4
  19. J Cheminform. 2019 Dec 05. 11(1): 76
      The chemfp project has had four main goals: (1) promote the FPS format as a text-based exchange format for dense binary cheminformatics fingerprints, (2) develop a high-performance implementation of the BitBound algorithm that could be used as an effective baseline to benchmark new similarity search implementations, (3) experiment with funding a pure open source software project through commercial sales, and (4) publish the results and lessons learned as a guide for future implementors. The FPS format has had only minor success, though it did influence development of the FPB binary format, which is faster to load but more complex. Both are summarized. The chemfp benchmark and the no-cost/open source version of chemfp are proposed as a reference baseline to evaluate the effectiveness of other similarity search tools. They are used to evaluate the faster commercial version of chemfp, which can test 130 million 1024-bit fingerprint Tanimotos per second on a single core of a standard x86-64 server machine. When combined with the BitBound algorithm, a k = 1000 nearest-neighbor search of the 1.8 million 2048-bit Morgan fingerprints of ChEMBL 24 averages 27 ms/query. The same search of 970 million PubChem fingerprints averages 220 ms/query, making chemfp one of the fastest CPU-based similarity search implementations. Modern CPUs are fast enough that memory bandwidth and latency are now important factors. Single-threaded search uses most of the available memory bandwidth. Sorting the fingerprints by popcount improves memory coherency, which when combined with 4 OpenMP threads makes it possible to construct an N × N similarity matrix for 1 million fingerprints in about 30 min. These observations may affect the interpretation of previous publications which assumed that search was strongly CPU bound. The chemfp project funding came from selling a purely open-source software product. Several product business models were tried, but none proved sustainable. Some of the experiences are discussed, in order to contribute to the ongoing conversation on the role of open source software in cheminformatics.
    Keywords:  FOSS; Format; High-performance; Molecular fingerprints; Open source; Performance benchmark; Similarity searching; Tanimoto
    DOI:  https://doi.org/10.1186/s13321-019-0398-8
  20. J Med Libr Assoc. 2021 Jan 01. 109(1): 84-89
       Background: With the mandate to review all available literature in the study's inclusion parameters, systematic review projects are likely to require full-text access to a significant number of articles that are not available in a library's collection, thereby necessitating ordering content via interlibrary loan (ILL). The aim of this study is to understand what effect a systematic review service has on the copyright royalty fees accompanying ILL requests at an academic health sciences library.
    Case Presentation: The library created a custom report using ILLiad data to look specifically at 2018 ILL borrowing requests that were known to be part of systematic reviews. This subset of borrowing activity was then analyzed to determine its impact on the library's copyright royalty expenditures for the year. In 2018, copyright eligible borrowing requests that were known to be part of systematic reviews represented only approximately 5% of total filled requests that involved copyright eligible borrowing. However, these systematic review requests directly or indirectly caused approximately 10% of all the Spencer S. Eccles Library copyright royalty expenditures for 2018 requests.
    Conclusion: Based on the sample data set, the library's copyright royalty expenditures did increase, but the overall financial impact was modest.
    DOI:  https://doi.org/10.5195/jmla.2021.1005
  21. J Med Libr Assoc. 2021 Jan 01. 109(1): 44-51
       Objective: The primary objective of this study was to determine how community college health sciences librarians perceive their proficiencies in the essential skills, knowledge, and abilities necessary for the practice of a health information professional as defined by the Medical Library Association (MLA) Competencies for Lifelong Learning and Professional Success. A secondary objective was to determine their current level of engagement with the professional community and identify barriers to further professional development.
    Methods: A survey was posted to various email discussion lists, and volunteer follow-up interviews were conducted.
    Results: The survey was completed by seventy-five community college health sciences librarians, and seven follow-up interviews were performed. Survey results indicated that community college health sciences librarians perceived themselves as having intermediate or advanced intermediate proficiency in the six MLA competencies. Survey and interview results indicated that community college health sciences librarians were engaged with the profession and faced the same barriers to continued professional development and continued education as other academic librarians.
    Conclusion: The results affirm that community college librarians who are responsible for collections and services in the health sciences meet the MLA competencies, which fills a gap in the literature regarding how these librarians develop professional competencies and are involved in professional associations. The results suggest that community college librarians can improve their skill levels by continuing their education and following trends in the literature.
    DOI:  https://doi.org/10.5195/jmla.2021.994
  22. J Med Libr Assoc. 2021 Jan 01. 109(1): 13-22
       Objective: While studies from the early 1990s show that library staff in nonlibrarian roles interpret the term "paraprofessional" as being demeaning to their roles, no recent research has been conducted on this topic. This study aims to investigate if health sciences library staff continue to have similar negative associations with the term "paraprofessional" and to determine if another term is preferred.
    Methods: The authors conducted a literature review to identify terms used to categorize library staff in nonlibrarian roles. Using these terms, we created an online Qualtrics survey asking participants to rank terms by preference. We distributed the survey via thirty-six professional email discussion lists, including MEDLIB-L, thirty-three MLA chapter and caucus email discussion lists, DOCLINE-L, and ACRL-HSIG-L. Survey participants included full-time and part-time health sciences library staff in any nonlibrarian position. Responses from librarians were not accepted.
    Results: Based on 178 completed surveys, "library staff" was the top choice of 49% of participants, over "other" (19%), "paraprofessional" (13%), "library support staff" (11%), "paralibrarian" (7%), and "nonprofessional" (1%). Although "library staff" was the top choice of participants across all ages, older participants (aged 45-75) preferred "library support staff" and "paraprofessional" to a greater degree than younger participants (aged 18-44), while younger participants preferred "other" to a greater degree. Out of 36 participants who specifically mentioned the terms "paraprofessional" or "paralibrarian," 32 (89%) of those comments were negative, indicating that the "para" in "paraprofessional" and "paralibrarian" is either insulting, inapplicable, or unfamiliar.
    Conclusions: Our results suggest that although the term "paraprofessional" may not intentionally be used to demean library staff, many library staff interpret the term to be demeaning to their roles. Instead, "library staff," a more inclusive and less divisive term, was preferred by survey participants. In accordance with our results, we believe the term "paraprofessional" should no longer be used in library and information scholarly literature or professional discourse.
    DOI:  https://doi.org/10.5195/jmla.2021.933
  23. J Med Syst. 2021 Jan 15. 45(2): 24
      Informal caregivers provide unpaid care to their physically or mentally ill loved ones and play a critical role in the healthcare delivery. eHealth tools, including the broadband internet, can facilitate care processes and impact the caregiving burden through seeking health information and health communication. This study examines the predictors of access to broadband internet and the factors associated with health information seeking and health communication among informal caregivers with broadband internet. We used data from cycles 1 and 2 of the Health Information National Trends Survey (HINTS 5) and employed generalized linear regression models with the maximum likelihood estimation. Specifically, we performed a two-part model: (1) a logistic regression model of broadband internet access among all caregivers (n = 929) and (2) a logistic regression model of health information seeking and health communication among caregivers with broadband internet access (n = 404). We found that caregivers who were younger (18-34 years versus 45+ years), female (versus male), and those who were divorced/widowed/separated (versus singles) were less likely to have broadband internet access. While those who were married/living as married (versus singles), with higher incomes (≥$100,000 versus <$35,000), and those living in metropolitan areas were more likely to have broadband internet access. Among caregivers with broadband internet access, younger, female, non-Hispanic white caregivers, and those with higher levels of education and income, as well as those who cared for cancer patients, were more likely to seek health information for someone else. Additionally, caregivers aged 35-39 years and those with more education were more likely to look for health information for themselves than their counterparts. Furthermore, caregivers who were aged 40-44 years, females, divorced/widowed/separated, those with higher incomes, and those who cared for patients with Alzheimer's, confusion, and dementia were more likely to communicate electronically with a provider. The results suggest disparities in broadband internet access and indicate variations in factors associated with health information seeking and health communication. The findings underscore the need to address barriers attributed to the digital divide among informal caregiving groups.
    Keywords:  Broadband internet; Digital divide; Health communication; Health information seeking; Informal caregivers
    DOI:  https://doi.org/10.1007/s10916-021-01708-9
  24. Pediatr Dermatol. 2021 Jan 15.
      In this study, we sought to analyze the readability of online patient education materials (PEMs) related to juvenile dermatomyositis (JDM). We analyzed the top 100 Google results and using six different readability scores, found 53 PEMs which had an average grade reading level of 17.4 (graduate level). PEMs by health care providers were written at higher grade levels than those by non-health care providers. Our findings demonstrate a clear need for online JDM PEMs that are written at an appropriate reading level and can be comprehended by patients and families of all levels of health literacy.
    Keywords:  Automated Readability Index; Coleman-Liau Index; Flesch Reading Ease; Flesch-Kincaid Grade level; Gunning Fog; Linear Write Formula; SMOG Index; inflammatory disorders; juvenile dermatomyositis; readability; skin signs of systemic disease
    DOI:  https://doi.org/10.1111/pde.14513
  25. Turk J Orthod. 2020 ;33(4): 203-209
       Objective: The purpose of this study was to evaluate the content and quality of internet information resources in Turkey about temporomandibular disorders (TMDs).
    Methods: In July 2020, the keywords "jaw joint disease" (çene eklemi rahatsızlığı) and "jaw joint pain" (çene eklemi ağrısı) were searched on Google, Bing, YAHOO!, and Yandex. The first 20 websites were listed for 2 keywords on the 4 search engines. Scientific articles, product websites, repetitive sites, advertisements, and irrelevant websites were excluded from the list. The remaining 77 websites were assessed using the Quality Criteria for Consumer Health Information (DISCERN), Global Quality Score (GQS) and Journal of American Medical Association (JAMA) benchmarks. The topics related to TMDs that were thought to be important in informing the patient were determined and the Temporomandibular Disorder Content Score (TMDCS) was calculated to evaluate whether these contents were available on the website.
    Results: The sources of the 77 websites included dentists in private practice (6.5%, n=5), hospitals/polyclinics (32.5%, n=25), universities (6.5%, n=5), and others (54.5%, n=42). The total DISCERN scores of all websites included were poor (average score 26.96). Mean scores of JAMA, GQS, and TMDCS were 1.75, 2.31, and 8.4, respectively.
    Conclusion: The quality and reliability of the information on the websites related to TMDs are poor. Clinicians should be aware that patients may have access to unreliable or incomplete information. There is a need for improvement on websites about TMDs, especially by professionals through imparting more comprehensive and reliable information.
    Keywords:  Internet; patient resource; temporomandibular joint disorders; temporomandibular joint pain
    DOI:  https://doi.org/10.5152/TurkJOrthod.2020.20129
  26. J Med Libr Assoc. 2021 Jan 01. 109(1): 68-74
       Objective: The authors used an assessment rubric to measure medical students' improvement in question formulation skills following a brief evidence-based practice (EBP) training session conducted by a health sciences librarian.
    Method: In a quasi-experimental designed study, students were assessed using a rubric on their pre-instructional skills in formulating answerable EBP questions, based on a clinical scenario. Following their training, they were assessed using the same scenario and rubric. Student pre- and post-test scores were compared using a paired t-test.
    Results: Students demonstrated statistically significant improvement in their question formulation skills on their post-instructional assessments. The average score for students on the pre-test was 45.5 (SD 11.1) and the average score on the post-test was 65.6 (SD 5.4) with an average increase of 20.1 points on the 70-point scale, p<0.001.
    Conclusion: The brief instructional session aided by the rubric improved students' performance in question formulation skills.
    DOI:  https://doi.org/10.5195/jmla.2021.935
  27. J Med Libr Assoc. 2021 Jan 01. 109(1): 137-140
      For its fifteenth anniversary, the Jay Sexter Library at Touro University Nevada (TUN) sought ways to capture its institutional history by founding an archive. Among many challenges, the library struggled to convince the administration of the importance of an archive. To generate interest in TUN's history, a task force comprising library, executive administration, and advancement staff hosted and recorded a panel event with some of the university's original faculty, staff, and administration. By having this event, new TUN employees were able to experience the shared knowledge of TUN's early days, and the library was able to create and preserve its own institutional history.
    DOI:  https://doi.org/10.5195/jmla.2021.1056
  28. Surgeon. 2021 Jan 12. pii: S1479-666X(20)30187-6. [Epub ahead of print]
       BACKGROUND: The internet is an important source of information for patients undergoing surgery. Multiple studies have identified inappropriately high reading levels of patient information online. The average reading level in the United States is 7-8th grade. Multiple organisations have recommended that patient information not exceed 6th grade level. This study aims to evaluate the reading levels and quality of information regarding ankle fusion surgery online.
    METHODS: Google, Bing and Yahoo were searched (MeSH "ankle fusion", "ankle arthrodesis") and the top 30 URLs analysed. Readability was assessed using an online readability calculator to produce 3 scores (Gunning FOG, Flesch Kincaid Grade and Flesch Reading Ease). Quality was assessed using a HONcode detection web-extension and the JAMA benchmark criteria.
    RESULTS: Ninety-eight webpages were identified. The mean Flesch Kincaid Grade level was 9.24 ± 2.33 (95% CI 8.78-9.71). The mean Gunning FOG grade was 10.88 ± 3.1 (95% CI 10.26-11.5). The mean Flesch Reading Ease score was 49.88 ± 14.46 (95% CI 46.98-52.78). 7 webpages were at or below the 6th grade reading level. The mean JAMA score was 1.34 ± 1.32 out of 4 (95% CI 1.07-1.6). 14 websites were HONcode accredited.
    CONCLUSION: The overall readability of medical information online is too high for the average patient. Given the important role that health literacy provides in patient reported outcomes, improving the readability and quality of these materials is imperative. Awareness by the general public is essential for them to critically appraise the information they receive online.
    Keywords:  Ankle fusion; Arthrodesis; Health literacy; Orthopaedics; Reading level; Surgery
    DOI:  https://doi.org/10.1016/j.surge.2020.12.001
  29. Biomed Res Int. 2020 ;2020 6687733
      Content-based medical image retrieval (CBMIR) systems attempt to search medical image database to narrow the semantic gap in medical image analysis. The efficacy of high-level medical information representation using features is a major challenge in CBMIR systems. Features play a vital role in the accuracy and speed of the search process. In this paper, we propose a deep convolutional neural network- (CNN-) based framework to learn concise feature vector for medical image retrieval. The medical images are decomposed into five components using empirical mode decomposition (EMD). The deep CNN is trained in a supervised way with multicomponent input, and the learned features are used to retrieve medical images. The IRMA dataset, containing 11,000 X-ray images, 116 classes, is used to validate the proposed method. We achieve a total IRMA error of 43.21 and a mean average precision of 0.86 for retrieval task and IRMA error of 68.48 and F1 measure of 0.66 on classification task, which is the best result compared with existing literature for this dataset.
    DOI:  https://doi.org/10.1155/2020/6687733
  30. J Med Internet Res. 2021 Jan 11. 23(1): e24733
       BACKGROUND: Since the rise of the internet, online health information seeking has become a worldwide phenomenon. However, health and health communication are inherently culture bound. A data-driven cross-country comparison enables us to better understand how cultural factors moderate the association between individual-level determinants and online health information seeking.
    OBJECTIVE: The objective of the study was to examine similarities and differences in determinants of internet cancer information seeking between the US and Chinese general public (excluding cancer patients and survivors) under the framework of a behavioral model of health services use.
    METHODS: This study used Health Information National Trends Survey (HINTS) 2017 (US data) and HINTS-China 2017 data to answer the research question. It focused on people with no cancer history and with internet access. For the HINTS 2017, the sample size was 2153; for the HINTS-China 2017, the sample size was 2358. To compare China and the United States, the researchers selected the same set of study variables for each dataset. Under the framework of the behavioral model of health services use, these predictors were predisposing factors, enabling factors, and need factors.
    RESULTS: In terms of the predisposing factors, a higher age, college degree or above, being currently unemployed, and having a family history of cancer were associated with internet cancer information seeking for the Chinese respondents; none of these factors were related to information seeking for the US respondents, although a lower age was associated with information seeking. Regarding the enabling conditions, lower trust in family members and friends as reliable information sources was the only factor associated with information seeking for the Chinese respondents, while no enabling factor was related to information seeking for the US respondents. Regarding the need factors, perceived health status was not related to information seeking for the Chinese respondents, while perception of poorer health condition was related to information seeking for the US respondents. Higher cancer fear was related to information seeking for both groups, but the magnitude of association was smaller for the Chinese respondents than for the US respondents.
    CONCLUSIONS: Overall, under the framework of the behavioral model of health services use, the results based on multivariate logistic regression reveal clear patterns of cross-country/cultural differences in the factors associated with internet cancer information seeking behaviors: predisposing characteristics and enabling conditions are more important in China, while perceived needs are more significant in the US. Such differences might reflect possible US-China differences in job environment (eg, job pressure) and culture (individualism vs collectivism and family structure).
    Keywords:  China; HINTS; United States; comparative research; cultural sensitivity; health information seeking behavior (HISB)
    DOI:  https://doi.org/10.2196/24733
  31. Ann Plast Surg. 2021 Jan 09.
       PURPOSE: In light of highly publicized media coverage on breast implant recalls and Food and Drug Administration hearings on breast implant safety, online searches of these topics have surged. It is thus critical to determine whether such searches are providing meaningful information for those who use them. Patient/laywomen-directed online education materials on breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) must not only be comprehensible but also accurate, actionable, and culturally concordant, especially as more diverse populations turn to the internet for breast implant-related information. This study assessed the overall suitability of BIA-ALCL patient-directed educational text and video-based materials online.
    METHODS: This was a cross-sectional, multimetric investigation of online text- and video-based patient-directed educational materials for BIA-ALCL using multiple validated measures. Two reviewers assessed each resource. Kruskal-Wallis and Fisher exact analyses were used as appropriate to compare text- and video-based online resources.
    RESULTS: In total, 30 websites and 15 videos were evaluated, more than half (56%) of which were from academic/physician or governmental/nonprofit sources. Overall, website and video content, as well as quality, varied by source. Academic/physician or governmental/nonprofit sources tended to be more comprehensive and have higher-quality information than commercial/media outlet sources. Median actionability of websites was 38%, well below the threshold of 70% used in the literature to identify actionable resources. The median suitability score for BIA-ALCL websites was 57%, which is considered "adequate" based on published thresholds. The mean overall Cultural Sensitivity Assessment Tool score for websites was 2.4; Cultural Sensitivity Assessment Tool scores higher than 2.5 are generally regarded as culturally sensitive. In general, videos were more understandable than websites. Substantial interrater reliability across the validated tools used in this study was noted using Pearson correlation coefficients.
    CONCLUSIONS: Online resources varied in content and quality by source. As BIA-ALCL becomes an increasingly salient topic among both providers and patients, it is important to empower women with accurate information about this implant-associated cancer. Of available resources, providers should refer patients or those seeking more information to websites from governmental/academic organizations (".gov" or ".org" domains) and videos from academic/physician or governmental sources, given that among high-quality resources, these were most clear/comprehensible. Overall, there is a need for improved online content on this topic.
    DOI:  https://doi.org/10.1097/SAP.0000000000002509
  32. J Med Libr Assoc. 2021 Jan 01. 109(1): 141-153
      The Medical Library Association (MLA) appointed a Diversity and Inclusion Task Force (DITF) in 2017. Sandra G. Franklin, AHIP, FMLA, chaired the task force and guided initiatives. From 2017 to 2020, the task force completed a review of MLA defining documents-including the mission, vision, values, and code of ethics-resulting in language updates to these documents. As MLA transitioned through the communities process, the DITF contributed to the transition. Other recommended essential changes to MLA profiles to promote awareness included updating pronouns to promote gender inclusivity and suggestions for the Annual Meeting Innovation Task Force. DITF members actively brought diversity and inclusion programming and engagement to MLA members at annual meetings. The task force held a fish bowl conversation, an open forum, and a Diversity Dialogues roundtable discussion; provided interactive discussion boards; and designed an MLA diversity button. Beyond MLA annual meetings, the task force hosted two critical librarianship meetings and a Twitter chat to engage MLA members with diversity and inclusion topics. Task force members promoted diversity and inclusion beyond their task force appointments with presentations at chapter meetings and other non-DITF MLA annual meeting programming. A notable task force accomplishment included completing a survey of MLA members to gather baseline demographic characteristics, including never before collected data about disability, socioeconomics, and caregiver status. This report provides an overview of DITF activities from 2017 to 2020.
    DOI:  https://doi.org/10.5195/jmla.2021.1112