A Case of Searching With Medical Precision

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 THE PROBLEM
Each day, physicians at Allegheny General Hospital face schedules full of tending patients, teaching residents, and participating in research. Doctors try to balance their time between researching and treating patients.


When it comes to researching, most physicians and medical researchers turn to one central database of information that contains a cache of articles published in thousands of medical and scientific journals. This database, known as MEDLINE, was compiled by the U.S. National Library of Medicine and is an essential resource for medical and scientific research. Physicians can research findings in many areas, including nursing, dentistry, veterinary medicine, and healthcare. Containing more than 18 million records from as many as 5,000 medical and scientific publications, this free database covers almost all biomedical and health research from 1950 to the present day.


Most of the search engines that currently sit on top of MEDLINE are best used by medical researchers. These search engines can produce thousands of results in a range of categories for a single search. Results come from a variety of sources and can cover a multitude of topics. Though these results may be ideal for researchers with time to spend on sifting through articles, for doctors and practitioners speedy solutions are essential. According to Athanasios Colonias, radiation oncologist and departmental director of Thoracic and Clinical Trials Programs at Allegheny General, "A typical MEDLINE search can yield hundreds, if not thousands, of articles, making it difficult to sift through these search results. As a practicing physician carrying a full daily schedule, anything that can help improve my efficiency in the workplace is desirable."

THE SOLUTION
Six months ago, Colonias was introduced to a new searching mechanism called MyEBMsearch, a portal that was designed as a front end to MEDLINE. Although MEDLINE is a good resource for locating data, the search results can be much too broad for certain user groups. Through the use of cluster technology, content categorization, and specific filters, MyEBMsearch proves to be a more efficient way to narrow searches for quick, relevant results.


"The uniqueness," says Frank Bilotto, CEO of E-WISE, Inc., the company that produces MyEBMsearch, "is that it is designed specifically for physicians practicing medicine, unlike all the other search engines on MEDLINE, which are designed for researchers." By offering services to a definite clientele, MyEBMsearch can narrow search results for a particular audience. What makes this search engine ideal for hospital staff and physicians is that it sorts through and finds results specifically for medical practitioners.


The first method for sifting through search results was minimizing the amount of articles. MyEBMsearch "automatically filters out animal studies, citations without abstracts, and older articles," says Colonias. By removing articles that are not relevant to a medical practitioner, the number of search results is already greatly diminished. Next, MyEBMsearch goes beyond simple keyword searching as a way to locate articles. In a typical search, users can enter terms into each of two search boxes so that the search mechanism has a better understanding of the searcher’s intent and can find and return articles contained in MEDLINE that are right on point. This way, searches that could once yield thousands of results can now yield as few as 40.


Another way that MyEBMsearch filters results is by allowing users to sort by category or by specialty. A series of static categories sits to the left of the browsing page, giving users the chance to select a specific category for results. For example, surgeons seeking specific results in their field can select the Surgery category and view the results therein. Filtering by specialty also offers results tailored specifically to physicians by allowing them to select results in a particular field, such as oncology. Another positive aspect of this search mechanism, according to Colonias, is the categorization of systematic reviews. "The portal not only separates systematic reviews, but also isolates more specifically Cochrane and Meta-analysis reviews. So, if I want to see Cochrane reviews, I know they are located in a category in the left margin that I can access with one click."


Other features of MyEBMsearch that have helped physicians such as Colonias find results faster include a saved searches feature (allowing users to revisit their old searches and view recent updates and additions to MEDLINE’s database), and a My Journals feature that connects users to their favorite journals. A function that works closely with both the Saved Search and My Journals features are automatic, weekly email updates. "After I perform a search and ask for an email alert, the system will alert me automatically to any future pertinent articles related to that query," says Colonias. "This allows me to continue to be up-to-date on any new information on that topic."


Finally, one of the strongest features of MyEBMsearch is the simplicity of understanding the program. Colonias insists that not only is "learning how to use MyEBMsearch effectively not difficult," but that "implementation is also a breeze. Literally, all I had to do was type in a username and password and I was up and running. There was no need to download specific software onto my computer to run the search mechanism." The ease of learning and using MyEBMsearch make it an accessible research implement for physicians everywhere.

THE OUTCOME
The doctors at Allegheny General are among the first in the U.S. to use this new search mechanism. MyEBMsearch is based in Holland and now serves up to 100,000 physicians in Europe. In its trial period in the U.S., 200 physicians tested out the new search engine, resulting in an overwhelmingly positive reaction. Bilotto states, "Eighty percent of trial users said that they would absolutely use it." The physicians at Allegheny General are the first to officially implement MyEBMsearch into their daily routine, and the response from the staff has been entirely optimistic. Six months after being introduced to MyEBMsearch, Colonias and his medical staff have had nothing but productive results, and they plan on continuing their use of this search engine into the future. "I am quite pleased with MyEBMsearch," says Colonias. "It continues to give me quality search results in an efficient and user-friendly format."

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