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Understanding Scientific Information About Your Illness
Obtaining valid scientific literature sometimes may demand complex and time-consuming searches of libraries and computer databases. Understanding the literature once it has been retrieved can be equally challenging. Unlike popular literature, scientific literature contains terminology and concepts which may be unfamiliar to the nonscientist. Another difficulty for people trying to understand scientific literature lies in the wide variety of types of scientific research. It is a good idea to have a health care professional, friend, or someone familiar with science help with the comprehension of the literature once it is obtained. Many types of scientifically valid research exist. These include studies that use biological substances (sometimes called in-vitro research), studies on animals, and studies using humans (called clinical research). There also are reviews of studies, such as meta-analyses, where a number of research papers are collected and analyzed. One important type of clinical research is the randomized controlled trial. This type of clinical research provides scientific evidence about the efficacy or effectiveness of a therapy. The trial generally uses two groups of people. One group receives the treatment while the other does not. If possible, neither the researchers nor the subjects know who receives the treatment (this is called a double-blind study). Many studies are put through peer review before they are published in a scientific journal. Peer review is the analysis of research by a group of professionals in a specific scientific or medical field. More information on research methodologies and understanding research may be obtained from public and medical libraries, including the U.S. National Library of Medicine (NLM). The NLM The NLM is the premier source of medical science research information in the world. To make research information as accessible as possible, NLM has indexed 20 million printed references into a computer-based bibliographic retrieval system called MEDLARS (Medical Literature Analysis and Retrieval System). MEDLARS includes more than 40 online electronic databases and databanks. The database of greatest interest to alternative medical researchers is MEDLINE (MEDLARS Online). MEDLINE contains more than 8.1 million records dating back to 1966. Although the full text of each article is not in the database, approximately 60 percent of the citations contain author-generated abstracts or summaries of the articles. The complete article may be ordered through a special feature in the software package called Grateful Med« (see below) with an agreement from a medical library in your region. MEDLINE is readily accessible either through Grateful Med« search software or by directly dialing NLM via standard online communications software, such as ProComm or Awremote. The use of standard software with NLM requires that the user understand the NLM command language by taking a course offered through the NLM. Grateful Med« software has built-in capability to understand the command language. Grateful Med« software is available from the National Technical Information Service, (800) 423-9255. It is available for the IBM PC or compatible personal computers, and for the Apple Macintosh. For additional information, consult the NLM Web Site, or contact the National Library of Medicine, 9000 Rockville Pike, Bethesda, MD 20894. Telephone: (301) 496-6308. Conducting Searches on Alternative Medicine Subjects MEDLINE uses a "key word" indexing system called MeSH (Medical Subject Headings) to access information. To search for a subject on MEDLINE, you may enter your own term, or you may select from the MeSH keyword list of approximately 18,000 terms. Currently, there are 23 main headings in MEDLINE under the term alternative medicine. More specific terms are listed under those main headings. For example, meditation is a more specific term under the heading relaxation techniques. Many alternative medicine terms are not yet included in MeSH. Although many articles relating to alternative medicine from conventionally focused peer-reviewed journals are in MEDLINE, researchers may have difficulty finding them. NLM is aware of the increasing interest in alternative medicine and the need for adequate MeSH terms. The National Center for Complementary and Alternative Medicine (NCCAM) is working with NLM to review the current terms, making suggestions for new terms, and improving the indexing for alternative medicine. Currently, more than 30,000 citations can be retrieved by searching under the term "alternative medicine." These are the main headings in MEDLINE under the term Alternative Medicine:
Alternative Medicine Journals Currently in MEDLINE The NLM procedure for reviewing and accepting journals of current interest is appropriately rigorous. Not all journals concerning alternative medicine are indexed on MEDLINE. For example, MEDLINE only abstracts 3 of the 16 journals available on chiropractic. Some of the journals relating to alternative medicine indexed in MEDLINE are:
Acupuncture and Electro-Therapeutics Research
Other databases are available through the NLM if MEDLINE does not satisfy your requirements. Most of these databases require an account and have usage fees. Users can search for many specific topics in biomedical science, including cancer, AIDS, toxicological and chemical data, health services research, and other specialized areas of health and disease. For a complete list contact the MEDLARS Management Section at the NLM (800) 638-8480, or refer to the NLM Home Page. The NLM produces a wide variety of publications to assist health professionals, researchers, librarians, and the general public to use the many available resources. The publications include indexes to biomedical literature, newsletters, reports about library activities, bibliographies, and manuals for using NLM programs. The newsletters include technical bulletins for Grateful Med« users and other online mechanisms, and personal stories by people who have researched their own illnesses. All publications are available online through the NLMÆs Internet Home Page, or you can visit the Library at the National Institutes of Health, 9000 Rockville Pike, Bethesda, Maryland. The CRISP (Computer Retrieval of Information on Scientific Projects) System is a major biomedical database containing information about research supported by the U.S. Public Health Service. Most of this research falls into the category of an extramural project. Extramural projects generally are conducted by investigators outside the government, such as scientists at universities, hospitals, and other research institutions. Intramural research programs are conducted by employees of the NIH and the FDA. Government institutions that fund research projects include the Agency for Health Care Policy and Research, Centers for Disease Control and Prevention, the FDA, the Health Resources and Services Administration, the NIH, and the Substance Abuse and Mental Health Services Administration. The CRISP database is accessible through the NIH Internet Home Page under Grants and Contracts. You may search by project title, principal investigatorÆs abstract, or term descriptors. A CRISP thesaurus and more exact search directions are available from the GOPHER accessed through the NLMÆs Internet Home Page. You may enter your own term, but the search will not be exact. For example, projects listed when searched by the term "alternative medicine" will list government-funded projects that the NCCAM considers as complementary and alternative medical treatments, as well as other treatments that are not considered "alternative" for that medical condition. For more information contact the Research Documentation Section of the Office of Extramural Research, National Institutes of Health , 6701 Rockledge Drive, MSC 7772, Bethesda, MD 20892-7772. Telephone: (301) 435-0650. Fax: (301) 480-2845. E-mail: DRT(AT)CU.NIH.GOV If You Do Not Have Access to a Computer A variety of options are available if you do not own a computer and want to do online research. Try your local public library (many local libraries have Internet access or a connection to NLM), a medical or academic library at a local college or university, and/or your health care practitioner (many practitioners will have a computer, or will have access to one).
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