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The National electronic Library for Communicable Disease

The National electronic Library for Communicable Disease. Julius Weinberg Infection 2000. A. cquired nformation eficiency yndrome. I. D. S. Decision making in the face of imperfect information The information you have is not the information you want

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The National electronic Library for Communicable Disease

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  1. The National electronic Library for Communicable Disease Julius Weinberg Infection 2000

  2. A cquired nformation eficiency yndrome I D S

  3. Decision making in the face of imperfect information The information you have is not the information you want The information you want is not the information you need The information you need is not known The information that’s known can’t be found in time

  4. Overload/Unfocussed Contradictory Lack of electronic publishing strategy eBNF Green Book Yellow Book Overstretched library services Under-financed Some users lack access to services Information management problems in the NHS

  5. The Evidence Base slow to incorporate evidence slow to drop incorrect information Books The NHS spend: c: £6 million a year on journals. Thousands of journals, Average library contains a few hundred. about ten important journals in each specialty, unlikely the average DGH has all ten. Journals of primary publication Traditionally a major source of knowledge but are unreliable and biased: Support opinions of authors. Unclear how decisions made to include/ exclude Tend towards a positive and optimistic view of the effectiveness of interventions. Editorials and reviews Submission bias : More likely to submit positive results Editorial bias: Editors are more likely to publish positive studies Methodological bias: Flawed randomisation produce positive biases Abstracting bias: Abstracts emphasise positive results Framing bias: Relative risk data produce a positive bias Journal articles

  6. Overloaded GPs... • 22 Practices in Cambridge • 855 different guidelines • a pile 68 cm high weighing 28 kg Guidelines in general practice: the new Tower of Babel? BMJ 1998;317:862-863

  7. Public Concern

  8. Keeping up with the literature A general physician would need to read about seventeen papers a day simply to keep up. Journals of secondary publication • ACPJournal Club • Model widely copied and there now exists: • Evidence-Based Medicine, combined with the ACP Journal Club and published as Best Evidence; • Evidence-Based Mental Health; Cardiovascular Medicine; Healthcare; Oncology. • developed explicit methods for scanning; • selected journal articles based on strict and explicit quality criteria; • selected a sub-set of these articles on the basis of their clinical relevance; • prepared structured abstracts of the selected articles; • invited a clinician to comment on the structured abstract; • prepared a single sentence "declarative title" which summarised the finding of the research study in a single sentence that can usually be read in under fifteen seconds. • These journals select c2% of the articles

  9. Information Strategy for the NHS: National electronic Library for Health by March 2002 provide health care professionals and the public with knowledge and know-how to support health care related decisions. Provide easy access to best, current knowledge and know-how To improve health and healthcare, clinical practice and patient choice available via NHSnet and the Internet.

  10. Concept: three “floors” Patient Know How Knowledge Knowledge Management And Health Informatics Atrium, Help Desk General Information, Generic Tools, Links, Guides

  11. Knowledge and Know-How Platform every healthcare professional working in the NHS access to linked databases across which a single search engine will work. Guidelines DataBase under development in consultation with NICE; Clinical Evidence The Cochrane Library The National electronic Library for Rare Diseases Refer – the R&D Programme Outputs Database Evidence Based On Call CATs The British National Formulary (with updating links to other DoH funded publications, e.g. Drugs and Therapeutics Bulletins)  NHS Direct On-Line,

  12. if there is no useful knowledge on the Knowledge and Know-How Platform: Medline, Journals of secondary publication. Virtual branch libraries

  13. Competition

  14. Identifying user requirements Advertising and advocating the NeLH Creating links to specialty information systems Contributing to support and training Communicable disease, cancer, public health, primary care, heart disease, diabetes, informatics, paediatrics Virtual Branch Libraries

  15. NeLCD Provide best available evidence in Treatment Prevention Control Investigation of Communicable Disease

  16. NeLCD FIS PHMEG BIS AMM BSACNHSE – RDPH DH PHLS Advisory Group Other Specialist Societies Royal Colleges ICN EHOs Steering Group

  17. NeLCD Plan 1999 – 2000 Establish Steering Group, Agree Work Plan Technical Specification Secure Short Term Funding Pilot Stage 1 2000 – 2001 Pilot High Priority areas of OVCD Live Pilot March 2001 Advisory Group Meeting Secure Long Term Funding

  18. NeLCD Issues What to put in - Whole text articles Catalogue cards and Links Quality Tagging Quality Information ?How to Find it Bottom Line Information How to QA - Use the Specialist Societies Use PHLS Expert Groups Maintenance, Up to date, Quality

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