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PubMed on Tap: Access PubMed on Handheld, Wireless Devices. Dina Demner-Fushman University of Maryland, College Park and CEB/LHNCBC/NLM/NIH/HHS. PubMed on Tap.

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PubMed on Tap: Access PubMed on Handheld, Wireless Devices

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Pubmed on tap access pubmed on handheld wireless devices

PubMed on Tap: Access PubMed on Handheld, Wireless Devices

Dina Demner-Fushman

University of Maryland, College Park



Pubmed on tap

PubMed on Tap

  • a pilot R&D project of the Communications Engineering Branch, Lister Hill National Center for Biomedical Communications, National Library of Medicine, National Institutes of Health,Health and Human Services

  • Goal

    • Develop a stable system to study design principles for delivery of medical information to handheld devices at the point-of-care

  • Designers/Developers

    • Susan Hauser, project leader

    • Glenn Ford

    • Dina Demner-Fushman



  • Motivation

  • PubMed at a glance

  • Design questions

  • Usability study

  • Next steps

Why patients need just in time information for clinicians

Why patients need just-in-time information for clinicians:

Patient Fact Sheet

20 Tips to Help Prevent Medical Errors

….Medical errors are one of the Nation's leading causes of death and injury. A recent report by the Institute of Medicine estimates that as many as 44,000 to 98,000 people die in U.S. hospitals each year as the result of medical errors. This means that more people die from medical errors than from motor vehicle accidents, breast cancer, or AIDS…..

Ask your doctor if your treatment is based on the latest evidence

AHRQ Publication No. 00-PO38, February 2000. Agency for Healthcare Research and Quality


Pubmed on tap access pubmed on handheld wireless devices

Doctors are encouraged to search for evidence based answers to their questions about patient care but most go unanswered

Fifty nine obstacles were found while attempting to answer clinical questions with evidence

3. Obstacles related to seeking information

3.1.3. Lack of time to initiate search

3.2.1. Uncertainty about where to look for information

3.3.1. Resource physically distant

3.3.9. Resource not current

3.3.10. …. Most general resources do not allow real time interaction with the searcher

(Ely et al., British Medical Journal. 2002)


Where to look for information

Where to look for information


Current interactive resource at hand

Current interactive resource at hand

  • Speed up search

    • Navigation

    • Presentation

  • Provide expected PubMed functionality


Pubmed search

PubMed Search


Advanced search

Advanced Search

("variola virus"[MeSH Terms] OR "smallpox"[MeSH Terms]) AND hasabstract[text] AND Clinical Trial[ptyp] AND jsubsetaim[text] AND "adult"[MeSH Terms] AND ("hominidae"[MeSH Terms] OR "Human"[MeSH Terms]) AND ("2000"[PDAT] :"2004"[PDAT])


Clinical queries

Clinical Queries


Search results

Search Results


Working with search results navigating results pages

Working with Search Results Navigating results pages


Working with search results viewing selected citations and links

Working with Search ResultsViewing selected citations and links


Working with search results saving selected citations

Working with Search ResultsSaving selected citations


Saving search strategy

Use the Cubby to store search strategies and LinkOut preferences. Access Cubby on the PubMed sidebar. You need to register for the Cubby and then login whenever you want to use it. Your web browser must be set to accept cookies.

Saving Search Strategy


Interface design challenges

Interface Design Challenges

  • Maximize utilization of 160x160 pixels, but don’t lose readability

  • Decide what information is essential for an overview and how to organize ‘detail on demand’

  • Organize content in an easy to navigate manner, avoid scrolling

  • Find clear graphical metaphors for task objects and actions

  • Maximally approximate users’ model of the existing desktop application


Our approach

Our Approach

  • Identify most likely target user’s tasks

  • Develop a working prototype, and present to potential users for feedback

  • Develop a stable system with a usable interface and sufficient features to be useful

  • Conduct usability study

  • Release the improved system to health care professionals, listen to users’ feedback, and study aggregate user statistics


Organizing content

usability study

prototype presentation

Organizing Content


Organizing content continued

Organizing Content continued


Finding metaphors is hard

Finding Metaphors is Hard


Maintaining common feel and look for different platforms and operating systems is hard

Maintaining common feel and look for different platforms and operating systems is hard


Usability study

Usability Study

  • Conducted at the National Cancer Institute (NCI) usability laboratory, facilitator Gregory Alexander, RN

  • 9 subjects (informatics students, nurses, physicians, and medical librarians)

  • 3 test tasks embedded in clinical scenarios

  • 6 observers taking “stream of consciousness” notes, while viewing participant’s face and the PDA projected on a large screen

  • Post-test questionnaire


Usability study results

Usability Study Results

All participants were able to find Medline citations containing answers to questions described in all test scenarios

There is strong correlation between time to completion and problems in locating functions and navigation


Usability study observations

Usability Study Observations

234 unique observations

Most frequent observations. Participants:

  • Found brief mode (more titles per screen) useful

  • Were confused by the related articles icon

  • Did not know how to get back to the search tab from the profiles

  • Did not know how to drill down to a citation

  • Expected more information messages, e.g. on saving profiles

  • Hesitated tapping the search globe


Next steps

Next Steps

  • Organize content using key points of clinical scenario

  • Conduct usability testing of all alternative layouts

  • Include other NLM resources, e.g. practical guidelines


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