by Stephen M. Pribut, D.P.M.
This is the first column in a series on the use and impact of
the Internet on Podiatric Medicine. Over the next several months
we will review both general aspects of the Internet and those
specific to Podiatric practice. This month we will review some
basic terminology, the use of indexes to find information while
surfing the web and how to access Medline via the Internet.
The Internet is a set of tens of thousands of interconnected networks
containing millions of computers joined together and able to communicate
with each other. The World Wide Web, also known as the WWW or
W3, is currently the most visible part of this network. The Web
is essentially a hypertext linking system which allows one to
traverse it by clicking on textual links. While originally designed
to contain only text links, it has now become a network of multimedia
links, containing graphics, sounds, and video images. A Web Browser
is software that is designed to view Web documents. One of the
first available browsers was Mosaic. The most widely used one
is Netscape and Microsoft, not to be left out, has produced Explorer.
Use of the Internet has been growing by leaps and bounds. Its
many uses include ease of communication and increased access to
a wide variety of information. The World Wide Web makes access
and use to the world of the Internet quite easy. In the past arcane
UNIX commands and unfriendly software were needed to peruse the
Internet. Now, user-friendly software gently allows one to use
a graphical interface to perform most of the functions that you
would desire. These functions can be accessed through "home
pages" on the Web. Home pages are designed and displayed
by both companies and individuals. It is a form of self-publication
that is affordable and accessible to nearly all. The most frequently
used functions on the Internet have been ftp (file transfer),
Telnet (running a program on another computer), e-mail (sending
messages), WAIS (full text search of documents) and Archie (a
search for information).
Windows and Macintosh software have made accessing the Internet
no more difficult than it would be to use a Windows style help
menu. Two problems have developed as a result of this. The first
is that the Internet is becoming more crowded and slower in general.
The other problem is the time delay that occurs when downloading
a graphics laden home page. As a result, some people now call
the World Wide Web, the World Wide Wait.
The Web has been criticized as being an unorganized amalgamation
of material. Many people feel that there is no easy way to identify
and use the ever growing information available on the Web. However,
a variety of indexes and searching utilities are available on
the Web to help locate information. One of the most popular has
been Yahoo (http://www.yahoo.com/).
Yahoo is a company that has an online selection of over 30,000
Web sites consisting of what they consider to be a "best
of the net." The selections are done manually by human inspection
of the sites. Point (http://www.point.com/)
lists what they call the "Top 5% of The Web." Their
listings also include a review of the site, a representative excerpt,
and a rating of three parameters (appearance, information, experience).
Both of these sites may be searched by topic or keyword. While
they will lead you to information on many topics, they will also
miss many sites. More compete searching is available from sites
that use "bots" or automated searching. The most popular
sites include: Alta Vista
Lycos purports to have 15 million pages indexed. Alta Vista, recent
winner of a C|net award for best search engine, claims to have
15 billion words indexed from 30 million pages. They report examining
2.5 million pages per day. Searches may be performed by using
a word, phrase or with simple Boolean combinations of words.
Our medical highlight this month is the U.S. National Library of Medicine's (NLM)
"Internet Grateful Med." This is the Web version of
a popular software product that performs searches on the NLM's
MEDLINE database. Grateful Med has been available as a stand alone
DOS program for the past several years. It allows for an automated
and assisted search of MEDLINE. An index of Medical Subject Headings
(MeSH) is available to help make the search more specific. The
Internet version of Grateful Med works with your Web browser and
requires no additional software. The cost is nominal for most
searches, consisting only of a per citation fee and search time.
There is no charge for setting up a search which is done by filling
out a form using your Web browser. Searches are easily limited
by categories such as study groups (human or animal), language,
age, year of article and so on. On line help is easy to use and
readily available. One of the special aids supplied by the NLM
is the Unified Medical Language System (UMLS) Metathesaurus .
This coordinates your keyword with a conceptual search which is
linked to the MeSH. A tree like display of search headings is
then presented for you to incorporate into your search. Searches
will automatically try to map your keyword to a medical subject
heading. A utility that will analyze a search and suggest ways
to improve it is also available.
To demonstrate the ease of use of this system and the specificity
possible in a search, a sample search was performed. Searching
on the terms Fibromyalgia and foot diseases gave one citation
between the years 1993 and 1996. Analysis of the search revealed
315 citations of Fibromyalgia and 995 citations of Foot Diseases
with only one containing both search terms. Clicking on "Find
Related" accessed the Metathesaurus and suggested adding
the search terms Fatigue Syndrome, and Chronic Fibrosis to the
term Fibromyalgia and also suggested adding Podiatry to Foot Diseases.
Adding terms is done by clicking on a green "go" button
and returning to the search window. The addition of the two terms
suggested yielded a search configuration of fibromyalgia OR fatigue
syndrome, chronic OR fibrosis combined with foot diseases. The
number of hits for fibromyalgia and related terms was increased
to 1,862 with 2 citations found with both terms. The second citation,
however, was not relevant to what we really wanted. It involved
Morton's neuroma and fibrosis of the tissue rather than fibromyalgia.
Sometimes less is more. Each article is a hypertext link. Clicking
on the article will change the display to reveal more information
and will also allow you to view the abstract.
A set of search results may be downloaded to your hard disk for
examination on your personal computer, provided you have the disk
based version of Grateful Med. It is also possible to have citations
e-mailed to your Internet address. In combination with a service
called "Lonesome Doc", you can arrange for a copy of
desired articles to be available at a nearby library. The Medline
service takes up 5.8 Gigabytes of disk space. The Metathesaurus,
alone, takes up over 950 Megabytes of storage space. Information
on Grateful Med and how
to set up an account is available on the Web at: http://igm.nlm.nih.gov/
Future columns will discuss online journals, list servers, Usenet,
E-mail, hypertext, urls, and more on how to find people, places
and things. If there are topics you would like discussed, please
send e-mail to email@example.com. The text
and hot links of this article will be available at my Home Page .
After publication in the APMA News, my columns will be available on my home page at https://www.drpribut.com/sports/sphome.html with a complete hypertext listing of all of the sites mentioned.
Published in APMA News, July 1996
Hot Links From This Article
National Library of Medicine's (NLM)
Internet Grateful Med
August 1996 - Dissecting an URL and Medical Journal Highlights