How to make the Internet work for you

1. How to make the Internet work for you Hans Pasterkamp, MD, FRCPC1 and Bill Poluha2 Dept. of Pediatrics and Child Health1 and NJMHS Library2 University of Manitoba Winnipeg, MB

2. Objectivesat the end of this workshop you should know how to • choose from the range of information resources on the Internet • use efficient search strategies to retrieve relevant information • evaluate Internet based information content • incorporate Internet derived information in your practice

3. Getting on the Internet • Computer hardware (PC) - Intel Pentium, 32 Mb RAM (minimum) - Modem compatible with Internet Service Provider - Modem speed min. 28.8 kbps • Internet Service Provider - Established company - Enough modems to avoid busy lines

4. Needles in Haystacks “Take a book ... Remove the cover, remove the title page, Remove the table of contents, remove the index, Cut the binding from the spine, Fling the loose pages that remain so that they scatter about the room ... Now, find the information you needed from the book. This is the Internet!“ attributed toMichael Gorman Dean of Library Services, CSU Fresno

5. Healthcare Web Sites • created by and for professions, societies • about diseases, wellness, healthcare, or health promotion • for educational purposes, instruction • directed at the public, at students, or at practitioners

6. world wide web search engines pathfinder sites subject catalogues other e-mail filters & filing file attachments listserve (discussion groups) find & subscribe unsubscribe newsgroups gopher chat Information resources

7. Search strategies • encyclopedic sites • e.g. http://www.ncbi.nlm.nih.gov (MedLine, OMIM etc.) • e.g. http://igm.nlm.nih.gov (Grateful Med - MedLine) • pathfinder sitese.g. http://www.med.jhu.edu/peds/neonatology/poi.html • navigator sites • free text search • e.g. http://www.altavista.com • meta-search engines, e.g., http://www.northernlight.com, http://www.dogpile.com, http://www.infind.com • PC-based searchbots, e.g. Copernic‘99 (http://www.copernic.com)

8. Encyclopedic sites • cover wide range of health care topics, providing direction and links • promise of quality control(but often, the more inclusive, the less quality) • convenience of one-stop shopping

9. Exercise 1 - Encyclopedic Sites You are the Attending Pediatrician in a Teaching Hospital. A 14 year old girl on the ward has just been admitted for the 3rd time this year because of asthma. The Intern asks if there is any relevant information on asthma on the Internet.

10. Pathfinder Sites • cover a single topic well • sometimes offer content; they always offer links! • think of them as bibliographies, guides to the topic on the web

11. Exercise 2 - Pathfinder Sites A mother brings her 5 year old son for vaccination. He has CF and she is concerned about routine vaccinations since she read about this on the Internet. She also wonders about potential use of ozone and of mullien tea. She cannot find the web site of the CCFF.

12. Navigator Sites • search engines • “purpose built” searches of the web with specific queries • don’t expect precision of bibliographic searches • advantages & disadvantages (too much or too little, out of context) • catalogues • collect & organize sites for browsing • allow searches of what they have collected • evaluated sites • like catalogues, they have a repertoire • they add extra value in description or approval of some kind • try hard to locate criteria for each service

13. Exercise 3 - Free Text Search A teenage patient with end-stage CF asks you about new therapies and about lung transplantation. She wants to use this information in a science project at school and she wonders if students could use the Internet to find other resources.

14. Exercise 4 - Subject Catalogue You have not been involved in the care of children with rheumatoid disorders for awhile and you wonder about your knowledge in this area, Are there any web sites that can test your disease-specific knowledge? If so, how would you find these sites and how would you validate their content?

15. Exercise 5 - Subject Catalogue A respiratory therapist has returned from a conference in Snowbird, USA, and now wonders about guidelines to use non-invasive IPPV in CF. Is there any point in resorting to the Internet for a search?

16. Exercise 6 - Listserv Foster parents of a 4 year old boy with attention deficit wonder if you know ADHD related Internet resources.

17. WWW - Critical Appraisal • how do you know what you can trust? • how do you evaluate print sources? • credentials of author • reputation of publisher • accuracy of content • timeliness of information • apply the same common sense standards to the WWW

18. Quality Assessment • Credibility: Source, Context, Currency, Relevance/Utility, Editorial Review Process • Content: Accuracy, Hierarchy of Evidence, Original Sources Stated, Disclaimer, Omissions Noted • Disclosure: Purpose of Site, Profiling • Links: Selection, Architecture, Content, Back Linkages and Descriptions • Design: Accessibility, Logical Organization, Internal Search Engine • Interactivity: Mechanism for Feedback, Chat Rooms, Tailoring • Caveats: Alerts from: Criteria for Assessing the Quality of Health Information on the Internetat http://hitiweb.mitretek.org/docs/criteria.html

19. Case Scenario A 52 year old mother brings her 9 year old daughter to you for assessment of Lyme disease. She states that she has Lyme disease herself and that her daughter’s problems of cough and wheeze are related to an intrauterine infection with B. burgdorfferi How do you find out about possible vertical transmission of Lyme disease? What could the mother know and what should you know?

20. Finding It Again • save meta-searches • use bookmarks in web browsers • “post-process” bookmarks • use index and search programs on PC and Mac • bibliography programs (e.g., Reference Manager, Procite etc.) • electronic filing cabinet • catalogue media (disks, CD-ROM, cassettes) • take it with you (PDA)