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Information retrieval CHAPTER 23
DIAL www.dial.org.uk Website of an information service, based at Royal Liverpool Children’s NHS Trust (Alder Hey),
offering advice on the use of medicines in children, to healthcare professionals working in
the UK and Eire
Drug and Therapeutics Bulletin http://
www.dtb.org.uk/
DrugScope http://www.drugscope.
org.uk
Health Protection Agency http://www.
hpa.org.uk/infections/
Health Technology Assessment
programme http://www.ncchta.org/
HIV Drug Interactions http://www.
hiv-druginteractions.org
Immunization Against Infectious
Diseases (the Green Book)
Indiana University cytochrome P450
website http://medicine.iupui.edu/
flockhart/
Subscription-based publication of the British Medical Journal group providing independent
evaluations of, and practical advice on, individual treatments and the overall management of
disease for healthcare professionals. Articles based on synthesis of evidence with opinions
from a wide range of specialist and generalist commentators
Independent centre of information and expertise on drugs of abuse in UK
Provides support and advice to various bodies and NHS professionals to protect UK public
health. Remit includes communicable disease surveillance and microbiology, radiation,
chemical and environmental hazards as well as major emergency response. Try index of
topics: http://www.hpa.org.uk/topics/index.htm
Independent research into the effectiveness, costs and broader impact of healthcare
treatments and tests for those who plan, provide or receive care in the NHS. Visit research
projects: http://www.ncchta.org/research/index.shtml
Educational HIV pharmacology resource providing specific advice on HIV drug interactions
Provides the latest information on vaccines and vaccination procedures for all the vaccinepreventable infectious diseases that may occur in the UK
Access http://www.dh.gov.uk/ then Home >> Public health >> Health protection >>
Immunisation >> Green book
Free paper copy from 0845 954 0000 or greenbook@broadsystem.com on leaving name,
occupation, address & RPSGB registration number
Information about drug interactions that are the result of competition for, or effects on, the
human cytochrome P450 system
IPPF Directory of Hormonal
Contraceptives http://contraceptive.
ippf.org
NHS Immunisation Information http://
www.immunisation.nhs.uk
Malaria Reference Laboratory http://
www.malaria-reference.co.uk
National Horizon Scanning Centre
http://www.pcpoh.bham.ac.uk/
publichealth/horizon/
The National Institute for Health and
Clinical Excellence http://www.nice.
org.uk/
Website of International Planned Parenthood Federation, recommended and used by the
RPSGB Information Service to identify foreign contraceptive pills. Free registration
NHS website providing a comprehensive, up-to-date and accurate source of information on
vaccines, disease and immunization in the UK
Based at the London School of Hygiene and Tropical Medicine, the Malaria Reference Library
provides an integrated service for public health in relation to malaria. Visit Malaria prevention
guidelines for British travellers under Advisory service
Based at the University of Birmingham, the centre provides advanced notice to the
Department of Health and national policy makers in England of selected key new and
emerging health technologies that might require urgent evaluation, consideration of clinical
and cost impact or modification of clinical guidance around 2–3 years prior to launch on the
National Health Service
The independent organization responsible for providing national guidance on the promotion of
good health and the prevention and treatment of ill health, produces guidance on areas of
Continued over
239
SECTION THREE Pharmacy prescribing and selection of medicines
Table 23.1 (Continued )
public health, health technologies and clinical practice. Visit and bookmark guidance: http://
www.nice.org.uk/guidance/index.jsp
National Library for Health http://www.
library.nhs.uk/
National Poisons Information Service:
Ò
Toxbase
http://www.toxbase.org/
National Prescribing Centre http://
www.npc.co.uk/
National Travel Health Network and
Centre (NaTHNaC) http://www.
nathnac.org/
Netting the Evidence http://www.shef.
ac.uk/scharr/ir/netting/
Palliative drugs.com http://www.
palliativedrugs.com/
NHS electronic library. Aims to be the best, most trusted health-related knowledge service in
the world. See other evidence-based sites and links included in this table. Visit and bookmark
Clinical Knowledge Summaries for ‘minor-ailment’ type guidance (formerly Prodigy
guidance): http://cks.library.nhs.uk/home
Visit and bookmark National electronic Library for Medicine (formerly DrugInfoZone): http://
www.nelm.nhs.uk/en/ and, for example, search for Patient Group Directions; find and
bookmark the online Dictionary; find and bookmark information on pre- and post-launch
reviews
A clinical toxicology database, freely available to UK NHS hospital departments and general
practices, NHS Departments of Public Health and HPA Units
Part of the NHS, the NPC aims to promote and support high-quality, cost-effective prescribing
and medicines management to improve patient care and service delivery. Visit and bookmark
Current Awareness Bulletins: http://www.npc.co.uk/ecab/ecab.htm. Visit and bookmark
MeReC Bulletins: http://www.npc.co.uk/merec_bulletins.htm
Funded by the Department of Health, the centre has been created to promote clinical
standards in travel medicine with the goal of protecting the health of British travellers
Academic department bringing together various organizations and learning resources related
to evidence-based medicine
Created by palliative care practitioners, the website aims to promote and disseminate
information about the use of drugs in palliative care. It features a Palliative Care Formulary but
some areas are password protected
Prescription Pricing Authority (Division)
http://www.nhsbsa.nhs.uk/
prescriptions
Pro-File Database http://www.pro-file.
nhs.uk
NHS Purchasing and Supply Agency
(PASA) http://www.pasa.nhs.uk/
PASAWeb
Royal College of Obstetricians and
Gynaecologists http://www.rcog.org.
uk/index.asp?PageID=8
Scottish Intercollegiate Guidelines
Network http://www.sign.ac.uk/
Scottish Medicines Consortium http://
www.scottishmedicines.org.uk/
240
Provides pricing information for NHS prescriptions dispensed in England and related services
with associated usage statistics. Monthly NHS electronic drug tariff available on this site
Tool designed to help NHS pharmacy staff to identify and source unlicensed ‘special’
medicinal products needed to treat individual NHS patients whose clinical needs can’t be met
by use of (a) licensed medicine(s)
Website of executive agency of the Department of Health concerned with getting the best
value for money for NHS purchased goods and services. Visit ‘Pharmaceuticals’ under
‘Products and Services’
Makes available a range of guidelines on women’s health. Visit Faculty of Sexual and
Reproductive Healthcare: http://www.ffprhc.org.uk/
SIGN develops and disseminates national clinical guidelines containing recommendations for
effective practice, based on current evidence. Visit and bookmark guidelines: http://www.
sign.ac.uk/guidelines/index.html
Provides advice across Scotland to NHS Boards and their area drug and therapeutics
committees about the status of new medicines, formulations or major new indications for
established medicines. Contains searchable database of reviews
Continued over
Information retrieval CHAPTER 23
Solutions http://www.uclhsolutions.
com/
Surgical Materials Testing Laboratory
http://www.smtl.co.uk/
Travax http://www.travax.nhs.uk/ An interactive online database providing up-to-the-minute travel health information for
UK Medicines Information (UKMi)
http://www.ukmi.nhs.uk
Welsh Medicines Resource Centre
http://www.wemerec.org/
Pharmacy organizations and associations
National Pharmacy Association http://
www.npa.co.uk/
Royal Pharmaceutical Society of Great
Britain http://www.rpsgb.org.uk/
Continuing professional development
UK National NHS Shortages Database focusing on communication and management of
pharmaceutical supply problems
Website of NHS laboratory for testing and evaluation of surgical dressings and medical
disposables. Click on site map for layout of content. Visit and bookmark dressing data cards:
http://www.dressings.org/dressings-datacards-by-alpha.html
healthcare professionals
The website hosts UKMi strategy, policies, clinical governance standards and training
materials, together with minutes of meetings of the UKMi Executive and its working groups.
Some areas are password protected
Website providing independent information on prescribing for healthcare professionals
working in Wales
Trade association for UK community pharmacy owners. Provides professional and
commercial support and represents community pharmacy at national negotiations. Try
searching for the quarterly Pharmacy Flyer
The professional and regulatory body for pharmacists in England, Scotland and Wales, it also
regulates pharmacy technicians, currently on a voluntary basis. Go to Download Society
Publications, find the latest copy of Medicines, Ethics and Practice and search ‘Section 1.3
Alphabetical list of medicines for human use’ to find legal classifications of medicines
Centre for Postgraduate Pharmacy
Education http://www.cppe.
manchester.ac.uk/
The College of Pharmacy Practice
http://www.collpharm.co.uk/
NHS Education for Scotland http://
www.nes.scot.nhs.uk/
Welsh Centre for Post-Graduate
Pharmaceutical Education http://www.
cf.ac.uk/phrmy/WCPPE/index.html
Pharmaceutical industry
The Association of the British
Pharmaceutical Industry http://www.
abpi.org.uk/
Electronic Medicines Compendium
http://emc.medicines.org.uk
The CPPE is funded by the Department of Health to provide continuing education for practising
pharmacists and pharmacy technicians providing NHS services in England
A limited company and registered charity, aiming to promote continuing education and
training in pharmacy. Try searching for ‘Competency Frameworks’ under the Faculty of
Prescribing and Medicines Management
Educational solutions for NHS Scotland staff. NHS Education for Scotland (Pharmacy) is the
National UK Centre for Continuing Pharmaceutical Education in Scotland. Visit and bookmark:
http://www.nes.scot.nhs.uk/pharmacy/default.asp
Provides continuing professional development service to all pharmacists and their support
staff in Wales
Trade association for UK companies producing prescription medicines. Also represents
companies engaged in the research and development of medicines for human use. Visit and
bookmark interactive educational pages: http://www.abpischools.org.uk/
Associate website of the ABPI. Provides electronic copies of Summaries of Product
Characteristics (SPCs) as well as patient information leaflets (PILs) for members’ products
Continued over
241
SECTION THREE Pharmacy prescribing and selection of medicines
Table 23.1 (Continued )
licensed in the UK. Continuously updated with new and revised SPC and PIL information after
approval by licensing authorities
The Proprietary Association of Great
Britain http://www.pagb.org.uk
Patient information
Best Treatments http://www.
besttreatments.co.uk/btuk/home.html
Family Planning Association http://
www.fpa.org.uk
Medicines Guides http://medguides.
medicines.org.uk/
Ò
Medline Plus
NHS Direct http://www.nhsdirect.
nhs.uk/
Netdoctor http://www.netdoctor.co.uk Collaboration of UK and European healthcare professionals. For information about drugs,
http://medlineplus.gov/ American health information website for patients with medicine-related information,
Trade association for UK producers of over-the-counter medicines and food supplements.
Visit and bookmark the Consumer Health Information Centre: http://www.chic.org.uk/
Visit and bookmark the Medicine Chest, a directory of medicines and food supplements are
available over the counter: http://www.medicinechestonline.com/
Website produced by the BMJ Publishing Group based on clinical evidence in a patientfriendly format. Also accessible via NHS Direct website. Subscription-based
Website of Family Planning Association, a leading sexual health charity
Produced by an independent not-for-profit group, the Medicine Guides are being developed in
partnership with NHS Direct to provide people with information about medicines, conditions
and different treatment options
illustrated medical encyclopaedia, interactive tutorials and health news. Belongs to the US
National Library of Medicine (http://www.nlm.nih.gov/), and the US National Institutes of
Health (http://www.nih.gov/). Visit and bookmark the interactive tutorial homepage: http://
www.nlm.nih.gov/medlineplus/tutorial.html
Official NHS website for 24-hours delivery of information and advice about health, illness and
health services to the public. Can search for a local health service or visit and bookmark
interactive tools and healthy living zones
search the Medicines section only: http://www.netdoctor.co.uk/medicines/
Patient UK http://www.patient.co.uk Authored by GPs, the website aims to provide non-medical people in the UK with good quality
information about health and disease
Talk to Frank http://www.talktoFrank.
com
Bookmarking
Independent government funded website providing information on drugs of abuse
Hyperlinks also provide a useful way of finding and
bookmarking other useful websites from existing
Readers are encouraged to set up their own bespoke
directory of health- and medicines-related websites
that they can update as required. Once a number of
relevant websites have been identified and authenticated for inclusion, a simple way of starting the collection is to store the directory as a saved text file,
using hyperlinks to connect each typed URL address
in the document to the address bar on the browser and
therefore the desired web destination. Hyperlinks are
usually in a different colour to the rest of the document or are underlined and can be activated by a
mouse click.
ones. Websites normally have a directory of related
websites as ‘links’. By clicking on a link, a request is
sent to the computer that holds that information,
asking it to send it to your screen. Following these
links on the screen is known as ‘browsing’, sometimes
referred to as ‘surfing’.
A well-accepted method of bookmarking relevant
pages is to use an Internet browser with functions
such as ‘Favourites’, ‘Bookmarks’ or ‘Hot List’.A
marker points at a website which then enables the
user to quickly return to that site without having to
remember and type in its URL. In this way, the
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Information retrieval CHAPTER 23
‘Favourites’-type function acts like a conventional
bookmark. Browsers usually offer the facility for organizing the bookmarks into folders and subfolders.
There are also innovations such as the social bookmarking website http://del.icio.us, which provides a
means of storing personal bookmarks online instead of
within the browser, thus enabling bookmark information to be accessed and shared online.
Searching the Internet
Accessing a list of useful websites and following the
links therein is one approach to finding health- and
medicines-related information on the Internet.
Browsing the net in this way is likely, however, to be
unproductive unless the query falls specifically within
the remit of a known website. With the web estimated to contain around 40 billion pages, at some point it
is likely that the website containing the required information is simply unknown to the user and it has not
been possible to reach it via ‘browsing’ the Internet.
For that reason, it is essential to have a good appreciation of Internet search options.
Commercial search engines
The Internet is not controlled or owned by any individual or organization in particular. Unlike a catalogue,
which is normally a well thought out record created
and maintained for a purpose, the Internet plays host
to a multitude of material with limitless authors. The
Internet is vast but far removed from a library of
approved and organized material. The manner in
which information is stored on, and then retrieved
from, the Internet is quite unique. There is no central
catalogue of the Internet and no ‘people’ physically
vetting the web to create large-scale records. Instead,
computers are used to create indexes of the web.
A variety of websites concentrate on providing Internet search facilities. Some are set up as web portals
with the aim of providing a complete resource for
everything on the web that they consider to be worthwhile. Portals display their own editorial material,
news headlines and other up-to-date information, as
well as links to commercial partners and paid advertisements. They are good for general or commercial
information but most will fail to identify websites for
non-profit organizations such as the NHS. Web portals also provide a search facility. Examples of web
portals include Yahoo
websites concentrate purely on providing a search
Ò
, MSNÒand AOLÒ. Other
facility; examples include the search engines
GoogleÔ, Altavista
Ò
and AskÔ. Search engines attempt to search all the text on all the pages of the
web. They use software to seek out and index web
pages, storing the results in sizeable databases. Essentially they are clusters of powerful computers, endlessly navigating the web and building indexes of pages
based on words and links found on those pages. When
a user types a query, the search engine searches its
database for pages that contain words matching the
query and displays the results as a list of links.
Box 23.3 gives a more detailed explanation of search
engine components. Each search engine ranks results
according to its own criteria and so different search
engines can give different results for the same query.
Search engines are useful for finding obscure information or for some research-type activities. They may,
however, retrieve a multitude of items that are of
little or even no relevance to the search activity.
Box 23.3
Search engines are essentially made up of
three interconnected parts: the crawler, the
indexer and the query processor
THE CRAWLER
(SPIDER)
THE INDEXER This program maintains an extremely large
THE QUERY
PROCESSOR
This is a specialized program, a form of robot
that constantly travels the web similar to a
browser, following links with absolute
diligence, returning a copy of each page it
finds for the indexer
database of computerized records. For any
given website, the index will list all the pages
on that site alongside other relevant
information. The database is then inverted so
that a typed phrase will lead to relevant URLs.
Indexes are analysed in a manner that ranks
the search results, giving preference to what
are thought to be web pages more relevant to
the user’s inquiry. Tagged and analysed pages
are ultimately handed over to the query
processor
This program moves between the user
interface and the indexer. The query processor
is designed to make it user-friendly, and to
enable it to make an intelligent guess about
the user’s intentions in making their query.
The query processor also finds a way of
dealing with misspellings, for example by
relating them to past misspellings
243
SECTION THREE Pharmacy prescribing and selection of medicines
Effective use of search engines
An informed approach to using search engines for
health- and medicines-related information starts from
an insight into the workings of these, as detailed
above. Before beginning a new search, the user should
take time to consider what they already know, the
knowledge gaps and the types of information required. It is always advisable to have a plan so as to
focus the search. The user should carefully select a set
of keywords that best reflect the information need
and narrow the search to a particular subject or topic.
Any subsequent search results should be compared to
the original information need. If appropriate material
is found on the first page of the search, the activity
need go no further. It is especially important to know
when to stop searching, especially when there is a
time limit on the search activity.
When, however, the results do not match the information need, for whatever reason, it is advisable to
pause and reflect. The user should take time out to
consider what they are searching for; can the search be
refined, by changing keywords, perhaps adding, taking
away or replacing them? The keywords must match
the information need. One additional approach is to
subtract any redundant words from the search query.
These include words such as ‘a’, ‘an’, ‘the’, ‘and’,
‘in’, ‘any’, ‘my’, etc. It might also be helpful to rearrange the search so that the more important search
terms are placed first, to give more influence when
the results are ranked.
Most search engines provide guidance on their specific ‘operators’. For example, GoogleÔ provides a
list of its most popular tools for refining searches
under its ‘cheat sheets’. Boolean terms for academic
databases are described in more detail in the sections
below. In GoogleÔ, the Boolean terms AND and
NOT are not used in the traditional sense. GoogleÔ
will automatically link a series of words using the
AND operator. Instead of NOT, to eliminate a word
from the results, a space should be left after the
word that is needed and a minus sign () should be
typed immediately before the word that is to be excluded. The term OR can, however, be used in
GoogleÔ by typing OR between the words. GoogleÔ
can also be forced to link words by using a plus sign
(+), especially where one of the words is a common
word that might normally be ignored. The search
engine can also be asked to search for a string of words
in a particular order, for example ‘Communityacquired pneumonia’. The user should examine
search engine tools to make the most of any advanced
features beyond the basic search box. Sometimes, the
search engine itself may need to be changed or the
basis of the search re-examined.
It is important to recognize that search engines do
not necessarily index the whole of each document
they retrieve. A search engine may upload each page
in full, but it may only use the first few thousand
characters for indexing. Therefore, should the vital
information exist further down the web page, beyond
where the robot will read, it will escape being
indexed. Where a search engine does return a link
to a site, sometimes it is not possible to access the
content if the user is behind their organization’s ‘firewall’. This is because some organizations either block
content from a list of undesirable websites or will only
allow content from a list of desirable websites. Also,
search engines do not locate everything on the web
first-hand. It might be that a general search engine
finds another site that is a more appropriate starting
point, for example a health services directory. In that
way, the search is narrowed automatically from a general search engine to a topic-specific one.
Some public web pages are protected from search
engines through use of a file (robots.txt) that blocks
access to the robot. This normally relates to personal,
sensitive, interactive, timely or premium (subscription, or paid for) content. The robot is excluded from
a page, the search engine does not get to index that
page, and thus will not return it as a result. Another
place that search engines cannot always reach is commercial data collections, or collections of valuable,
copyrighted content, such as subscription-based academic journal databases and other specialized databases, information in professional directories, patents,
and news articles.
Assessing the quality of
information on the web
There is no restriction on what is placed on the web,
by whom or from which geographical location. There
is certainly no process of editorial or peer review for
material placed on the web. No UK organization is
currently responsible for regulating health- and
medicines-related information on the Internet. Under these conditions, there is always the danger that
an Internet site contains incomplete, inaccurate, irrelevant, obsolete or even hoax information. As a result,
the utmost care should be taken in making use of
health- and medicines-related information from the
244
Information retrieval CHAPTER 23
Table 23.2 Evaluating the quality of an Internet-based website for health- and medicines-related information
Activity Purpose
Follow internal links To find out as much as possible about the resource. For example: the scope of the material; the
intended audience and the intended coverage; the origin of the information; who owns the website
and who is responsible for the content; the provenance of the website; involvement of others in the
production of material; any access restrictions; frequency of updates
Analyse the URL To find out where the information comes from and to judge if they are qualified to provide the
information. For example the individual or group that has taken responsibility for the website, relevant
contact details and specifically all involved in the production and dissemination of the information,
including the author, webmaster or equivalent, copyright owner, publisher, sponsor
Examine the information
contained
Consider the presentation To find out if the resource is frequently unavailable or noticeably slow to access; any access
Obtain additional information To find out if an individual or group has taken responsibility for the website; whether they are qualified
Compare to other similar
websites
Internet. An informed approach must include a system for evaluating the quality of the information
found against the intended use of that information.
No single quality indicator exists; the user must piece
together a variety of indicators to assess the value of
the website on its merits. Factors listed below can all
affect the quality of an information source; they are
not mutually exclusive and must be considered in
combination. Table 23.2 provides summary guidance
on evaluating the quality of a website.
To find out the subjects and types of materials covered; comprehensiveness of coverage; notable
omissions; audience and level of detail if explicitly stated; notable indicators of accuracy (e.g.
potential for bias, ability to e-mail corrections); editorial or refereeing procedures; research basis to
the information; ‘main creation date’; the frequency and/or regularity of any updating
restrictions (e.g. by geographical region, hardware/software requirements); whether there is a
registration procedure and whether this is straightforward; whether the available content is free or
subscription based; the copyright statement and copyright restrictions; notable design features and
facilities and whether these are particularly good or bad; appropriateness of images and/or
advertising; whether the site is particularly difficult or easy to use; presence or absence of user
support facilities and/or help information; and particularly good or bad help information or support
services
to provide this information; whether the resource is well known (e.g. recommended via links),
reviewed and/or heavily used
To find out if a resource is unique in terms of content or format and any differences between mirror
and original sites for the same materials
example, although accurate, information on a product licensed in the USA may not be applicable in the
UK market.
The user should also assess the authority and
reputation of the author(s) and website providing
the information. Authority is based primarily on the
perceived knowledge, qualifications and expertise of the author(s) as well as the reputatio n of
the parent organization; for example, an author
writing in their capacity as a lecturer at a university
and a healthcare professional writing as an em-
Context of the website
The user must identify the scope of the website
(i.e.whatitaimstocover)aswellastheintended
audience (i.e. at whom the information is aime d).
Knowledge of URL nomenclature helps to contextualize information found; the organization’sname,
domain and country all give discernible clues. For
ployee at an NHS h ospital both offer acceptable
credibility.
Reputation is created when others endorse the value of a website by using it. The user should consider
and draw inferences from the popularity of a website.
Establishing the provenance of a source can also help
assess its potential quality, for example knowing
when the website, including any preceding material
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SECTION THREE Pharmacy prescribing and selection of medicines
(e.g. CD-ROM), was first established. A final consideration is how the website compares with rival
material and whether it offers anything unique. This
is especially important with ‘mirror sites’, which are
essentially copies of existing websites. Mirror sites
exist to enhance efficiency; for example a UK mirror
site from a US-based pharmaceutical company provides a faster service to European users than the original US site. However, although mirror sites are
expected to cover the same information, there may
be a time lag in updating the material compared to the
original website.
Content of the website
The reputation and popularity of a site, or even the
expertise of an author, do not guarantee the quality
of content. Here, the key questions relate to the accuracy, currency and coverage of the health- and
medicines-related information found. The likely accuracy of a website is inextricably linked to its perceived
authority. Users will rely on a number of markers to
judge accuracy, including: whether the information
has been edited or peer reviewed; the basis of the
information (e.g. whether evidence based or arising
from research); possible bias (e.g. ulterior motives for
dissemination of the information and whether that
can impact on accuracy); and the overall impression
provided by a website (e.g. presence of typographical
errors – see also ‘Format of the website’ below).
In relation to currency, it is important to find out
when the information found was produced (and
updated) and if the user is planning on consulting
the website again, whether the frequency of updates
can provide up-to-the-minute information. A final
consideration is the coverage provided by material
found on the website. The relevance of this factor
depends very much on the user’s information needs.
The quality of coverage includes the comprehensiveness of a resource, links to further information, the
range of topics covered and any retrospective coverage in the form of archived material.
Format of the website
As well as a marker of immediate usefulness, the
format of a website is important when considering
its potential use in the future, for example when deliberating whether or not to include a website in a
bespoke directory. Three distinct factors can be considered here, namely accessibility, presentation and
usability. In relation to accessibility, as previously
indicated, some resources are simply not available to
the public. However, of the ‘available’ websites, some
require special software or hardware for accessing
content; some require subscription, or at least registration; some websites contain material with copyright restrictions; and some are not written in
English or are available only as an English translation.
Also, overwhelming demand, server unreliability and
heavy use of graphics can all impede access to an
otherwise good website. These factors can all be considered when judging accessibility of a website as a
marker of its quality and future usefulness.
Most probably users will also intuitively form an
impression of a website based on its design and interface. This might be based on such factors as sensible use of hypertext links and other navigation
aids, indexes, menus and search facilities, consistency of screen design, font sizes used, appropriateness
of imagery, the level of advertising and other markers of functionality and professionalism. Usability
is, of course, re lated to accessibility and presentation. A good website should allow the user to navigate the s ite and find the required information; help
and support facilities, contact information, training
material and user support groups also contribute to
usability.
User-generated content
Recent times have seen an upsurge in what is known
as user-generated content on the Internet. W hereas
previously, a relatively select group of publishers and
editorsdeterminedthekindsof‘content’ that would
be made available, nowadays anyone can create content. Users have no difficulty publishing their output if they can find a way to put it on the Internet,
where it is instantly available to a global audience and
where it can be found by search engines. Many kinds
of user-generated content exist. A particular example is a wiki, a type of webs ite that allows the visitors
to easily add, remove, edit and change some available
content, sometimes without the need for registration. An important example is Wikipedia, marketed
as a free encyclopaedia. This is a vast online reference
work that is written and edited by its users. For this
reason, it has also been the subject of endless debate.
If it can be changed at will by (literally) anyone, how
can it be an authoritative reference source? Yet, because it is easily accessible and provides wide coverage, students will (sadly, erroneously) use websites
such as Wikipedia in preference to good, authoritative textbooks.
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Information retrieval CHAPTER 23
The sequence of information
Information is often repackaged, re-versioned and developed for different audiences and different uses.
Whether available on the Internet or elsewhere,
health- and medicines-related information has by tra-
material. An awareness of the chronology and origin
of information can help pharmacists identify where to
look for the most appropriate type of information for
their particular information needs. Table 23.3 lists the
advantages and disadvantages of each category of information.
dition been categorized on the basis of an accepted
chronology of inception and development. As such,
Primary reference sources
information is labelled, on an ordinal scale, as belonging to a primary, secondary or tertiary reference
source depending on its position in the information
supply chain. Primary reference sources are those in
which new information is published, usually in the
form of research, such as papers in biomedical journals. Secondary reference sources, such as academic
databases, act to index and/or abstract literature from
primary sources. Tertiary sources provide an overview of a topic in a condensed readable form and
include textbooks, drug compendia and formularies;
with authors drawing on the primary literature for
Table 23.3 Advantages and disadvantages of primary, secondary and tertiary reference sources
Source Advantages Disadvantages
Primary Contains current, original and ‘cutting-edge’
information
The primary literature is the basis of the information
hierarchy, leading to the development of secondary
and tertiary literature, although with variabletime lags.
The term primary literature is used in essence to refer
to original publications and normally entails research
papers published in journals, although it can include
other material such as case reports, case series, editorials and letters to journal editors. Preliminary research
findingsare sometimes presented at conferences in the
form of poster or oral presentations. A record of these
is normally published in the conference abstract book
Potential for bias and not guaranteed to be without errors
Interpretation and critical appraisal required by readers
Time lag from publication to widespread acceptance
Secondary Rapid access to the primary literature Time period between article publication and inclusion in
secondary sources (lag time) varies between databases (e.g.
weeks to months)
Large spectrum of information on specific
topics
Journals covered generally of a high standard The number of journals indexed by each system depends on
Ability to link concepts to perform complex
searches
Most resources have a facility for provision of
routine updates on selected topics (selective
dissemination of information)
Tertiary Present users with a manageable digest of a
vast amount of published information
Easy to handle, readable, contain concise
information and indexed
User needs to have access to primary sources
the scope of the database
Command language varies between databases
The user needs to be familiar with a particular database’s
structure and terminology and to have proficient search skills
in order to search effectively (training)
Need for user to be proficient in sifting through the sources
listed on a particular subject to find the most relevant
information
Not suitable for browsing
Can be expensive to access relative to tertiary sources
Out of date almost as soon as published – exceptions include
electronic books with frequent updates
Information in textbooks sometimes not comprehensive
Poorly referenced
Opinion of author
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SECTION THREE Pharmacy prescribing and selection of medicines
Table 23.4 Reporting guidelines for specific study designs
Initiative Type of study Source
CONSORT Randomized controlled trials http://www.consort-statement.org
STARD Studies of diagnostic accuracy http://www.consort-statement.org
QUOROM Systematic reviews and meta-analyses http://www.consort-statement.org
STROBE Observational studies in epidemiology http://www.strobe-statement.org
MOOSE Meta-analyses of observational studies in epidemiology http://www.consort-statement.org
or the conference website. Sadly, conference abstracts
are the only place that some research ever materializes
in an original form; this is especially so for some pharmacy practice research.
The publication of research papers
Primary research enters the public domain once the
researchers write and submit their work to a primary
reference source, such as a journal publication. To this
end, authors aim to create accurate, clear and easily
accessible reports of their studies that can be considered for publication by a journal editor. Authors are
generally considered to be those who have made substantive intellectual contributions to the paper. This
includes conception and design, or acquisition of data,
or analysis and interpretation of data, drafting the
article or revising it critically, for important intellectual content and final approval of the version to be
published. Each journal is headed by an editor who is
the person responsible for its entire editorial content,
although some journals also have an independent editorial advisory board to help establish and maintain
editorial policy.
Most health- and medicines-related research
papers based on empirical methods such as observational and experimental studies follow a conventional
style such as that advocated by the International
Committee of Medical Journal Editors (ICMJE).
The text of these papers is usually divided into sections with the headings Introduction, Methods,
Results and Discussion, and sometimes Conclusion.
This so-called ‘IMRAD’ structure is not an arbitrary
publication format, but rather a direct reflection of
the process of scientific discovery. Other portions of
published papers include the title, abstract, keywords, acknowledgments, references, and individual
tables, figures and legends. Other types of articles,
such as case reports, reviews and editorials, usually
follow other formats. Specific research designs have
additional reporting requirements (Table 23.4).
Abstracts and keywords merit a special note, since
abstracts are the only substantive portion of articles
indexed in many electronic databases and the only
portion many readers read. Keywords assist indexers
in cross-referencing the article. Abstracts should reflect the content of the article accurately and provide
the context or background for the study, stating the
study’s purposes, basic procedures (selection of study
participants, observational and analytical methods),
main findings (giving specific effect sizes and their
statistical significance, if possible) and principal conclusions. The abstract should emphasize new and important aspects of the study or observations. Some
journals request that, following the abstract, authors
identify 3–10 keywords or short phrases that capture
the main topics of the article. The keywords may be
published with the abstract. Terms from the medical
subject headings (MeSH) list of Index Medicus
should be used (see sections below); if suitable MeSH
terms are not yet available for recently introduced
terms, current terminology may be used.
Once a manuscript is received, a process known as
‘peer review’ is used by editors to help decide which
manuscripts are suitable for their journals. Peer review also helps authors and editors in their efforts to
improve the quality of reporting. Peer review is the
critical assessment of manuscripts submitted to journals by experts who are not part of the editorial staff.
Unbiased, independent, critical assessment is an intrinsic part of all scholarly work and peer review is
considered to be an important extension of the scientific process. It can also be a time-consuming process.
A peer reviewed journal is one that has submitted
most of its published research articles for outside
review. However, even the ‘best’ journals contain
some material, such as letters and short reports, that
have not been refereed.
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