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Searching for Medical Information on the Internet

                     Hong Kao
                  Bsc, BscPhm, BCPS
                   Clinical Pharmacist


            HSICT Professional Practice Day
                    Sept 14, 2011
Objectives



    Internet and Medical Information search

    History of iMedisearch Development

    The Advantages of iMedisearch vs Google

    How to use iMedisearch
A Little about Me


    Graduated from U of T Pharmacy in 2000

    Worked as community pharmacist x 2 years

    Worked as Long Term Care pharmacist x 1 year

    Work as clinical pharmacist at Trillium Health Centre x 8 years
    
        Specializing in Stroke and Spine
    
        Involved with research studies in stroke prevention (1)
Internet and Medical Information


    There are countless medical information websites on the Internet

    These sites vary enormously with regards to credibility, reliability and
    intended audience

    Anyone can post anything on the Internet including about health

    Millions consumers use Internet to get medical information (2)

    Clinicians also regularly use the Internet for references

    Most use Google to search for these information

    Most don’t go past the first couple of pages of search results
The Internet Challenge
Weaknesses of Google


Google uses complex mathematical formula to determining the ranking of each
page on the Internet based on the number of other websites linking to it.
When a user searches for medical information on the Internet, site with the most
number of other sites linking to it will show up at the top of Google results for a
specific keyword containing in that site.

Problems when searching for medical information:

 Context - Google does not know who is doing the search
    
        For a search term, Google presents results that are mixtures of materials meant for
        the general public and those meant for medical professional

 Quality - Google cannot distinguish between reputable and non-
reputable web resources
    
        Search results presented tend to be mixture of reputable & non-reputable sources
    
        The user would have to determine which is which.
A little History


    Before Google was popular, it was common practice to collect links of
    useful, credible and reliable sites for references

    Hospital pharmacists including myself had our own ways of saving
    URL (bookmark, sheet of paper, notebooks…)

    Problems - not easy to retrieve website when needed, hard to
    remember which site is for what

    RPhWorld.com was created in 2003

    The website serves as a descriptive link repository for useful sites for
    pharmacists. Websites are organized in easy to use manner.

    This site was shared and became popular among pharmacists around
    the world
RPhWorld.com


    More and more useful links were added to RPhWorld over time

    Eventually, it became harder to find a website to answer particular clinical question.
    There were too many useful websites.

    Need for a search capability

    Google Custom Search became available
    
        Allows customization of Google engine to search selected websites instead of
        the entire Internet

    URL’s from RPhworld were added to Google Custom Search to create a new
    search engine

    The search engine were tweaked to return results that pharmacists would find
    useful e.g. clinical guidelines, CE, renal dosing…

    Search results were quite reliable as they were from reputable sources

    The search engine also “seems” to know that the searcher is a pharmacist
iMedisearch.com


•   Feedbacks for the new search engine were overwhelmingly positive
•   This lead to further development of the search engine to allow for searches by
    other health professionals and the general public.
•   iMedisearch.com was created and went online in 2008
•   Over the years, it has been fine-tuned and improved with more websites entry
•   Currently it searches from over 40,000 reliable websites.
•   Each URL entered into iMedisearch engine is carefully selected based on
    criteria developed by US FDA (2) and HON (Health On Net)
Inclusion Criteria for iMedisearch


•   To be included in iMedisearch engine, a website has to be:
    •   Government site
    •   Military site
    •   Educational institution site (e.g. university, college, continuing education)
    •   Professional regulatory site
    •   Professional association site
    •   HON-accredited site
    •   Hospital or medical clinic site
    •   Medical reference publisher site
Inclusion Criteria for iMedisearch


•   Medical journal site
•   Drug information site
•   Poison control site
•   Site authored by an MD or pharmacist with referenced contents (e.g.
    Globalrph.com)
•   Pharmaceutical manufacturer (e.g. Merck.com)
•   Support group society site
•   Expert site (e.g. Naturaldatabase.com, WebMD)
•   Critic site (e.g. Quackwatch.org)
Exclusion Criteria for iMedisearch


The following type of websites are excluded from iMedisearch:
•Sites with unknown or unlisted author/editor
•Sites which anyone can freely write or edit articles
•Sites which contain bogus miracle cure claims
•Sites with too many ads that obscure the actual contents
iMedisearch and HON


•   iMedisearch complies with HON code standard for trustworthy health
    information
•   iMedisearch collaborates with HON to offer users plug in for web browser,
    so that iMedisearch can be accessed directly from Firefox browser search
    box(3)
Features of iMedisearch
Advantages of iMedisearch


In contrast to regular Google, iMedisearch:
•Search only from reputable sites (Quality)
•Targeted search results based on who the searchers are (Context):
   •   General Public
   •   Physician
   •   Pharmacist
   •   Nurse
   •   Allied Health
•Customized Search Refinements (Targeted Fine-tuning)
   •   Further refines the search results to find the right article
How to Use iMedisearch




       www.imedisearch.com
Future Development


•   Websites are added on regular basis
•   Synonym function will be added where a search for a brand name drug will also
    search for the generic equivalent (e.g. enter Flagyl, will search for metronidazole as
    well)
•   Option to search from entire Internet with the current searcher definition and search
    refinements
Thank You

for your attention!




       ?
References


1. Kao et al, Pharmacist’s Intervention Significantly Increases Usage of Angiotensin-Converting
Enzyme Inhibitors/Angiotensin Receptor Blockers and HMG-CoA Reductase Inhibitors in Stroke
Patient, http://stroke.ahajournals.org/content/38/2/453.full.pdf

2. How to Evaluate Health Information on the Internet,
http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/BuyingMedicinesOver

2. http://www.imedisearch.com/download.html

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Medical Search Engine iMedisearch Provides Quality Results

  • 1. Searching for Medical Information on the Internet Hong Kao Bsc, BscPhm, BCPS Clinical Pharmacist HSICT Professional Practice Day Sept 14, 2011
  • 2. Objectives  Internet and Medical Information search  History of iMedisearch Development  The Advantages of iMedisearch vs Google  How to use iMedisearch
  • 3. A Little about Me  Graduated from U of T Pharmacy in 2000  Worked as community pharmacist x 2 years  Worked as Long Term Care pharmacist x 1 year  Work as clinical pharmacist at Trillium Health Centre x 8 years  Specializing in Stroke and Spine  Involved with research studies in stroke prevention (1)
  • 4. Internet and Medical Information  There are countless medical information websites on the Internet  These sites vary enormously with regards to credibility, reliability and intended audience  Anyone can post anything on the Internet including about health  Millions consumers use Internet to get medical information (2)  Clinicians also regularly use the Internet for references  Most use Google to search for these information  Most don’t go past the first couple of pages of search results
  • 6. Weaknesses of Google Google uses complex mathematical formula to determining the ranking of each page on the Internet based on the number of other websites linking to it. When a user searches for medical information on the Internet, site with the most number of other sites linking to it will show up at the top of Google results for a specific keyword containing in that site. Problems when searching for medical information:  Context - Google does not know who is doing the search  For a search term, Google presents results that are mixtures of materials meant for the general public and those meant for medical professional  Quality - Google cannot distinguish between reputable and non- reputable web resources  Search results presented tend to be mixture of reputable & non-reputable sources  The user would have to determine which is which.
  • 7. A little History  Before Google was popular, it was common practice to collect links of useful, credible and reliable sites for references  Hospital pharmacists including myself had our own ways of saving URL (bookmark, sheet of paper, notebooks…)  Problems - not easy to retrieve website when needed, hard to remember which site is for what  RPhWorld.com was created in 2003  The website serves as a descriptive link repository for useful sites for pharmacists. Websites are organized in easy to use manner.  This site was shared and became popular among pharmacists around the world
  • 8. RPhWorld.com  More and more useful links were added to RPhWorld over time  Eventually, it became harder to find a website to answer particular clinical question. There were too many useful websites.  Need for a search capability  Google Custom Search became available  Allows customization of Google engine to search selected websites instead of the entire Internet  URL’s from RPhworld were added to Google Custom Search to create a new search engine  The search engine were tweaked to return results that pharmacists would find useful e.g. clinical guidelines, CE, renal dosing…  Search results were quite reliable as they were from reputable sources  The search engine also “seems” to know that the searcher is a pharmacist
  • 9. iMedisearch.com • Feedbacks for the new search engine were overwhelmingly positive • This lead to further development of the search engine to allow for searches by other health professionals and the general public. • iMedisearch.com was created and went online in 2008 • Over the years, it has been fine-tuned and improved with more websites entry • Currently it searches from over 40,000 reliable websites. • Each URL entered into iMedisearch engine is carefully selected based on criteria developed by US FDA (2) and HON (Health On Net)
  • 10. Inclusion Criteria for iMedisearch • To be included in iMedisearch engine, a website has to be: • Government site • Military site • Educational institution site (e.g. university, college, continuing education) • Professional regulatory site • Professional association site • HON-accredited site • Hospital or medical clinic site • Medical reference publisher site
  • 11. Inclusion Criteria for iMedisearch • Medical journal site • Drug information site • Poison control site • Site authored by an MD or pharmacist with referenced contents (e.g. Globalrph.com) • Pharmaceutical manufacturer (e.g. Merck.com) • Support group society site • Expert site (e.g. Naturaldatabase.com, WebMD) • Critic site (e.g. Quackwatch.org)
  • 12. Exclusion Criteria for iMedisearch The following type of websites are excluded from iMedisearch: •Sites with unknown or unlisted author/editor •Sites which anyone can freely write or edit articles •Sites which contain bogus miracle cure claims •Sites with too many ads that obscure the actual contents
  • 13. iMedisearch and HON • iMedisearch complies with HON code standard for trustworthy health information • iMedisearch collaborates with HON to offer users plug in for web browser, so that iMedisearch can be accessed directly from Firefox browser search box(3)
  • 15. Advantages of iMedisearch In contrast to regular Google, iMedisearch: •Search only from reputable sites (Quality) •Targeted search results based on who the searchers are (Context): • General Public • Physician • Pharmacist • Nurse • Allied Health •Customized Search Refinements (Targeted Fine-tuning) • Further refines the search results to find the right article
  • 16. How to Use iMedisearch www.imedisearch.com
  • 17. Future Development • Websites are added on regular basis • Synonym function will be added where a search for a brand name drug will also search for the generic equivalent (e.g. enter Flagyl, will search for metronidazole as well) • Option to search from entire Internet with the current searcher definition and search refinements
  • 18. Thank You for your attention! ?
  • 19. References 1. Kao et al, Pharmacist’s Intervention Significantly Increases Usage of Angiotensin-Converting Enzyme Inhibitors/Angiotensin Receptor Blockers and HMG-CoA Reductase Inhibitors in Stroke Patient, http://stroke.ahajournals.org/content/38/2/453.full.pdf 2. How to Evaluate Health Information on the Internet, http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/BuyingMedicinesOver 2. http://www.imedisearch.com/download.html