Sidelines 17 (1)

Centre for Reviews and Dissemination

University of York

Web: http://www.york.ac.uk/inst/crd

Childs S, Blenkinsopp E, Hall A, Walton G. Effective e-learning for health professionals and students - barriers and their solutions. A systematic review of the literature - findings from a HeXL project. Health Info Libr J. 2005;22 (Suppl. 2):20-32.

E-learning is growing in importance and receiving increasing emphasis in various government initiatives where lifelong learning is being advocated. The research reported in this paper was undertaken in North East England during 2003-2004 and used a systematic review, telephone interviews and a questionnaire survey. The systematic review examined the barriers to effective use of e-learning options and solutions that have been identified. The findings of the review were then 'tested' in 12 interviews and a questionnaire survey (149 respondents). The review identified many organizational issues that create barriers to e-learning and it represents a very useful and exhaustive checklist of issues which e-learning project developers and users need to appreciate and for which they need to plan.

The reviewers concluded that the review findings reflected the experience of the daunting early days of e-learning. Although the subsequent interviews and questionnaires supported the systematic review findings, the reviewers noted that, despite continuing barriers and issues, e-learning has really progressed and improved since the research, on which the review was based, was published. The reviewers indicate that the majority of NHS managers and health service trainers considered e-learning to be effective and that learners were very positive about its effectiveness.

As well as providing a useful list of issues to consider when developing e-learning programmes, this paper also suggests various levels at which librarians can support e-learning and e-learners. This ranges from individual support and the provision of support materials, to information literacy skills training, and providing access to publications on the web by creating digital libraries. This paper provides much food for thought for anyone considering the planning or use of e-learning programmes.

Druss BG, Marcus SC. Growth and decentralization of the medical literature: implications for evidence-based medicine. J Med Libr Assoc. 2005;93(4):499-501.

This paper describes several trends in the number and content of MEDLINE records over time by looking at 8.1 million journal articles published from 1978 through to 2001.

The authors present the findings in an easy to read table with figures showing an increase in the amount of material on MEDLINE (in terms of number of articles and number of pages), as well as an increase in human subject studies, randomised controlled trials (RCTs) and the number of authors per publication. They also measured trends in funding sources for the research. This shows an increase in the number of studies declaring the source of funding and a shift from public to private funding. The authors then go on to discuss these results in the context of the published literature.

Although the results may hold few surprises to an experienced searcher, the results nevertheless are interesting. Overall the results in this paper reemphasize the vast literature available and the growing value of synthesised information such as that provided by systematic reviews.

Leclercq E.  Indexing of a clinical paper by Embase and Medline. CILIP Health Libraries Group Newsletter. 2005; 22(4):10-14.

This is an interesting and thought provoking article albeit limited to an investigation into the indexing of just one paper. The author compares the indexing assigned to this particular paper in MEDLINE and EMBASE. The author looked at the usefulness of the indexing by examining the full text of the paper and attempting to understand the relationship between the indexing terms used and the content of the paper.

Something which has concerned many information specialists recently has been the over indexing in EMBASE and this example reiterates this concern. For example, the paper addressed in this study is indexed in EMBASE as a ‘controlled study’ despite being a retrospective study. It also has the index term ‘adolescent’, despite not including any patients between the 13-19 years old, and uses an index term for a drug therapy term which does not appear in the study (but is used in one of the references included). On the other hand, the longer time lag for indexing publications in MEDLINE is demonstrated here as the paper in question was indexed in EMBASE 6 months before it was indexed in MEDLINE.

The author concludes, however, that although EMBASE may over index, MEDLINE may under index. The differences in indexing may have implications for those constructing searches in MEDLINE and then ‘translating’ into EMBASE as the author states that different approaches may be required.

Little can be concluded from an assessment of just one paper and it would be instructive to carry out this comparison of indexing terms in MEDLINE and EMBASE on further papers.

Skinner B. Web alert: advanced techniques for simple searches. Quality in Primary Care. 2005;13:171-5.

InternetInternet based search engines, and especially Google, are popular means of retrieving healthcare information despite their limitations (for example, the large number of hits they retrieve). It is possible, however, to learn to use them effectively and the author of this paper outlines a number of ways in which this can be done. Firstly, he suggests using other search engines (Yahoo!, Scirus, Dogpile) in addition to Google so that a search is more comprehensive. Secondly, he highlights a number of search features such as phrase and field searching that can increase the precision of InternetInternet searches. Finally, he reviews how Google Images and Google News can be used when a narrower search focus is required. Overall, the article gives some time saving hints and tips for all InternetInternet users.

Abad Garcia F, Gonzalez Tervel A, Bayo Cadduch P, de Ramon Frais R, Castillo Blasco L. A comparative study of six European databases of medically oriented Web resources. J Med Libr Assoc. 2005; 93(4):467-79.

The authors investigated the performance of a number of subject gateways (including OMNI and the Health On the Net Foundation) by carrying out one simple search and comparing the results. The performance indicators constructed are based on the number of unique resources identified, the number of resources with active links, and relevancy of resources. Of the gateways investigated, OMNI, CISMeF (Catalogue et Index des Sites Medicaux Francophones) and DDRT (Diseases, Disorders and Related Topics) performed well. The study concludes that subject gateways are useful as quick reference sources.

Armstrong R, Jackson N, Doyle J, Waters E, Howes F. It's in your hands: the value of handsearching in conductingon systematic reviews of public health interventions. J Public Health. 2005: 27(4):388-91

This paper reports on a pilot scheme organised by the Cochrane Health Promotion and Public Health Field. A set of six journals that were proven to contain a high number of trials from the field of health promotion and public health interventions were handsearched for randomised controlled trials, controlled clinical trials and systematic reviews.  All of these journals are indexed by MEDLINE but not currently handsearched by the Cochrane Collaboration.  The pilot research found that whilst a high percentage of those papers retrieved in this exercise would have been retrieved by an electronic search, a small number would not.  This was due to key information pertaining to the study type not being present in the title, abstract or MeSH headings, or because the supplement issues of the journal are not indexed in MEDLINE.

The paper discusses ways to improve the reporting of study type via abstracts, referring particularly to the CONSORT statement. It also talks about retrospective work on CENTRAL (Cochrane Central Register of Controlled Trials, available on The Cochrane Library) that will code health promotion studies with study type.  There is also a brief discussion concerning ways to encourage the recruitment and retention of quality handsearchers, and the problems of time and resource access for handsearchers.

The paper concludes by discussing the lessons learnt from this pilot and how these can be applied to the handsearching of non-indexed journal relating to health promotion and public health.

Ahern NR. Using the Internet to conduct research. Nurse Res. 2005;13(2):55-70.

This paper addresses the increased opportunities for research provided by the internetInternet within the last decade. Technological advances, the use of graphics, images and sounds to enhance usability, and the huge explosion of contributors make the internetInternet a vast potential source of information for researchers.

A literature search of EBSCO and PubMed to retrieve articles addressing the internetInternet and research or data collection was conducted, and resulting papers retrieved from a variety of disciplines were pooled to assess the uses, advantages and disadvantages to researchers of conducting web-based research.

Uses included recruiting subjects, completing online surveys or participating in online discussion boards. Advantages were the cost-effectiveness, efficiency and speed involved. The ability to get in touch with otherwise hard to reach or vulnerable populations is mentioned, as is the opportunity for anonymity. The internetInternet is seen as an ideal medium for collecting data on children. The ability of the researcher to maintain levels of control throughout the research project is also an advantage.

Limitations and disadvantages are also investigated. The potential bias of the population groups is an acknowledged problem: it is likely that they are largely middle class computer owners. Technical issues such as network incompatibility are mentioned. The lack of control over the setting of the test/interview and time spent on designing user-friendly interfaces are other possible disadvantages. Privacy, confidentiality, copyright and ethical issues can arise from internetInternet research and must be addressed.

The paper provides two boxes listing the advantages and disadvantages of using the internetInternet for research and advises on the importance of weighing one list against the other before engaging in internetInternet research. A section on implications for research, education and practice is included. The paper recommends that guidelines are developed that will deal with some of the more practical issues raised by internetInternet research.

Generally the paper concludes that the benefits of conducting internetInternet research outweigh the limitations, and sees the new technology as offering a great opportunity for researchers.

Simon C, Hegedus S. Exploring websites on cancer clinical trials: an empirical review. Contemp Clin Trials. 2005;26:530-3.

The aim of this study was to review the first 100 websites retrieved after searching for “cancer clinical trials”. Searches were carried out using Google and Yahoo during October 2004. After duplicates had been removed 66 sites were analysed. Quality indicators included confidentiality assurances, supported user feedback and comprehensible language.

Websites analysed included sponsored links, 70% were .com or .org sites of which 82% were non-profit or non-commercial sites. The majority of sites provided a question and answer format for users to get more information about clinical trials, including what they are and how they work. 46% of sites allowed users to search for information on specific trials, 17% of sites provided information on advances in clinical trials and breakthroughs. All 66 sites allowed searching using key words.

A number of sites were difficult or time consuming to navigate or were not working properly (for example, faulty scroll functioning). There were also confidentiality issues with several sites that required personal information from the user. Other sites charged a fee for users to take part in one or more trials, to receive reports on trials and one charged to match users with trials.

The authors conclude that cancer patients have reported that the InternetInternet has increased their understanding of clinical trials and their ability to discuss trials with their health care professionals. However, the authors acknowledge that complex language, lack of confidentiality and the amount and diversity of information available may discourage users. There is also an issue that sites recruiting users for trials can impede equitable access to trials by discriminating against non users of the internetInternet. The authors finish by suggesting that further research be carried out to understand the possible benefits and problems associated with commercial and other online sites aimed at prospective clinical research subjects.

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This page was last updated on: 21 August 2006