Diary of Unknown Symptoms

Mystery of the Internal Vibration

Entry for June 09, 2006

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One of the links lead me to a website and it has the following article:

How Google is changing medicine

What a remarkable year it has been for those of us monitoring changes in the global information landscape. Since last Christmas, there has been a flurry of activity: the digitisation of the world’s libraries began in earnest (despite the copyright fracas); open access publishing gained much-needed support internationally (especially in science and medicine); and Google, MSN Search, and Yahoo introduced a number of customisation tools for desktops and mobiles, podcasts, blogs, and video searches.

Google’s influence and power is writ large in the search field—so large that librarians are asking themselves some difficult questions. With all of this technology and freely available digital information, what will happen to physical libraries? Google’s mission is to provide access to the world’s information—but this is librarians’ mission too. Will they be needed in the new information age?

For all the benefits technology provides, it does provoke anxiety. In a recent letter in the New England Journal of Medicine, a New York rheumatologist describes a scene at rounds where a professor asked the presenting fellow to explain how he arrived at his diagnosis.4 Matter of factly, the reply came: “I entered the salient features into Google, and [the diagnosis] popped right up.” The attending doctor was taken aback by the Google diagnosis. “Are we physicians no longer needed? Is an observer who can accurately select the findings to be entered in a Google search all we need for a diagnosis to appear—as if by magic?” In a post-Google world, where evidence based education is headed is anyone’s guess. Googling your diagnosis; Googling your treatment—where is all this leading us?

Google has won the battle of the search engines, at least for the time being (see example in table), and its more serious minded offspring, Google Scholar, is rapidly gaining ground. Within a year of its release Google Scholar has led more visitors to many biomedical journal websites than has PubMed (J Sack, personal communication, 2005). Once they discover it, many medical students and doctors prefer Google Scholar.6 Although both tools benefit from Google’s trademark simplicity, Google Scholar indexes more peer reviewed research and is especially quick in locating highly cited items and the proverbial needle in a haystack. Doctors are encouraged to consult Google Scholar for browsing and serendipitous discovery, not for literature reviews; and they should use the advanced search page to find words and names that occur often in the medical literature.

Scholar’s mode of presentation hinders its usefulness and may take up valuable time. Google’s algorithm—which weighs the significance of articles—may be partly to blame. The quantity of search results is acceptable, but quality is often not. Using some of the subject tags in advanced mode may offer some assistance, and more precision. Because current articles are not displayed first, and cannot be sorted, downloaded, or emailed—expect to do a lot of sifting.

Still, Scholar does simplify basic searching for doctors, and it’s free, like PubMed. For anyone not affiliated with a large medical centre or university, the ability to search for and access research material that is available free on the web is a boon.

As scientific societies and associations consider moving their journals to open access models, Google Scholar and Elsevier’s Scirus will likely provide a reliable gateway to this information. The most useful feature to come out this year on Google Scholar is “cited by” referencing. This free tool links searchers to other scholarly papers that have cited the paper being viewed. Scholar also provides links to local library catalogues through its library link program and through an international database called WorldCat.

In searches for clinical trials and systematic reviews, Google Scholar should of course never be used in isolation. However, it is a useful addition to PubMed, Cochrane, and other trusted sources of information, such as the TRIP or UpToDate databases, or a good medical librarian. For hard to find government or conference papers, don’t forget to search regular Google in addition to Google Scholar.

Some basic questions remain for Google Scholar. What does Google consider “scholarly”? Will Google ever tell us exactly what is in the database? Could the Google algorithm present the most current research at the top of the results display? And how often will Google update the database?

What do we make of Google’s future? Google’s past success seems predicated on a simple business principle: do no evil. Founders Sergey Brin and Larry Page are said to be interested in using Google’s computers to advance the cause of medical science. Apparently, Google’s data mining techniques are well suited to analysing gene sequences in the human genome project. It may even be possible for patients to “google their own genes” one day.

But “do no evil” is a far cry from “do what’s best for humanity.” Google is still a business. However, if it wishes to do something for medicine, Google should consider creating a medical portal. Call it Google Medicine; design an interface with medical filters and better algorithms; lead to the best evidence (just don\’t forget to consult with librarians about where the evidence is located). This kind of all purpose tool is badly needed in medicine, particularly for developing countries.

Build Google Medicine. The benefits to human health would be immeasurable.

Dean Giustini, UBC biomedical branch librarian
University of British Columbia, Vancouver, BC, Canada

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June 9, 2006 Posted by | Health | | Leave a comment

Entry for June 09, 2006

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Calling Doctor Google…

For a while now I’ve been thinking about writing a book about my experiences with the Ontario Health Care System. I was thinking using the title: “Calling Doctor Google”

I mention this to a friend who says I should google that title to see if it has been taken already. Good idea! Let’s see what comes up.

One of the searches pulls up a blog written by a librarian dated December 23rd, 2005 at 3:01 pm. The entry is called “Calling Doctor Google” and it talks about how the medical community is using google as a diagnostic tool.

Within a year of its release Google Scholar has led more visitors to many biomedical journal websites than has PubMed (J Sack, personal communication, 2005).

I was particularly interested to see the table from the BMJ’s web access stats, which lists Google as its number one referrer, by far, in November 2005 (345,756), and Google Scholar as its number two referrer (105,185). PubMed trailed significantly far behind — fourth place was PubMed Medline (14,522) and fifth place was PubMed Central (9,616). Of course, one shouldn’t read too much into this relatively raw access-data. A lot of factors must play into the numbers.

Who are these searchers? Medical consumers typing in terms in google, hoping for consumer information? If they end up going to the BMJ, that’s probably more than most of them want to know, at least in an initial search. Or are they physicians realizing google is a shortcut to particular articles? Does this set of referrals include, for instance, academic-affiliated researchers? Many of them probably have access to their own institutional subscriptions to BMJ, and if requests are being routed through a local proxy then how is that reflected in these numbers?

Still, anyway you slice it, it’s obvious that Google — or maybe it’s better to describe it as “general search” — is becoming significant for medical research. And Google Scholar is more successful than I’d realized.

And then this cropped up in the editorial, too:

In a recent letter in the New England Journal of Medicine, a New York rheumatologist describes a scene at rounds where a professor asked the presenting fellow to explain how he arrived at his diagnosis.[4] Matter of factly, the reply came: “I entered the salient features into Google, and [the diagnosis] popped right up.” The attending doctor was taken aback by the Google diagnosis. “Are we physicians no longer needed? Is an observer who can accurately select the findings to be entered in a Google search all we need for a diagnosis to appear—as if by magic?”

Ten years ago librarians were all a-twitter about the fear that search engines (Yahoo! and Altavista were the big contenders then) would displace librarians. Most librarians blustered it out: “Nothing can replace a librarian!” but there was definitely some anxiety in the ranks. Now physicians. Relax, docs. Librarians, doctors, and search engines, all will find their place in the brave new world of infinite search. And it’s important that consumers have access to as much information as possible to critically evaluate and assess all the other info streamed at us daily. For example, since the FDA has deemed it acceptable for drug companies to “inform” us about their wares via millions of dollars of direct-to-consumer advertising, consumers get barraged with info about commercial drugs provided by commercial for-profit entities. In that information environment, it’s vital for consumers to have consumer-directed diagnostic information to assess Big Pharma’s claims.

Ultimately it will improve healthcare. What did you think all those consumer health awareness services were about if not, ultimately, this?

June 9, 2006 Posted by | Health | , , | Leave a comment

Entry for June 09, 2006

Woke up this morning and I didn’t feel as plugged up so maybe the new toothbrush is working?

Today I thought I’d try something new. I’ll start the day with 300 mg of Niacin instead of splitting it up at the end of the day. I take the rest of my vitamins: B Complex, Zinc, Calcium/Magnesium, Acidophilus and Vitamin C.

Just after I get into work, I start having stomach cramps and a bit later I have diarrhea. I’ve read about the high doses of Niacin and it’s supposed to be safe. It’s the only thing that I’ve done differently. I had an apple for breakfast and I do that every morning.

After some reading, an upset stomach and diarrhea are both symptoms of a high dose of Niacin so I won’t try that again. 300 mg is what the naturopath prescribed so I didn’t really do anything wrong. I just took it all at once. It also recommended taking Niacin with a meal. Maybe an apple wasn’t enough?

June 9, 2006 Posted by | Health | , , , , , , , , | Leave a comment

Entry for June 09, 2006

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I’ve heard about a movie called Super Size Me for a while and Kevin Trudeau mentions it in his book. I finally decide to rent it and see what it’s all about.

Half way through the movie and I start feeling sick. I don’t think I can ever eat at McDonalds again. It’s truly amazing how fast food can have such an effect on the body and everyone does it. No wonder everyone is so sick. I used to love the chicken McNuggets but not after watching how they make them. No thanks.

The best part of the movie for me was the bonus material. He did an experiment where he had a McDonalds product in a sealed glass jar and left it for weeks to watch it break down. He compared it to a burger and fries from a local resturant. After two weeks, the Big Mac still looked good without any mold or signs of age. Week after week various types of mold would form on the burgers but the amazing thing was the fries. After ten weeks the fries still looked perfect with no sign of any mold. Makes you wonder if it is really food at all?

I’ll never have McDonalds fries again…

June 9, 2006 Posted by | Health | , , , | Leave a comment

   

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