Re: Tench et al. An insight into rheumatology resources available on the World Wide Web

R. Mcnally, B. Rooney and O. Stewart

ARC Epidemiology Unit, University of Manchester, Stopford Building, Oxford Road, Manchester M13 9PT, UK

SIR, We read with interest the recent paper by Tench et al. [1] and we are concerned that, because of the approach adopted, their findings may discourage others from making use of the Internet. The range of material available is greater and, if the suggestions below are followed, more accessible than that from Tench et al.'s use of Websites indexed by search engines. No mention is given of newsgroups or mailing lists, which exist to serve different interest groups, providing an on-line forum for discussion, and a means of soliciting help and information. Any strategy to assess Internet resources should include these, especially given the focus on the use of information technology within the National Health Service in the new White Paper `Information for Health' [2]. Research into the provision of rheumatology care via telemedicine has already been presented [3].

Tench et al. assume that search engines are the best and the only access points to rheumatology information on the Internet. The authors chose to use only two search engines, Lycos and Webcrawler, to locate sites containing the term `rheumatology'. The success of this strategy depends on the word `rheumatology' being used as an indexing word, title word, or reasonably prominent word, in the text of Web pages. A patient would be far more likely to search using the name of the disease they have been diagnosed with rather than `rheumatology'. Not all Web pages of interest to rheumatologists (or their patients) will be exclusively rheumatological. Web pages about autoimmune diseases may also be useful, but these would not necessarily occur in a search for rheumatology. It is, therefore, important to devote some attention to the choice of search terms.

It is important to distinguish clearly between the different needs of those likely to be searching the Internet for information on the rheumatic diseases. Different user groups will have different expectations and information needs. Tench et al. should also have distinguished between the different purposes behind searching. People may be seeking a very specific document or an answer to a particular question. They may simply be browsing generally or aiming to get a comprehensive overview of a whole subject. This has to be taken into account when devising a search strategy. We have a number of positive suggestions to enhance effective use of the Internet.

If you are searching for a particular piece of published research, it may be easier to ask your local medical librarian who will be able to advise you on the best sources and medium for your requirements.

Secondly, if possible, use a quality filter to enhance your search. In the field of medical information, Online Medical Networked Information (OMNI) http://www.omni.ac.uk is an extremely useful quality filter, which we recommend to new users.

In the absence of a built-in quality filter, start from a quality site and follow the links provided. In addition to the ACR Website, which Tench et al. cite, we recommend:

Arthritis Research Campaign http://www.arc.org.uk/ ILAR (International League Against Rheumatism) http://www.ilar.org/ British Society for Rheumatology http: //www.rheumatology.org.uk/ We have also included a list of useful addresses on our own Website, http://www.arc.man.ac.uk

There is much information of relevance to the rheumatologist on the Internet, which would not be retrieved by searching under the word `rheumatology'. The full text of Index Medicus (Medline) is now available at http://igm.nlm.nih.gov/. Some parts of the Cochrane Database are available at http://www.update-software. com/ccweb/cochrane/cdsr.htm

If you cannot find what you want using the above, then use a search engine. Read the help pages of the search engine because each search engine operates differently, so naturally it takes a little time to familiarize oneself with them. Experiment with the search features, such as the use of wildcards and Boolean logic, to help tailor your search more accurately to your needs. For those wishing to learn more about search engines, the UK Online User Group has compiled a list of articles explaining their use and providing tips at http://www.ukolug.demon.co.uk/links/search.htm.

Most search engines allow selection or exclusion of language(s). Alternatively, consider using a specific search engine which returns WebPages from certain countries only:

UK Plus http://www.ukplus.co.uk UK

Euroferret http://www.euroferret.com/ Various European

AAA Matilda http://www.aaa.com.au/world/america/ USA and various countries

To search across the sites covered by a number of search engines, a meta search engine can be used, e.g. Dogpile (http://www.dogpile.com/).

Using the categories from the search engine's front page will limit your search to a subject area and this would be advisable for patients looking for health information. For example, Excite has a channel called `health and fitness'.

Finally, newsgroups and mailing lists can also provide a useful source of information and discussion. Further details on mailing lists can be found at http://www.mailbase.ac.uk/ or http://www.reference.com

Happy surfing!

References

  1. Tench CM, Clunie GPR, Dacre J, Peacock A. An insight into rheumatology resources available on the World Wide Web. Br J Rheumatol 1998;37:1233–5.[ISI][Medline]
  2.  Information for Health: an information strategy for the modern NHS. NHS Executive, 1998 (URL http://www.nhsia.nhs.uk/).
  3.  Pal B, Hlaing S, Estrach C, Morris J. Virtual/Cyber rheumatology clinic? A feasibility study towards e-mail/internet based distant consultation and advisory service. Br J Rheumatol 1998;37 (Abstract suppl. 2):19.
Accepted 15 March 1999