MedInfoRus – A New Path To Medical Information Exchange Between Russia & USA
Friedman, Yelena, MLS, AHIP
Sophia F. Palmer Library
Lippincott Williams & Wilkins
New York, NY, USA
Dolinsky, Luda, MLS, AHIP
Health Sciences Library
Lutheran Medical Center
Brooklyn, NY, USA
Perelman, Rimma, MLS
Wyckoff Heights Medical Center
Brooklyn, NY, USA
The purpose of this paper is to introduce MedInfoRus, a web site developed by a group of medical librarians from New York City. The paper briefly discusses the history of medical information exchange between Russia and the USA, and evaluates needs for improving access to medical information for Russian-speaking users. MedInfoRus has been created with the goal of helping Russian-speaking audience in searching the Internet for medical information. This website brings together a collection of links to medical websites, electronic publications, directories, and other resources available online in Russian. A very important part of MedInfoRus is a guide written in Russian, on how to search PubMed, a service of the National Library of Medicine (NLM). This guide has been created to help Russian-speaking people with limited knowledge of English to search MEDLINE, the largest bibliographic database of medical information, and other databases developed by the NLM. The guide explains the structure of PubMed and its components, discusses various methods of searching PubMed and navigating search results; it also includes a description of additional services offered by PubMed, and related resources. The guide has been used for a series of workshops for Russian-speaking information professionals and has proven to be very useful.
Though medical information exchange between Russia and the USA has a long history, for many decades very few people in Russia had access to this information. There were numerous reasons for this, all of them well known. The major obstacles standing on the way of free information exchange were the following: political or organizational, technical, and language barriers. During the 1990s first two barriers had been overcome: the collapse of the Soviet Union and the Communist system opened borders between states, making possible travel abroad, numerous exchange programs, business partnerships, etc. Widespread introduction of personal computers and telecommunications has practically eliminated the technical barrier; indeed, the Internet has truly changed the world, enabling direct contacts between people and organizations on opposite sides of the planet. However, the third obstacle - the language barrier - still remains a major hurdle, which prevents access to the world’s medical information in Russia. In the former Soviet Union knowledge of foreign languages had never been encouraged. Though most students studied foreign languages in schools and colleges, almost no one could practice speaking and very few could read foreign literature. In practical terms, English and other foreign languages were “dead” for public. Today, the situation is changing gradually. As more Russian-speaking people travel abroad, they realize the necessity of studying foreign languages, particularly English. Many young people from the former Soviet Union study abroad where they have an opportunity to learn English. Unfortunately, for most Russian physicians, nurses, and other medical staff, as well as consumers of medical information, these opportunities are still unavailable. Though more and more people have computers and Internet access, the limited knowledge of foreign languages make it difficult to use current medical information sources, which are mostly written in English.
Thus, our goal is to arrive at a point where no one is hindered from using English-language information sources. This is the reason why many medical information professionals are attempting to improve access to the world medical information through translation. In 1986, the National Library of Medicine (NLM) began a long-term effort to build a Unified Medical Language System® (UMLS®). The State Central Scientific Medical Library in Moscow (SCSML), participating in this project, started producing translations of medical subject headings (MeSH) to make the vocabulary useful for Russian-speaking people. The translation has been included in the year 2000 version of the Unified Medical Language System (UMLS®) Metathesaurus®¹. This tremendous project, however, will require many years to complete since the MeSH, the NLM's controlled vocabulary thesaurus, includes more than 19,000 main subject headings. At present, the medical database of SCSML contains about 340,000 bibliographic records ², compared with over 11 million records in MEDLINE, the world’s major bibliographic medical database run by the NLM. Another important project worth mentioning has been the International Health Information Networking Project, developed by the Library of the Health Sciences at the University of Illinois at Chicago. This project focused on enhancing access to biomedical information and facilitating professional networking between the Newly Independent States of the former Soviet Union and the United States. Within this project Helen Teplitskaia, a librarian from the University of Illinois at Chicago Library of the Health Sciences, developed needs assessment recommendations to the American International Health Alliance and provided training for Russian medical professionals in searching computer medical databases, MEDLINE first of all. Ms. Teplitskaia stated, particularly, that only 9% of her workshop participants had a good level of proficiency in English, and about 25% had moderate proficiency3.
Today, some medical web sites developed in Russia offer access to MEDLINE. Most of them just provide a link to the database, but a Russian server called Medline.ru has also developed its own Russian interface. This was a major success for the developers of Medline.ru in facilitating access to MEDLINE for Russian users. However, the site provides only general information on basic searching rules, such as the use of Boolean operators. As a result, MEDLINE retrieval in this interface is fairly limited in comparison with the original NLM database.
All the facts discussed above show a significant gap between needs in medical information and its availability for the Russian audience. Analysis of these facts motivated the authors, medical librarians with Russian backgrounds currently working in American libraries, to start a project aimed at improving access to medical information for Russian-speaking users. From everyday contacts with our fellow librarians we learned about the significant demand for information sources in Russian – both consumer information and professional search instructions. Here is an excerpt from an electronic message from a librarian at a hospital in Cincinnati, Ohio: “Our internal medicine department has many residents from the former Soviet Union. Getting them comfortable with MEDLINE searching is frustrating for them and for the library staff. If you have ANYTHING that you can share regarding searching MEDLINE in Russian, it would be extremely useful…”4. There have been numerous similar messages posted over the medical librarian listserv.
We started our project by planning the major goals of the work. We established two main objectives: 1) to create a web site compiling medical information sources in Russian available on the Internet; 2) to develop a Russian guide on how to search MEDLINE. We attempted to target both Russian-speaking audience in the United States and users in Russia, as we wanted to create a resource equally useful for people from both countries. The second task, developing a guide, turned to be the most difficult and time-consuming. Access to MEDLINE can be obtained through different providers. Our goal was to create a guide to search MEDLINE in the original interface of the National Library of Medicine (NLM) through the PubMed retrieval system. PubMed is a powerful searching tool that allows the use of different search strategies from very basic to the most sophisticated. Thus, it can be used by both professionals and consumers. PubMed also allows searching the NLM databases other than MEDLINE, for example, MEDLINEPlus, PreMEDLINE, and others. Access to PubMed is available free of charge; the system can be accessed from every part of the world by anybody who has a computer and connection to the Internet. There are many English guides on searching PubMed available online, first of all, a training manual developed by the NLM. Most of these guides are very detailed and require some special skills to comprehend. Our goal was to create a guide explaining the structure of PubMed and its components, yet with no technical details. This guide would discuss various methods of searching PubMed and navigating search results and, most importantly, be easily understandable for people with no experience in searching medical databases. We came to the decision to compile a guide based on our own experience in searching PubMed, rather than on the direct translation of ready English guides. As a basis, we used a tutorial developed by the National Network of Libraries of Medicine's for medical information professionals.
This work took approximately six months. A particular difficulty was translating special terms related to information and computer terminology, as we wanted to make our guide understandable and linguistically correct in Russian without simplistic and slang-based terminology. We had to explore many terminology guides and Russian websites to find equivalents for such terms and expressions as “click by the mouse”, “by default”, or “clipboard”. The guide begins with an introduction explaining the goal and purposes of the work and its scope. Five chapters follow: a general description of PubMed; basic and advanced search strategies; navigating the search results; PubMed services, and related resources. The guide also contains some illustrations based on original web pages5. After the work was completed, the guide was sent for approval to specialists from the National Library of Medicine. Marina Rappoport, a specialist of the NLM Bibliographic Services Division, kindly provided a careful review to the guide and made some valuable comments.
Along with developing the guide, we were working on creating a website that was called MedInfoRus6. On this website we have tried to bring together a collection of links to medical and nursing websites, electronic publications, directories, patient information, and other resources available online in Russian. We included sources both from Russia and from other countries in this collection. Each link had a brief annotation in English, explaining what kind of information can be found there. We did not intended, however, to evaluate these sources from the point of view of their informative value or reliability. The users of the website should keep in mind that they had to carefully review any medical information found on the Internet and use their own judgment. Our webmaster, Luda Dolinsky, designed the website. Finally, in December 2001 the MedInfoRus website, including the PubMed guide, was posted on the Internet. Promotion of the website was done over several listservs. We also sent letters to the medical information related organizations, such as the National Network of Libraries of Medicine's, Eurasia Health Alliance, The State Central Science Medical Library in Moscow, and others. The project proved to be very successful. We received dozens of messages from our medical librarian colleagues in appreciation of our work. Over two months we had almost 1,500 visits to the website. The major medical information and library websites both in the US and Russia, such as Librarians' Index to the Internet of the University of California, National Network of Libraries of Medicine's, EurasiaHealth Knowledge Network, RuslanNet (Science and Education Library Network of Northwest Regions of Russia,) and others, have provided annotated links to MedInfoRus. Perhaps the most valuable feedback has come from the American International Health Alliance. According to Irina Ibragimova, a librarian from Moscow, the PubMed guide was used for a series of workshops for information specialists provided by this organization, particularly, for training sessions in Tbislisi and Ashgabat in December 2001, and proved to be extremely helpful.
Our further plans are to continue working on our project. We plan to develop MedInfoRus by adding new valuable sources to our collection. We also would like to continue working on its design. We plan to revise our PubMed guide keeping it updated with any new developments of the NLM system. We have considered providing special search training for professionals and the public, both active and interactive. For all these plans we need new resources, so we are searching for grant opportunities. We are also looking for help from our colleagues in the United States and Russia. We will greatly appreciate any ideas, advice, and cooperation.
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