THE HEART OF THE MATTER
a special program of the National Emergency Medicine Association (NEMA) 

Transcripts: 540.3 and 540.4

Week: 540.3 Guest: Dr. Lawrence Kingsland, Asst. Dir. For Applied Informatics, National Library of Medicine Topic: Grateful Med Internet program- Part One of Two Producer/Host: Steve Girard

NEMA: Imagine vast amounts of medical information for you to peruse, a place where you could check through hundreds of thousands of case histories and articles to find just the right reference to what's ailing you...or perhaps a friend or loved one is having health problems, and you want to know enough to help out. Where is this place? Well, it's everywhere. It's the National Library of Medicine's Grateful Med program. Today, we're with Dr. Lawrence Kingsland III, the library's assistant director of applied formatics, who has helped develop the program. Dr. Kingsland, how did the program begin....?

KINGSLAND: Grateful Med began about ten years ago, and was designed as a front end system to help end users get access to the information in the file called Medline...Medline is a file of nearly eight million biomedical citations dating back to 1966.

NEMA: How was the system designed...and how has it changed?

KINGSLAND: The original Grateful Med system was a dial in system that worked over a modem...the more recent versions of the system, such as Internet Grateful Med, worked over the Internet and the World Wide Web. So, the idea is to help people get access to the information they need, from a very large file...from wherever they may be.

NEMA: What will a user need to get to the Grateful Med site, and what can be expected once there?

KINGSLAND: They need to have Internet access and a World Wide Web browser, such as Netscape Navigator or Microsoft Internet Explorer. And with one of those browses, they point the browser to the name...location of the Internet Grateful Med, which is called the URL - the Uniform Resource Locator - and when they do that, they get to a introductory screen that tells a little about the program, what it does, and offers specific background information that people often find useful. And when they move on from that point, having entered a user I.D. and password, they come to a search screen. And on that search screen they can enter query terms, and go ahead and perform the search, and have various options for assistance in finding good terms, or for analyzing a search that didn't quite get what they wanted, or for adding limits to a search that got too much...because, remember Medline is a multi-million record file, and sometimes searches get more than you wanted.

NEMA: With so much information, I suppose it would be paramount to be as specific as you can with your search language, so you don't end up with thousands of articles or citations....

KINGSLAND: Right, most people don't have the time to read three thousand or four thousand journal articles...most folks are looking for fewer than that in a more direct response. And so the program offers the ability to focus a retrieval that was pretty much on target, but needed a little nailing down.

NEMA: Perhaps you're a high school student dreaming of medical school, or a college scholar looking for some knockout information for a report, or maybe a mom looking for information on why your daughter's rash keeps coming back...Internet Grateful Med is a great resource, at very low cost. We'll talk about registering with the program...it's easy...and what new developments are coming, in our next program. I'm Steve Girard.

Transcripts:

Week: 540.4 Guest: Dr. Lawrence Kingsland, Asst. Dir. For Applied Informatics, National Library of Medicine Topic: New Goals for Internet Grateful Med - Part Two of Two Producer/Host: Steve Girard

NEMA: We're with Dr. Lawrence Kingsland, who helped develop the Internet Grateful Med program for the National Library of Medicine...which gives a user instant access to great stores of medical information. You can use the search engine on your web browser to get there...just punch in Grateful Med...I'll give you the URL in just a minute. Doctor, when someone accesses Internet Grateful Med, there is a fee for some services...tell me about how that works...

KINGSLAND: There's an online registration process that's available right, on the World Wide Web. It's done using Netscape Navigator, in secure mode, so that you can give us your credit card number over the net in some confidence. The charges for using the system are as small as we can keep them, in general, searches tend to cost a little over a dollar for a normal search involving several search statements and then looking at a couple of screens of records of citations.

NEMA: Grateful Med has gone from that dial-in modem set-up you mentioned earlier to giving instant access to a vast amount of information through the Internet....what does the future hold for the public's ability to get the medical knowledge they want through the National Library of Medicine?

KINGSLAND: Some pretty exciting things, really. The initial version of Internet Grateful Med searched in Medline, and the most recent version issued, actually on September 9th, which can search in Medline and in other files called Healthstar, Aids-line, and Pre-med Line. There will be searching in additional files coming...The National Library of Medicine actually has more than 40 databases on-line. Among the things that we're looking forward to doing in the next year or two will be taking a user query and doing a search in multiple files from that query and bringing back information from resources you might not have known were out there, to try to help you find what you need when you're not quite sure where it was.

NEMA: I understand that one of the unique things about Internet Grateful Med is that a user always has assistance in finding the articles or case citations needed...

KINGSLAND: That's information from the Unified Medical Language System Metathesaurus, that's a knowledge resource that's built into Internet Grateful Med to help you find good search terms. As you know, there are many different vocabularies and thesauri used to classify different parts of medicine, and medical practice...and we all have Snowmed and ICD-9 and medical subject headings and the read codes, and a great many other vocabularies. So, what the National Library of Medicine has done is set out on project to build an electronic Rosetta Stone, if you will, the Metathesaurus, that let's you map from terms in one vocabulary across to terms in another. And this becomes a very exciting and useful way of finding additional terms, when you know something by one name, but it actually might be indexed in one of our databases by a different one. An example might be a user who comes to search on heart attack, and doesn't realize that those articles are indexed under the term myocardial infarction.

NEMA: Professional or lay person, the Internet Grateful Med program is like having a library of your own, with unrestricted access and borrowing privileges. Get there with this URL... http://igm.nlm.nih.gov...thanks to Dr. Lawrence Kingsland for taking us on the tour. I'm Steve Girard.