bims-librar Biomed News
on Biomedical librarianship
Issue of 2023–04–30
forty papers selected by
Thomas Krichel, Open Library Society



  1. Med Ref Serv Q. 2023 Apr-Jun;42(2):42(2): 140-152
      Health sciences librarians may be experiencing a fundamental sense of disconnection from medical students as the reliance on online resources and post-pandemic acceptance of remote learning chip away at use of the physical library. In response, librarians have investigated a variety of virtual approaches to counter the loss of face-to-face contact with patrons. Numerous reports in the literature explore ways to build virtual relationships with patrons. This case study discusses a project by the Savitt Medical Library of the University of Nevada, Reno School of Medicine to implement a Personal Librarian Program that promoted communication between librarians and learners.
    Keywords:  Librarians; outreach; personal; remote
    DOI:  https://doi.org/10.1080/02763869.2023.2194146
  2. Med Ref Serv Q. 2023 Apr-Jun;42(2):42(2): 175-180
      Bookshelf is a database maintained by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine that contains freely accessible online biomedical documents, including systematic reviews, technical reports, textbooks, and reference books. The database allows users to browse and search across all content and within individual books, and it is linked to other NCBI content. This article provides an overview of Bookshelf and demonstrates its usage in a sample search. The resources available in Bookshelf are useful for students, researchers, healthcare professionals, and librarians.
    Keywords:  Bookshelf; NCBI; Online database; research resource; review
    DOI:  https://doi.org/10.1080/02763869.2023.2194145
  3. Genes (Basel). 2023 Apr 19. pii: 942. [Epub ahead of print]14(4):
      Scientific knowledge is being accumulated in the biomedical literature at an unprecedented pace. The most widely used database with biomedicine-related article abstracts, PubMed, currently contains more than 36 million entries. Users performing searches in this database for a subject of interest face thousands of entries (articles) that are difficult to process manually. In this work, we present an interactive tool for automatically digesting large sets of PubMed articles: PMIDigest (PubMed IDs digester). The system allows for classification/sorting of articles according to different criteria, including the type of article and different citation-related figures. It also calculates the distribution of MeSH (medical subject headings) terms for categories of interest, providing in a picture of the themes addressed in the set. These MeSH terms are highlighted in the article abstracts in different colors depending on the category. An interactive representation of the interarticle citation network is also presented in order to easily locate article "clusters" related to particular subjects, as well as their corresponding "hub" articles. In addition to PubMed articles, the system can also process a set of Scopus or Web of Science entries. In summary, with this system, the user can have a "bird's eye view" of a large set of articles and their main thematic tendencies and obtain additional information not evident in a plain list of abstracts.
    Keywords:  citation databases; data mining; literature digest; scientific literature
    DOI:  https://doi.org/10.3390/genes14040942
  4. Med Ref Serv Q. 2023 Apr-Jun;42(2):42(2): 91-107
      Conducting comprehensive but efficient literature searches for complex evidence syntheses involves selecting databases that will retrieve the greatest number of relevant results on the question. Lack of a comprehensive single database on allied health educational topics challenges those seeking such literature. In this study, six participants contributed research questions on instructional methods and materials for allied health patients, caregivers, and future health professionals. Two health sciences librarians created search strategies for these questions and searched eleven databases. Both the librarians and the six participants evaluated the search results using a rubric based on PICO to assess extent of alignment between the librarians' and requestors' relevance judgments. Intervention, Outcome, and Assessment Method constituted the most frequent bases for assessments of relevance by both librarians and participants. The librarians were more restrictive in all of their assessments except in a preliminary search yielding twelve citations without abstracts. The study's results could be used to identify effective techniques for reference interviewing, selecting databases, and weeding search results.
    Keywords:  Complex evidence syntheses; database search functions; database selection; health professions; relevance assessment
    DOI:  https://doi.org/10.1080/02763869.2023.2193122
  5. Med Ref Serv Q. 2023 Apr-Jun;42(2):42(2): 163-174
      The authors compare and contrast the structure and function of librarians and library services using a convenience sample online survey of pediatric hospitals in the Southeast based on the rankings from the Regional U.S. News & World Report Best Children's Hospitals and Magnet status. This approach is intended to determine how librarians and library services at hospitals that are recognized by the above programs differ from those that are not recognized.
    Keywords:  Accreditation; hospital librarianship; library services; standards
    DOI:  https://doi.org/10.1080/02763869.2023.2194143
  6. Recenti Prog Med. 2023 May;114(5): 256-257
      The presence of librarians or documentalists with expertise in scientific literature in the healthcare team has positive effects on patient care and can also make clinical decision-making more appropriate and efficient. Virtuous experiences are not lacking also in Italy. These include the Virtual Library for Health - Piedmont and the Alessandro Liberati Library of the Department of Epidemiology of the Lazio Health Service. These experiences confirm the importance of the role of online medical libraries in improving the quality of care. They offer a very welcome service to healthcare personnel, who are aware of the positive impact of competent support for the selection and evaluation of literature, useful for clinical choices at the patient's bedside.
    DOI:  https://doi.org/10.1701/4032.40073
  7. J Med Libr Assoc. 2022 Oct 01. 110(4): 471-477
       Objective: To compare electronic drug information resources for scope, completeness, and consistency of off-label uses information, and to group resources into tiers based on these endpoints.
    Methods: An evaluation study of six electronic drug information resources (Clinical Pharmacology, Lexi-Drugs, American Hospital Formulary Service Drug Information, Facts and Comparisons Off-Label, Micromedex Quick Answers, and Micromedex In-Depth Answers) was conducted. All off-label uses for the top 50 prescribed medications, by volume, were extracted from all resources and used to determine scope (i.e., whether the resource listed the use). Fifty randomly selected uses were then evaluated for completeness (i.e., whether the entry cited clinical practice guidelines, cited clinical studies, provided a dose, described statistical significance, and described clinical significance) and consistency (i.e., whether the resource provided the same dose as the majority).
    Results: A sample of 584 uses was generated. The largest number of listed uses was in Micromedex In-Depth Answers (67%), followed by Micromedex Quick Answers (43%), Clinical Pharmacology (34%), and Lexi-Drugs (32%). The highest scoring resources for completeness were Facts and Comparisons Off-Label (median score 4/5), Micromedex In-Depth Answers (median score 3.5/5), and Lexi-Drugs (median score 3/5). Consistency with the majority in terms of dosing was highest for Lexi-Drugs (82%), Clinical Pharmacology (62%), Micromedex In-Depth Answers (58%), and Facts and Comparisons Off-Label (50%).
    Conclusion: The top-tiered resources for scope were Micromedex In-Depth and Quick Answers. For completeness, the top-tiered resources were Facts and Comparisons Off-Label and Micromedex In-Depth Answers. Lexi-Drugs and Clinical Pharmacology were the most consistent in dosing.
    Keywords:  Drug information; electronic databases; off-label uses
    DOI:  https://doi.org/10.5195/jmla.2022.1419
  8. J Med Libr Assoc. 2022 Oct 01. 110(4): 525-529
      Rare book collections do not form in a vacuum; they are shaped by the individuals who assemble and curate them. This is certainly the case with the rare book holdings of Becker Medical Library at Washington University in St. Louis School of Medicine. This paper examines some of the most significant donors to Becker's rare book collections in order to explore how these collections are a reflection of the interests and priorities of the physicians who assembled them, and also raises the issue of how the makeup of these collections create a Western-focused narrative regarding the history of medicine.
    Keywords:  Rare books; history of medicine; special collections
    DOI:  https://doi.org/10.5195/jmla.2022.1551
  9. J Med Libr Assoc. 2022 Oct 01. 110(4): 478-484
       Background: Doctor of pharmacy educational accreditation standards state student pharmacists should be able to evaluate the scientific literature as well as critically analyze and apply information in answering drug information questions. Student pharmacists often struggle with identifying and using appropriate resources to answer medication-related questions. To ensure educational needs were met, a college of pharmacy hired a health sciences librarian to support the faculty and students.
    Case Presentation: The health sciences librarian collaborated with faculty and students throughout the doctor of pharmacy curriculum to identify and address any gaps related to appropriate drug resource utilization. Adding instruction time to the new student pharmacist orientation, coursework throughout the first year of the pharmacy program, and a two-semester evidence-based seminar course provided opportunities for the health sciences librarian to work with student pharmacists in the areas of library resource access, instruction on drug information resources, and evaluation of drug information found on the internet.
    Conclusion: The deliberate inclusion of a health sciences librarian into the doctor of pharmacy curriculum can benefit faculty and students. Opportunities for collaboration are available throughout the curriculum, such as providing instruction for database utilization and supporting the research activities of both faculty and student pharmacists.
    Keywords:  Information literacy; Instruction; Interprofessional collaboration; Pharmacy education; drug information; health sciences librarians; student pharmacists
    DOI:  https://doi.org/10.5195/jmla.2022.1486
  10. J Med Libr Assoc. 2022 Oct 01. 110(4): 520-524
      Email solicitations for manuscript submissions are a common tactic employed by predatory journals to attract potential victims. Both new and established researchers alike have fallen prey to this tactic, justifying the need for librarians to provide further education and support in this area. This commentary provides a succinct overview of predatory journals; briefly describes the problem of predatory journal email solicitations; explains the role librarians can play in their identification; and lists some red flags and tactics librarians can tell researchers to look out for, as informed by the literature and the author's analysis of 60 unsolicited journal emails she received in her own institutional inbox.
    Keywords:  Commentary; fraud; librarians; predatory journals; publishing; scholarly communications
    DOI:  https://doi.org/10.5195/jmla.2022.1554
  11. J Med Libr Assoc. 2022 Oct 01. 110(4): 399-408
      The Hospital Library Caucus of the Medical Library Association (MLA) follows the practice established in 1953 of developing quality indicators and best practices in the newly developing and fast-changing world of hospital libraries. As these libraries increased in number and prominence, the Joint Commission on the Accreditation of Hospitals (JCAHO) included in 1978 a hospital library standard developed in collaboration with MLA. Subsequent changes in JCAHO, then The Joint Commission (TJC) knowledge management criteria as well as technological changes in the curation and delivery of evidence-based resources influenced standards changes over the years. The 2022 standards mark the most recent edition, replacing the 2007 standards.
    Keywords:  Librarians; evidence-based information; hospital library standards; libraries; library services/standards; personnel staffing and scheduling/standards; professional role; virtual library services
    DOI:  https://doi.org/10.5195/jmla.2022.1590
  12. J Med Libr Assoc. 2022 Oct 01. 110(4): 530-540
      In this profile, Shannon D. Jones, MLS, MEd, AHIP, FMLA, Medical Library Association President, 2022-2023, MJ Tooey describes her as someone who "takes chances on people, valuing those others might not see as valuable". Jones embraces lifelong learning, and it shows up in her collegiate journey; she has been a student of leadership, a leader of institutions, especially within the Medical Library Association (MLA); and a leader in librarianship. She is a trailblazer, the second African American MLA president, and a champion of diversity, equity, inclusion, and belonging. Jones has been Director of Libraries & Professor at the Medical University of South Carolina (MUSC) for the past seven years and is also Director of Region 2 of the National Network of Libraries of Medicine, National Library of Medicine.
    DOI:  https://doi.org/10.5195/jmla.2022.1634
  13. J Med Libr Assoc. 2022 Oct 01. 110(4): 419-428
       Objective: To understand the experience of academic health sciences libraries during the pandemic using a phenomenological approach.
    Methods: This study used a multisite, mixed-method approach to capture the direct experience of academic health sciences libraries as they evolved during the COVID-19 pandemic. Phase one of the study involved administering a qualitative survey to capture to capture current evolutions of programs and services. The survey for phases two (August 2020) and three (February 2021) contained eight questions asking participants to share updates on their evolution and experiences.
    Results: Qualitative data were analyzed using open coding techniques to ensure emergent themes were allowed to surface. Additional post-hoc sentiment analysis ascertained the frequency of positive and negative words in each data set. Of the 193 possible AAHSL libraries, 45 (23.3%) responded to the April 2020 survey, 26 to the August 2020 survey, and 16 to the February 2021 survey. Libraries represented 23 states and the District of Columbia. The majority of libraries closed in March 2020. The ease of transferring library services to a remote environment varied by type of service. For the quantitative analysis, ten distinct areas were analyzed using text coded as "Staff" as a lens for understanding the connection between codes.
    Conclusion: Innovations by libraries during the early stages of the pandemic are having a long-term impact on library culture and the delivery of services. Even as libraries returned to in-person services, elements of telecommuting, using online conferencing software, safety precautions, and monitoring of staff well-being persisted.
    Keywords:  COVID-19; Libraries; health sciences librarians; medical
    DOI:  https://doi.org/10.5195/jmla.2022.1475
  14. Int J Technol Assess Health Care. 2023 Apr 25. 39(1): e22
       BACKGROUND: Systematic reviews (SRs) are usually conducted by a highly specialized group of researchers. The routine involvement of methodological experts is a core methodological recommendation. The present commentary describes the qualifications required for information specialists and statisticians involved in SRs, as well as their tasks, the methodological challenges they face, and potential future areas of involvement.
    TASKS AND QUALIFICATIONS: Information specialists select the information sources, develop search strategies, conduct the searches, and report the results. Statisticians select the methods for evidence synthesis, assess the risk of bias, and interpret the results. The minimum requirements for their involvement in SRs are a suitable university degree (e.g., in statistics or librarian/information science or an equivalent degree), methodological and content expertise, and several years of experience.
    KEY ARGUMENTS: The complexity of conducting SRs has greatly increased due to a massive rise in the amount of available evidence and the number and complexity of SR methods, largely statistical and information retrieval methods. Additional challenges exist in the actual conduct of an SR, such as judging how complex the research question could become and what hurdles could arise during the course of the project.
    CONCLUSION: SRs are becoming more and more complex to conduct and information specialists and statisticians should routinely be involved right from the start of the SR. This increases the trustworthiness of SRs as the basis for reliable, unbiased and reproducible health policy, and clinical decision making.
    Keywords:  Information services; biostatistics; professional role; systematic reviews as topic
    DOI:  https://doi.org/10.1017/S026646232300020X
  15. Med Ref Serv Q. 2023 Apr-Jun;42(2):42(2): 108-124
      Due to the rapid growth of information technology and medical information resources, medical personnel need to search and retrieve valid and updated information. However, with limited time to access these resources, there is a need for clinical librarians to connect medical staff to evidence-based medicine (EBM). The present study was conducted to identify the challenges in the absence and the benefits of the presence of clinical librarians in the application of EBM in clinical departments. Ten clinical physicians working at Children's Medical Center Hospital in Tehran, Iran were interviewed for this qualitative study. Most of the hospital-based physicians did not make any systematic use of EBM and seven were not familiar with the term "clinical librarian." In their opinion, the clinical librarians' activities included training the clinical and research teams, providing them with the required information, and providing an EBM-oriented approach to morning report and educational rounds. Therefore, the services delivered by clinical librarians in various hospital departments might positively influence the hospital-based physicians' information-seeking behavior.
    Keywords:  Clinical librarian; evidence-based medicine; information behavior
    DOI:  https://doi.org/10.1080/02763869.2023.2193123
  16. Med Ref Serv Q. 2023 Apr-Jun;42(2):42(2): 181-191
      Within academic libraries there are a variety of models for faculty status or classification applicable to librarians within their institutions. Some librarian positions are tenure track, some are non-tenure track, and some are classified as non-faculty administrative staff roles. This column will outline things to consider when a librarian classified as staff, professional or non-faculty is approached to take on a faculty role in an academic department outside of the library or is presented with the opportunity to pursue faculty status as a librarian. Having these statuses has benefits as well as challenges which should be considered before taking on such a role.
    Keywords:  Academic library partnerships; faculty status; staff librarians
    DOI:  https://doi.org/10.1080/02763869.2023.2193125
  17. Med Ref Serv Q. 2023 Apr-Jun;42(2):42(2): 153-162
      This study compares health science librarian job postings in the MEDLIB-L listserv from 2018-2019 and 2021-2022 to assess whether there was an increase in remote or hybrid schedule arrangements listed in job advertisements after the pandemic's onset. Results indicated a notable increase in advertising remote/hybrid work arrangements rising from 1.2% of listings in 2018-2019 to 16% of listings in 2021-2022. Data from a 2022 survey of library directors, however, indicated that approximately 70% of respondents expressed confidence in the continuance of remote/hybrid work. Additionally, from a very limited sample size, salaries for remote/hybrid positions did not appear to be less than in-person postings. While current employees at many institutions may benefit from flexible scheduling, this study examines whether job postings, which are often the primary information available to applicants, included information about remote and hybrid work options.
    Keywords:  Flexible work arrangements; Librarianship; recruitment; remote work
    DOI:  https://doi.org/10.1080/02763869.2023.2194144
  18. J Med Libr Assoc. 2022 Oct 01. 110(4): 449-462
       Objective: Health sciences librarians frequently engage in scholarly publication, both with other librarians undertaking intradisciplinary scholarship, and increasingly as members of research teams centered in other disciplines. We sought to assess the emotional and institutional context of authorship among health sciences librarians, including emotions experienced during authorship negotiation, the frequency with which authorship is denied, and the correlation of perceived support from supervisors and the research community with the number of publications produced.
    Methods: 342 medical and health sciences librarians took an online survey of 47 questions regarding emotions experienced when asking for authorship, denial of authorship, if they have been given authorship without asking, and the extent to which they felt supported to conduct research in their current job.
    Results: Authorship negotiation creates varied and complex emotions among librarians. The emotions reported differed when negotiating authorship with librarian colleagues and when negotiating authorship with professionals in another field. Negative emotions were reported when asking either type of colleague for authorship. Respondents reported feeling mostly supported and encouraged by their supervisors, research communities, and workplaces. Nearly one quarter (24.4%) of respondents reported being denied authorship by colleagues outside of their departments. Perceived research appreciation and support by the research community is correlated with the total number of articles or publications produced by librarians.
    Conclusion: Authorship negotiation among health sciences librarians involves complex and frequently negative emotions. Denial of authorship is frequently reported. Institutional and professional support appear to be critical to publication among health sciences librarians.
    Keywords:  Authorship; health science librarians; intradisciplinary scholarship; librarians; medical librarians; negotiation; professional support; research ethics
    DOI:  https://doi.org/10.5195/jmla.2022.1485
  19. J Med Libr Assoc. 2022 Oct 01. 110(4): 409-418
       Objective: The study aimed to analyze the documented role of a librarian in published systematic reviews and meta-analyses whose registered protocols mentioned librarian involvement. The intention was to identify how, or if, librarians' involvement was formally documented, how their contributions were described, and if there were any potential connections between this documentation and basic metrics of search reproducibility and quality.
    Methods: Reviews whose PROSPERO protocols were registered in 2017 and 2018 and that also specifically mentioned a librarian were analyzed for documentation of the librarian's involvement. Language describing the librarian and their involvement was gathered and coded, and additional information about the review, including search strategy details, was also collected.
    Results: A total of 209 reviews were found and analyzed. Of these, 28% had a librarian co-author, 41% named a librarian in the acknowledgements section, and 78% mentioned the contribution of a librarian within the body of the review. However, mentions of a librarian within the review were often generic ("a librarian") and in 31% of all reviews analyzed no librarian was specified by name. In 9% of the reviews, there was no reference to a librarian found at all. Language about librarians' contributions usually only referenced their work with search strategy development. Reviews with librarian coauthors typically described the librarian's work in active voice centering the librarian, unlike reviews without librarian coauthors. Most reviews had reproducible search strategies that utilized subject headings and keywords, but some had flawed or missing strategies.
    Conclusion: Even among this set of reviews, where librarian involvement was specified at the protocol level, librarians' contributions were often described with minimal, or even no, language in the final published review. Much room for improvement appears to remain in terms of how librarians' work is documented.
    Keywords:  Systematic reviews; documentation; librarians
    DOI:  https://doi.org/10.5195/jmla.2022.1505
  20. Med Ref Serv Q. 2023 Apr-Jun;42(2):42(2): 125-139
      Librarians collaborate in their positions daily to assist patrons with their needs. Many of these interactions are brief with collaborations quickly forming and then being dissolved as librarians provide for the needs of their patrons. Collaborations allow librarians to advance the purposes of the library and reach out and assist the institution. Unlike these brief daily interactions, research collaborations require librarians to make long-term commitments to projects. How can we ensure that these collaborations are successful? Study of research collaborations can assist librarians in determining how to build and maintain research collaborations and avoid or overcome conflicts and barriers. Finding others with similar interests, maintaining communication through multiple channels, and basic project management skills are key to successful research collaborations.
    Keywords:  Collaboration; conflict; health sciences; librarian
    DOI:  https://doi.org/10.1080/02763869.2023.2194753
  21. J Med Libr Assoc. 2022 Oct 01. 110(4): 485-493
       Background: Ethical decision-making regarding data collection, visualization and communication is of growing importance to librarians. Data ethics training opportunities for librarians, however, are uncommon. To fill this gap, librarians at an academic medical center developed a pilot data ethics curriculum for librarians across the US and Canada.
    Case Presentation: Three data librarians in a health sciences library developed a pilot curriculum to address perceived gaps in librarian training for data ethics. One of the team members had additional academic training in bioethics, which helped to provide an intellectual foundation for this project. The three-module class provided students with an overview of ethical frameworks, skills to apply those frameworks to data issues, and an exploration of data ethics challenges in libraries. Participants from library schools and professional organizations were invited to apply. Twenty-four participants attended the Zoom-based classes and shared feedback through surveys taken after each session and in a focus group after the course's conclusion.
    Discussion: Responses to the focus group and surveys indicated a high level of student engagement and interest in data ethics. Students also expressed a desire for more time and ways to apply what was learned to their own work. Specifically, participants indicated an interest in dedicating time for networking with other members of their cohort, as well as more extensive discussion of class topics. Several students also suggested creating concrete outputs of their thoughts (e.g., a reflective paper or final project). Finally, student responses expressed a strong interest in mapping ethical frameworks directly to challenges and issues librarians face in the workplace.
    Keywords:  Data ethics; education; library school; professional development
    DOI:  https://doi.org/10.5195/jmla.2022.1418
  22. Med Ref Serv Q. 2023 Apr-Jun;42(2):42(2): 202-210
      In 2022, a benchmarking survey was completed to gage learner satisfaction with library services, spaces, and resources across 10 Mayo Clinic Libraries. The discussion for this project began around a previously published survey of what medical students wanted from their library. Librarians were asked if Mayo Clinic Libraries could do a similar survey, as a full survey of the Mayo Clinic College of Medicine and Science had not been done. Overall, the findings were positive and provide a baseline for future surveys.
    Keywords:  Benchmarking; learner survey; library surveys; multi-campus library services
    DOI:  https://doi.org/10.1080/02763869.2023.2194148
  23. J Med Libr Assoc. 2022 Oct 01. 110(4): 507-512
       Background: A growing body of research demonstrates that adapting the popular entertainment activity "escape rooms" for educational purposes as an innovative teaching method can improve the learning experience. Escape rooms promote teamwork, encourage analytical thinking, and improve problem solving. Despite the increasing development and use of escape rooms in health sciences programs and academic libraries, there is little literature on the use of this method in health sciences libraries with health professions students.
    Case Presentation: Staff at a health sciences library collaborated with faculty to incorporate escape rooms into library instruction in a variety of settings (in-person, hybrid, online) and formats (team, individual) with health professions students from various disciplines (optometry, pharmacy, medicine). The escape rooms described in this paper offered unique experiences for students through active learning.
    Discussion: Important considerations when planning escape rooms for health sciences library instruction include deciding on team-based or individual design, calculating potential costs in time and money, deciding on an in-person, hybrid, or online format, and determining whether grades should be assigned. Escape rooms can be an effective strategy for library instruction in the health sciences, working in multiple formats to bring game-based learning to a variety of health professions students.
    Keywords:  Escape room; active learning; game-based learning; gamification; health professions students; instruction; medicine; optometry; pharmacy; teaching; team-based learning
    DOI:  https://doi.org/10.5195/jmla.2022.1463
  24. JMIR Infodemiology. 2022 Jul-Dec;2(2):2(2): e37286
       Background: Search engines provide health information boxes as part of search results to address information gaps and misinformation for commonly searched symptoms. Few prior studies have sought to understand how individuals who are seeking information about health symptoms navigate different types of page elements on search engine results pages, including health information boxes.
    Objective: Using real-world search engine data, this study sought to investigate how users searching for common health-related symptoms with Bing interacted with health information boxes (info boxes) and other page elements.
    Methods: A sample of searches (N=28,552 unique searches) was compiled for the 17 most common medical symptoms queried on Microsoft Bing by users in the United States between September and November 2019. The association between the page elements that users saw, their characteristics, and the time spent on elements or clicks was investigated using linear and logistic regression.
    Results: The number of searches ranged by symptom type from 55 searches for cramps to 7459 searches for anxiety. Users searching for common health-related symptoms saw pages with standard web results (n=24,034, 84%), itemized web results (n=23,354, 82%), ads (n=13,171, 46%), and info boxes (n=18,215, 64%). Users spent on average 22 (SD 26) seconds on the search engine results page. Users who saw all page elements spent 25% (7.1 s) of their time on the info box, 23% (6.1 s) on standard web results, 20% (5.7 s) on ads, and 10% (10 s) on itemized web results, with significantly more time on the info box compared to other elements and the least amount of time on itemized web results. Info box characteristics such as reading ease and appearance of related conditions were associated with longer time on the info box. Although none of the info box characteristics were associated with clicks on standard web results, info box characteristics such as reading ease and related searches were negatively correlated with clicks on ads.
    Conclusions: Info boxes were attended most by users compared with other page elements, and their characteristics may influence future web searching. Future studies are needed that further explore the utility of info boxes and their influence on real-world health-seeking behaviors.
    Keywords:  Bing; Microsoft; USA; ads; behavior; data; health information; health misinformation; information boxes; internet; internet search; knowledge graph boxes; linear; logistic; medical; misinformation; regression; results; search engine; symptoms; users; web
    DOI:  https://doi.org/10.2196/37286
  25. Healthcare (Basel). 2023 Apr 17. pii: 1154. [Epub ahead of print]11(8):
       BACKGROUND: Health information concerns both individuals' engagement and the way services and professionals provide information to facilitate consumers' health decision making. Citizens' and patients' participation in the management of their own health is related to the availability of tools making health information accessible, thus promoting empowerment and making care more inclusive and fairer. A novel instrument was developed (Evaluation Tool of Health Information for Consumers-ETHIC) for assessing the formal quality of health information materials written in Italian language. This study reports ETHIC's content and face validity.
    METHODS: A convenience sample of 11 experts and 5 potential users was involved. The former were requested to evaluate relevance and exhaustiveness, the latter both readability and understandability of ETHIC. The Content Validity Index (CVI) was calculated for ETHIC's sections and items; experts and potential users' feedback were analyzed by the authors.
    RESULTS: All sections and most items were evaluated as relevant. A new item was introduced. Potential users provided the researchers with comments that partly confirmed ETHIC's clarity and understandability.
    CONCLUSIONS: Our findings strongly support the relevance of ETHIC's sections and items. An updated version of the instrument matching exhaustivity, readability, and understandability criteria was obtained, which will be assessed for further steps of the validation process.
    Keywords:  education materials; health information; health literacy; patient education; quality information assessment; validation study
    DOI:  https://doi.org/10.3390/healthcare11081154
  26. Int Urogynecol J. 2023 Apr 27.
       INTRODUCTION AND HYPOTHESIS: The objective was to comprehensively analyze YouTube™ videos focusing on genital gender-affirmation surgery (GAS) from the perspective of urologists and gynecologists and to utilize results to create educational videos for transgender individuals with accurate and engaging content.
    METHODS: A YouTube search was performed using the keywords "Metoidioplasty," "Phalloplasty," "Gender affirmation surgery," "Transgender surgery," "Vaginoplasty," and "Male-to-female surgery." Video results that were duplicated, non-English, of low relevance, non-audio, and/or short duration (under 2 min) were excluded. The upload source was classified as university/nonprofit physician or organization, health information websites, medical advertisement/for-profit organizations, or individual patient experience. Viewer engagement metrics were obtained for each video. Each video was evaluated using the DISCERN, Global Quality Score (GQS), and Patient Education Materials Assessment Tool for audio-visual content (PEMAT A-V) tools.
    RESULTS: A total of 273 videos were evaluated. Viewer engagement metrics of videos from the patient experience group were higher than those of both universities/nonprofit physicians and medical advertisement/for-profit groups. DISCERN and GQS scores were significantly lower in videos uploaded by the patient experience group than in each of the other upload sources. More videos covered female-to-male (FtM) transition (168, 61.5%) than covered male-to-female (MtF; 71, 26.0%), and both (34, 12.5%). MtF transition videos had significantly higher total view counts than videos from the other groups (p<0.001). The like counts of videos were significantly higher in both MtF transition and FtM transition groups than for videos explaining both types of transition within the same video. The total DISCERN score was significantly lower in FtM transition videos than in the other content groups. Two educational videos were prepared, informed by the tools and results of this study, and hosted on YouTube.
    CONCLUSIONS: The findings suggest that genital GAS videos with less technical content have higher audience engagement. This information should be used to aid medical organizations when creating YouTube content to provide accurate information to larger audiences in the transgender community.
    Keywords:  Gender affirmation surgery; Metoidioplasty; Phalloplasty; Transgender surgery; Vaginoplasty; YouTube
    DOI:  https://doi.org/10.1007/s00192-023-05542-0
  27. Digit Health. 2023 Jan-Dec;9:9 20552076231171239
       Objective: Previous studies have reported low quality and reliability on YouTube videos about various medical issues including videos related to hallux valgus (HV) treatment. Therefore, we aimed to evaluate the reliability and quality of YouTube videos on HV and develop a new HV-specific survey tool that physicians, surgeons, and the medical industry can use to create high-quality videos.
    Methods: Videos viewed over 10,000 times were included in the study. We used the Journal of the American Medical Association (JAMA) benchmark criteria, global quality score (GQS), DISCERN tool, and new HV-specific survey criteria (HVSSC) developed by us to evaluate the quality, educational utility and reliability of the videos, the popularity of which was assessed using the Video Power Index (VPI) and view ratio (VR).
    Results: Fifty-two videos were included in this study. Fifteen videos (28.8%) were posted by medical companies producing surgical implants and orthopedic products, 20 (38.5%) by nonsurgical physicians, and 16 (30.8%) by surgeons. The HVSSC indicated that the quality, educational value, and reliability of only 5 (9.6%) videos were adequate. Videos posted by physicians and surgeons tended to be more popular (p = 0.047 and 0.043). Although no correlation was detected among the DISCERN, JAMA, and GQS scores, or between the VR and VPI, we found correlations of the HVSSC score with the number of views and the VR (p = 0.374 and p = 0.006, respectively). A good correlation was detected among the DISCERN, GQS, and HVSSC classifications (rho = 0.770, 0.853, and 0.831, respectively, p = 0.001).
    Conclusions: The reliability of HV-related videos on YouTube is low for professionals and patients. The HVSSC can be used to evaluate the quality, educational value, and reliability of videos.
    Keywords:  Hallux valgus; YouTube; internet; patient education; quality; surgery
    DOI:  https://doi.org/10.1177/20552076231171239
  28. Arthrosc Sports Med Rehabil. 2023 Apr;5(2): e459-e464
       Purpose: To evaluate the content and quality of YouTube videos concerning patellar dislocations.
    Methods: "Patellar dislocation" and "kneecap dislocation" were searched on the YouTube library. The Uniform Resource Locator of the first 25 suggested videos was extracted, for a total of 50 videos. The following variables were collected for each video: number of views, duration in minutes, video source/uploader, content type, days since upload, view ratio (views/day), and number of likes. Video source/uploader was categorized as academic, physician, nonphysician, medical source, patient, commercial, and other. The Journal of the American Medical Association (JAMA), Global Quality Scale (GQS), Patellar Dislocation Specific Score (PDSS), and DISCERN scores were used to assess each video. A series of linear regression models were used to explore relationships between each of these scores and the aforementioned variables.
    Results: The median video length was 4.11 minutes (interquartile range 2.07-6.03, range 0.31-53.56), and the total number of views for all 50 videos was 3,697,587 views. The mean overall JAMA benchmark score ± standard deviation was 2.56 ± 0.64, GQS: 3.54 ± 1.05, total PDSS: 5.76 ± 3.42. Physicians were the most common video source/uploader (42%). Academic sources had the greatest mean JAMA benchmark score (3.20), whereas nonphysician and physician sources had the greatest mean GQS scores (4.09 and 3.95, respectively). Videos uploaded by physicians had the greatest PDSS scores (7.5).
    Conclusions: The overall transparency, reliability, and content quality of YouTube videos on patellar dislocation measured by the JAMA benchmark score and PDSS, respectively, are poor. Additionally, the overall educational and video quality, as assessed by the GQS, was intermediate.
    Clinical Relevance: It is important to understand the quality of information patients receive on YouTube so providers can guide patients to greater-quality sources.
    DOI:  https://doi.org/10.1016/j.asmr.2023.01.014
  29. J Back Musculoskelet Rehabil. 2023 Apr 12.
       BACKGROUND: Videos uploaded to YouTube do not go through a review process. The educational aspect of these videos may be insufficient for patellofemoral pain syndrome (PFP).
    OBJECTIVE: To examine the reliability and educational quality of PFP videos on YouTube.
    METHODS: A standard search was performed in the YouTube database using the following terms: patellofemoral pain syndrome/anterior knee pain syndrome/anterior knee pain/patellofemoral pain. For each search term, the top 50 videos based on "relevance" assignment of YouTube's algorithm were included in the examination. The remaining 96 videos after exclusion were included in the study. The educational quality and reliability of videos was analyzed using DISCERN, JAMA (The criteria of Journal of the American Medical Association), GQS (Global Quality Score) and PFPSS (Patellofemoral Pain Specific Score).
    RESULTS: According to PFPSS, 81.2% of the videos were evaluated as low and very low quality. According to the DISCERN classification, 74.9% of the videos were evaluated as poor and very poor. According to GQS, 59.4% of the videos had scores of 2 or less, which were considered poor quality. According to JAMA, 41.7% of the videos scored 2 and below.
    CONCLUSIONS: The information content of YouTube videos is inadequate. Video design should be created to be understandable by patients and to attract their attention while making these videos.
    Keywords:  DISCERN; Patellofemoral pain syndrome; YouTube; patient education; quality of information
    DOI:  https://doi.org/10.3233/BMR-220158
  30. J Med Libr Assoc. 2022 Oct 01. 110(4): 429-437
       Objective: Open science (OS) is a global movement focused on improving research equity, reproducibility, and transparency of research outputs in publicly funded research. While OS education in academia is becoming more common, examples of health sciences librarians providing OS training are not. This paper describes how a librarian collaborated with teaching faculty and a research program coordinator to integrate an OS curriculum into an undergraduate professional practice course and assess students' perceptions of OS after participating.
    Methods: A librarian developed an OS-specific curriculum for an undergraduate professional practice course in Nutrition. This course is part of the First Year Research Experience (FYRE) program, which is integrated into 13-week undergraduate courses to introduce students to core elements of the research process in their first year of study by carrying out a research project. The OS curriculum included an Introduction to OS class, a requirement that students share their research outputs in the Open Science Framework, and an assignment asking students to reflect on their experience learning about and practicing OS. Twenty-one of 30 students consented to having their reflection assignment undergo thematic analysis.
    Results: Students indicated transparency, accountability, accessibility to research outputs, and increased efficiency as positive attributes of OS. The time commitment, fear of being scooped, and concerns over having research be misinterpreted were considered negative attributes. 90% (n=19) of students indicated that they intend to practice OS in the future.
    Conclusion: Based on strong engagement from the students, we believe that this OS curriculum could be adapted to other undergraduate or graduate student contexts where a research project is required.
    Keywords:  Open science; curriculum integration; education; open scholarship; open science framework; research transparency
    DOI:  https://doi.org/10.5195/jmla.2022.1457
  31. J Med Libr Assoc. 2022 Oct 01. 110(4): 501-506
      This case study presents the results of a data internship and workshop series on data analysis in qualitative biomedical systematic reviews. In a newly developed librarian-led internship program, an intern was trained on data literacy concepts and data analysis tools and, in turn, helped recruit and train other graduate health sciences students. Due to COVID-19 restrictions, a flipped classroom model was applied to develop a completely virtual learning experience for both the intern and workshop attendees. Both the data intern and workshop participants reported improved confidence in data literacy competence at the end of the project. Assessment results suggest that while the workshop series improved participants' data literacy skills, participants might still benefit from additional data literacy instruction. This case also presents a model for student-led instruction that could be particularly useful for informing professional development opportunities for library interns, fellows, and student assistants.
    Keywords:  Data literacy; NVivo; data analysis; internship; qualitative; systematic review; training
    DOI:  https://doi.org/10.5195/jmla.2022.1498
  32. Musculoskelet Sci Pract. 2023 Apr 10. pii: S2468-7812(23)00039-5. [Epub ahead of print]65 102754
       OBJECTIVE: To systematically search the internet for conservative rehabilitation protocols for people with an anterior cruciate ligament (ACL) injury and critically appraise the websites and exercise protocols.
    DESIGN: Systematic review of online rehabilitation protocols.
    SEARCH: We searched four online search-engines (Google, Yahoo, Bing, DuckDuckGo).
    SELECTION CRITERIA: Rehabilitation protocols on active, English language websites aimed at conservative (non-surgical) management of an ACL injury.
    DATA SYNTHESIS: We extracted descriptive information and assessed quality of the websites using the Journal of the American Medical Association (JAMA) benchmark criteria, the Health on the Net Code (HONcode) certificate, and the Flesch-Kincaid Reading Ease (FKRE). We assessed completeness of exercise protocol reporting using the Consensus on Exercise Reporting Template (CERT). We performed a descriptive analysis.
    RESULTS: We found 14 websites that met our selection criteria. The protocols varied between 10 and 26 weeks duration, nine were from the United States, five targeted patients, and 13 used multiple phases with a variety of different criteria for progression. Three protocols scored good quality with the JAMA, two were HonCode certified, and ten had good readability according to the FKRE. Completeness of exercise protocol reporting in all but one protocol was poor according to the CERT.
    CONCLUSION: Few rehabilitation protocols for conservative management of ACL injuries were available online. Most of the websites showed good readability, but poor quality and credibility with inadequate description of exercise protocols.
    Keywords:  Exercise protocols; Knee injury; Quality assessment websites
    DOI:  https://doi.org/10.1016/j.msksp.2023.102754
  33. JMIR Form Res. 2023 Apr 24. 7 e44010
       BACKGROUND: In the information era, patients can easily be misled by inaccurate internet content, thus making not well-informed decisions about medical issues. Adenoid hypertrophy, one of the most common causes of chronic upper airway obstruction in children and adolescents, may lead to serious complications, including sleep apnea and craniofacial change. There have been no critical studies about the quality of websites on adenoid hypertrophy, posing a challenge for users without a medical background to determine which website offers more reliable information. Moreover, the blockage of access to internet search tools such as Google, Yahoo, and others has created an isolated internet environment for the enormous user population in mainland China. Differences in internet legislation, the commercial environment, and culture are also likely to result in varied quality of online health information inside and outside mainland China. To date, no study has compared the quality difference between mainland Chinese and English websites.
    OBJECTIVE: The aims of this study were to (1) analyze the quality of websites about adenoid hypertrophy accessible by patients, (2) investigate the quality differences between Chinese and English websites, (3) determine which type of website (eg, government-sponsored, health care provider) is more reliable in terms of medical information, and (4) determine whether the blockage of foreign websites is hindering users' accessibility to better-quality websites in mainland China.
    METHODS: The first 100 websites (excluding advertisements) displayed on the top three search engines worldwide and in mainland China for the key search term "enlarged adenoids" were collected as the data source. The websites were evaluated based on accessibility, accountability, interactivity, structure, and content quality (accuracy, content coverage, and objectivity). Cohen κ was calculated, and one-way ANOVA and the Kruskal-Wallis test were performed to compare the results between groups and subgroups.
    RESULTS: The mean score for the content quality of English websites was significantly higher than that of Chinese websites (6.16 vs 4.94, P=.03 for Google, Bing, and Yahoo; 6.16 vs 4.16, P<.001 for Baidu, Sougou, and Bing China). Chinese users who are not influenced by the Internet Censorship System are more likely to access higher-quality online medical information (4.94 vs 4.16, P=.02). In within-group Student-Newman-Keuls q posthoc analysis, professional organization and government-sponsored websites were generally of better quality than other websites for both Chinese and English websites (P<.05).
    CONCLUSIONS: Generally, the English websites on adenoid hypertrophy are of better quality than Chinese websites; thus, Chinese users residing outside of the Chinese mainland are less influenced by inaccurate online medical information.
    Keywords:  Chinese; English; English and Chinese; accessibility; adenoid hypertrophy; airway; airway obstruction; critical analysis; decisions; internet; medical issues; online; patient; quality; website quality
    DOI:  https://doi.org/10.2196/44010
  34. J Med Libr Assoc. 2022 Oct 01. 110(4): 513-519
       Background: Since 2003, the MLA Membership Committee has facilitated an in-person mentoring program called Colleague Connection at the annual meeting. The program hinged on meeting attendance, so members who could not attend were excluded. The 2020 virtual meeting created an opportunity to rethink the Colleague Connection experience. Three members of the Membership Committee developed an expanded and virtual version of the mentoring program.
    Case Presentation: Colleague Connection was promoted via the MLA '20 vConference Welcome Event, MLAConnect, and email lists. The 134 participants were matched based on same-chapter preference, library type, practice area interest, and years of experience. Mentees chose mentor-mentee or peer pairs, resulting in 4 peer matchings and 65 mentor-mentee matchings. Pairs were encouraged to meet monthly, and conversation prompts were provided. A Wrap-Up Event was held for participants to talk about their experiences and network. A survey evaluated the program and sought suggestions for improvement.
    Conclusion: The online format boosted participation, and the format change was well received. In the future, a formal orientation meeting and communication plan can ensure pairs make their initial connections and provide clarity about program details, expectations, timelines, and contact information. The type of pairings and size of the program are important considerations for the feasibility and sustainability of a virtual mentoring program.
    Keywords:  Medical Library Association; Mentors; medical librarians; mentoring; mentorship; professional organizations
    DOI:  https://doi.org/10.5195/jmla.2022.1356
  35. J Med Libr Assoc. 2022 Oct 01. 110(4): 494-500
       Background: Despite the challenges the COVID-19 pandemic placed on libraries' existing workflows and operations, many librarians developed and debuted new services that addressed novel needs that emerged during the pandemic. This report describes how two electronic resource librarians at regional hospitals within a healthcare corporation used exhibition platforms to showcase resident research in an online format as a complement to in-person resident research programming.
    Case Presentation: Over the course of the pandemic, two exhibition platform variants were implemented, one year apart. This case report describes how each platform was developed. The first online event was conducted using a virtual exhibit platform to minimize in-person contact. The second online event, held the following year, blended a traditional live event with virtual elements using the online exhibit platform. To ensure completion of tasks, project management techniques were adopted throughout the event planning process.
    Conclusions: The pandemic created opportunities for hospitals to explore transforming meetings from primarily live and onsite into hybrid and fully virtual events. While many corporate hospitals have transitioned back to primarily in-person programming, newly adopted online practices such as online judging platforms and automation of continuing medical education tasks will likely remain. As in-person restrictions within healthcare settings are lifted or eased at uneven rates, organizations may continue to explore the value of in-person meetings versus the video conference experience of the same meeting.
    Keywords:  COVID-19; Online systems; continuing; education; medical; user-computer interface
    DOI:  https://doi.org/10.5195/jmla.2022.1345
  36. J Med Libr Assoc. 2022 Oct 01. 110(4): 438-448
       Objective: A mixed methods survey was conducted at a health sciences library to assess patrons' perceptions of the library's digital and physical environments in relation to diversity, equity, and inclusion (DEI).
    Methods: Developed by the library's DEI Team and preceded by a pilot assessment, the survey posed 17 Likert Scale questions and 2 free-text response questions on the topics of belonging, inclusivity, equitability, emotional and physical safety, and commitment to DEI. The survey was created in Qualtrics, pilot tested, and launched in February 2020 for approximately 12 weeks.
    Results: Objective question responses were received from 101 individuals, with 24 open-ended responses. The quantitative findings showed largely positive perceptions of the DEI climate. Questions about feeling welcome and feeling physically safe were among those with the highest responses. The three lower-scoring questions indicate areas for improvement, including services for people whose native language is not English, for individuals with disabilities, and for families. The qualitative findings indicate the library's strengths include its exhibitions, welcoming atmosphere, and LGBTQ+ inclusivity initiatives. In contrast, opportunities for enhancement encompass non-English language resources, website updates, and accessibility to some physical spaces.
    Conclusion: The DEI Team is using the online survey data to enhance library services, staffing, programming, policies, and spaces. These improvements include looking into providing a space for patrons with families, expanding services for individuals whose first language is not English, assessing library accessibility for people with physical disabilities, and enhancing the physical space with quiet areas, improved lighting, and meditation spaces. Employee DEI training is ongoing, using results from a training needs survey to identify knowledge gaps. The library has a history of successful partnerships with campus entities, which will help the DEI Team to move forward with their work.
    Keywords:  Diversity; equity; health science libraries; inclusion; medical libraries; mixed methods; online surveys
    DOI:  https://doi.org/10.5195/jmla.2022.1436
  37. Patient Educ Couns. 2023 Apr 15. pii: S0738-3991(23)00142-8. [Epub ahead of print]113 107762
       OBJECTIVE: Online health information contributes to patient education and knowledge on disease management. The aims of this study were to design the Health Information Website Evaluation Tool (HIWET) to evaluate the quality of online information, and to investigate the reliability, validity, and utility of HIWET.
    METHODS: HIWET was developed by a literature search and small-scale pilot testing. Upon development, psychometric properties of HIWET were evaluated on 20 neck pain websites. Reliability was analysed using Intra class correlation coefficient (ICC). Validity was analysed using Pearson and Spearman correlation coefficients. Utility was analysed using an independent samples t-test.
    RESULTS: HIWET demonstrated excellent intra-rater reliability (0.94 (0.98-0.99), p < .001) and fair inter-rater reliability (0.55 (0.88-0.10), p = .04). HIWET demonstrated validity with strong correlation against DISCERN (r = 0.656, n = 20, p = .002) and LIDA (r = 0.564, n = 20, p = 0.010). HIWET was time-efficient when compared to three comparison tools combined.
    CONCLUSION: HIWET is a reliable and valid tool for evaluating the qualities of online health information.
    PRACTICAL IMPLICATIONS: HIWET has the advantages of being a simple, quick to use and freely accessible tool. It can be implemented into clinical practice, education, and research to evaluate quality of online health information.
    Keywords:  Online health information; Quality evaluation; Tool reliability; Tool utility; Tool validation
    DOI:  https://doi.org/10.1016/j.pec.2023.107762
  38. Med Ref Serv Q. 2023 Apr-Jun;42(2):42(2): 194-201
      ChatGPT, a leading large language model, has achieved some success beyond previous language models and caught the world's attention since its release in late 2022. Businesses and healthcare professional fields have raised strong interests in investing in large language models to assist various kinds of information searching in their domain of expertise. Under the influence of ChatGPT, searched information may be received in a new personalized chat format, in contrast to the traditional search engines with pages of results for users to evaluate and open. Large language models and generative AI present new opportunities for librarians to understand more about language models' development as well as the future directions of the language models that are developed behind the user interfaces. Being aware of how language models impact the communication of information will enrich librarians' abilities to examine the quality of AI outputs and awareness of users' rights and data curation policies, to better assist patrons' research activities that involve using language models in the foreseeable future.
    DOI:  https://doi.org/10.1080/02763869.2023.2194149
  39. J Med Libr Assoc. 2022 Oct 01. 110(4): E34
      [This corrects the article DOI: 10.5195/jmla.2022.1443.][This corrects the article DOI: 10.5195/jmla.2022.1447.][This corrects the article DOI: 10.5195/jmla.2022.1579.].
    DOI:  https://doi.org/10.5195/jmla.2022.1671
  40. J Med Libr Assoc. 2022 Oct 01. 110(4): 463-470
       Objective: This study updates a 2009 study which examined uniform resource locator (URL) decay in health care management journals and seeks to determine whether continued URL availability relates to publication date, resource type, or top-level domain. The authors also provide an analysis of differences in findings between the two study periods.
    Methods: The authors collected the URLs of web-based cited references in articles published in five health care management source journals from 2016 to 2018. The URLs were checked to see if they were still active and then analyzed to determine if continued availability was related to publication date, resource type, or top-level domain. Chi-square analysis was conducted to determine associations between resource type and URL availability, and top-level domain and URL availability. A Pearson's correlation was conducted to determine the relationship between publication date and URL availability.
    Results: There were statistically significant differences in URL availability across publication date, resource type, and top-level domain. Domains with the highest percentage of unavailable URLs were .com and .net, and the lowest were .edu and .gov. As expected, the older the citation, the more likely it was unavailable. The overall percentage of unavailable URLs decreased from 49.3% to 36.1% between studies.
    Conclusion: URL decay in health care management journals has decreased in the last 13 years. Still, URL decay does continue to be a problem. Authors, publishers, and librarians should continue to promote the use of digital object identifiers, web archiving, and perhaps study and replicate efforts used by health services policy research journals to increase continued URL availability rates.
    Keywords:  URL availability; URL decay; citation analysis; health care management
    DOI:  https://doi.org/10.5195/jmla.2022.1456