U.S. Government Non-Commercial Medical Search Engines
Compiled by Claudia Krenz, Ph.D. (datafriend @ gmail-.-com)

4everunderconstruction PERPETUALLY UNDER CONSTRUCTION

I posted the first version of this page in the mid 1990s, a byproduct of working on a U.S. government-funded medical research grant: I'd found it helpful and others did as well. I list below interfaces to the 4 engines--out of nearly a dozen--that work the same way now--July, 2007--as they did then. This page is, in other words, no longer a census of U.S. non-commercial medical search engines (b ut people evidently still find it useful so I keep updating it).

The internet has changed (!) and the idea of a one-page interface no longer makes sense. If you're looking for personally relevant health information--which I assume you are or else you wouldn't have landed on this page--you're far more likely to find accurate information by searching several different sources and then comparing the results: take HIV as an example.

Now, in the 21st century, the very idea of "U.S. government" medical search engines makes no sense, for anyone looking for substantive uncensored medical information. I still go first to PubMed but wonder whether it, too, has become infested with advertising: the U.S. government has, in the past 8 years, stifled the conclusions reached by its own scientists, has a health care system that, in the words of one prominent movie, is "sicko," has a higher infant mortality rate than any of the other G8 countries, threw money at religious groups which promised everything and were accountable for nothing, proposed anti-abortion legislation that didn't allow for a woman's health, and deliberately lied about air quality to the volunteers who, in 2001, worked to clear the wreckage of the former twin towers--to name a few prominent examples. We now have a new President; policies are changing--but don't substitute optimism for your own critical thinking!

   Engine Index    Notes


Engine Index (the few that haven't functionally changed since 1997)

NLM Health Organizations | NIH Clinical Trials | DHHS HealthFinder | Medicare |

Government agencies1  and health professional societies around the globe are concerned by the caliber of health information being retrieved from the Internet by hordes of patients. There is reason for concern.2

 

Individual physicians (M.D.s) though, by and large, are generally clueless and not Internet savvy: they don't know how to guide their patients. And their patients, by and large, are not Internet savvy and so don't know where to look, other than where the media and marketers tell them.

Clueless? Let me tell you how I 'hacked' my own medical records: Waiting in a private room, I saw a computer screen showing a login name and a blank field for password (oh no, I thought, couldn't be). Empiricist that I am, I typed in the login name as the password. Bingo.

The void is filled by the many dot.coms hawking their sites as the best Internet source for current, relevant, and accurate health information. Nowhere is this more apparent than in the context of the low-carb high-fat U.S. dieting craze. Just as the number of post-Cherbnoyl cancers in Pripyat were predicted to rise long before they did--so, too, will the number of LCHF induced coronary cases rise, predictably increasing as the low-carb diets become even more popular: admission demographics will change somewhat as younger patients are admitted with arteries so clogged that they require emergency angioplasties.

Numerous government agencies and health organizations have begun addressing this misinformation problem by building Internet sites that provide patients with current, relevant, and accurate health information. 3  Yet, by and large, these are individual, isolated, independent ventures, typically focusing on a single health topic.

A patient with a question about, say, digestive disorders may, with a large portion of luck, wade through the dot.coms and locate an accurate truth oriented and factually accurate web site. But knowing about that site won't help when the question is about Aunt Sadie's asthma 4  or the baby's rapidly spreading rash. Expecting patients to filter out enough noise to obtain quality answers to their every health question is not reasonable. One size does not fit all when it comes to individual questions.

One site would be more likely fit all by listing, on one page, a collection of search engines which, crawling databases of credible information, give patients the means to retrieve quality answers to a wide spectrum of health questions. It was the purpose of this page to provide such an interface. It still does. But there are many other medical search engines--all looking better designed than this clunker--in today's online world (go to any search engine and paste in "medical search engine").

imho

Since I still have your ear, so to speak, let me say one thing: BE CAREFUL. There is so much money to be made in the health industry--from medical search engines to the pharmaceuticals--that you'll be doing yourself a favor by reading all that's presented online as fact with a critical and skeptical eye: *always* ask yourself who is pushing what--where's the money?--who benefits if I believe that health fact x is true and behave according? IT's a JUNGLE OUT THERE. You want facts: be suspicious of the ones that are served to you. In summary, although a one-page interface was quite sensible last century, it is less so now, given the enormous text filtering power of the modern commercial search engines.

You don't need medical expertise to learn more than you know now. Make your search more productive by not being intimidated by what you don't know. People reading outside their specialties won't be able to follow all they read--but they can always learn more than they knew before.

In short, take advantage of the enormous text filtering power of the modern search engines. Never content yourself with a single search: use previous searches to inform subsequent ones. Select terms to include in and exclude from your search results (some engines allow searching on 10-plus terms). Don't be intimidated by all that you don't know: we all can learn more. Although a single one-page interface to sources of medical knowledge made sense back 7 years ago, it no longer does (both search engines and browsers have evolved into yet more useful tools). I hope you find the facts you are seeking.

 

User Directions

Type your query into the form and hit the return key (or click the search button).

 

Engines


Health Organizations (also maintained by NLM)

Enter term(s)

Select term combination phrase exact words singular and plural forms word variants

Fields (all is default) Organization Name/Acronym MESH Headings/Keywords

Select records containing all of the words any of the words
Only organizations with toll-free numbers
Only organizations with services for the hearing impaired
Only organizations located in

 

Search for particular organizations concerned with health and biomedicine. Enter your term(s); indicate whether you're searching for an exact phrase or some variant; select a field (not checking any yields the most hits; checking both yields the next most and checking MeSH terms, the least--beats me). Next select an organizational category (e.g., one with a toll free number), and then again specify the relationship between your terms. Click submit; you'll get one or more pages of organization names; click on a given one for more information (note that only some of these organizations have web pages). See the DIRLINE Fact Sheet for a more complete description of the databases and the medical subject headings page for help with specific terms.


Clinical Trials (sponsored by NIH's Clinical Center)

Enter term(s)  and specify eligibility criteria:
Include
Exclude

This site comes with a help page and one on search tips. In addition to searching, you can browse by sponsor. Also provided is information about participating in, referring someone to, questions about, and what is a clinical trial. There is also a clinical trials page sponsored by NLM and NIH, which one would think would have greater coverage, being sponsored by two agencies; I'm not sure.


HealthFinder (maintained by the U.S. Department of Health and Human Services)

Enter term(s)  

Words separated by a comma are interpreted as "or;" words separated by a space or enclosed in quotation marks are interpreted as a phrase. Click "Go" to initiate your search. Results consist of one or more pages listing web resources and organizations. These same categories are linked, in the other tools page, to toll free numbers and corresponding federal health clearinghouses.


Medicare (there's also a lot of compiled information on their home page)

Enter term(s) 

Words separated by a space or enclosed in quotation marks are interpreted as a phrase; words separated by a comma choke the engine; separating words by and does something but I don't understand what. Results consist of one or more pages of article titles with a brief abstracts; click on a title's URL to retrieve the article. For more information. check the glossary. Incidentally, the Medicare site indicates there is an "advanced search" engine--but I couldn't find it.


Footnotes

Take menorrhagia--a condition affecting up to a third of all women at one time or another--as an example: I found two abstracts representing two independent descriptive empirical studies--not experimental clinical trials--in which *all* subjects, although their lab test values fell within the normal range, reported cessation of problems within 3 months of taking some kind of thyroid supplement. Such information, freely available online, would likely be of interest to someone wanting to expand her existing knowledge with a literature review of the different treatment modalities studied by medical researchers (operationalized by appearing in medline abstracts).

Would a woman with this problem a priori conclude a thyroid deficiency caused her problem (no, of course not). Should such a person conclude that, just because there haven't been many studies, that a treatment modality is ineffective (no, most academic research is sponsored by industry--and, in terms of pharmaceuticals, thyroid meds are dirt cheap).

I've found that individuals are quite capable of sifting through information from diverse sources.
There are, of course, other problems like uneven access to physicians. But might as well search a quality primary than a derivative secondary--technical information filtered through the eyes of someone who wants to sell you something and may or may not know what s/he's talking about--database.

  1 My focus on U.S. medical search engines was a byproduct of having spent many years working on grants funded by the U.S. medical establishment; although I have found these databases useful on numerous occasions, my intention is not to imply the superiority of said establishment. I value all input. One finds valuable information on sites maintained by professional organizations, other governments, and the U.N. (to name but several). However, it's a fair statement that the search engines listed on this page were generally thought of as established, respected, dependable, independently reviewed, quality-filtered--ones whose purpose is educational rather than selling a product (nevertheless, see note 3 below: Caveat Emptor).

  2 I don't mean to suggest that there's nothing interesting or useful at commercial websites (or that non-commercial sites contain nothing of general interest): You can probably guess the opinions that 19th century EuroAmerican physicians had towards American Native medicine--but it's nice to hear them damn themselves in their own words (sort of like the microsfot trial).

As far as the other major portals' health sites, let me illustrate by example:

  • First, the old Apple/Excite health portal health greeted me with a banner ad blinking that I could lose 29 pounds in 2 weeks, then offering information about ideal body weight, tools for calculating bmi, sexual health, and where you can buy seriously good vitamins, even a desert calculator (finally, answers to my questions about the Gobi and the Sahara)! Each click launched a new happier-thinner-younger banner ad; a search for vision yielded numerous links, including one to a "Shopping center [that] shines the light on products;" a search on "weight loss" retrieved over 6000 articles and one on "bunions," less than 30.

  • AOL's Health Portal greeted its visitors similarly. A search for marijuana came up with two articles, neither dealing with health problems other than jail; a search on CBS' HealthWatch for "what my doctor was reading" about myopia yielded two articles, one about cataracts and nasal sprays and the other about fatigue and shortness of breath.

  • Netscape's health portal stood shoulder-to-shoulder. A search on vision yielded--ranked by 4 stars and down--a division of Upjohn Pharmaceutica (3.5 stars), the health-by-topic feature of the Georgia Department of Public Health (3), the University of Washington Division of Gynecology and Oncology (1.5), and a Student Insurance Division of somethingorother (a meagre 1-star). Oh well, perhaps the Nouveauderm Moisturing Socks (for only $40) have medicinal properties that will help me understand.

Seriously, have you ever wondered how much someone got paid to develop "health data" bases like these? So much for the upscale product sellers. Note that I haven't spoken of the sleazeballs, the scum trying to sell you sugar pills laced with arsenic or whatever (at great expense) to cure your arthritis--or the true believers, who, having found THE way, want to share it with you, be it a mantra or something that comes in a bottle, whether you want it or not. You'll encounter many upscale product sellers, sleazeballs and true believers on the Net: evidence suggesting that some online health sites deliberately violated their own privacy policies (Wired, 18 Feb 00) further makes me doubt their integrity. Caveat Emptor.

  3 Also available in the peer-reviewed, grant-supported articles published in the research journals that make their way into databases like Medline is crap. We have all read stories about scientific misconduct.

IMHO, sloppy research is a much bigger problem than falsified data. In research faculty positions and as an independent contractor, I have helped conduct numerous federally funded longitudinal medical research projects (AIDs, Alzheimer's, drug prevention and addiction, fibromyalgia, herpes, you name it). In the course of so doing, I have had the pleasure of working with many competent, brilliant, researchers, from whom I have learned much:
I have though also had the misfortune to work with many incompetent ones. I've encountered longitudinal studies where researchers changed their scales without updating their scoring protocols and others where particular variables were changed, without anyone recording when. And I have corresponded with colleagues whose articles were rejected because of journal editors being pressured by others, e.g., the pharmaceutical industry. And then there are the studies where the data are fine but the statistical analysis is toast. Take the book The Bell Curve as a prominent example. Published in 1994 and widely panned by the scientific community, it remains influential in U.S. public attitudes and policy decisions (National Public Radio, Talk of the Nation, 21 Jan 99). In their first analysis, the authors wanted to predict poverty status--either above or below an official level--from a model consisting of 3 variables, which they called "age," "socioeconomic status," and "IQ" (in their book, they included printouts from their statistical analyses, which looked spiffy, all those numbers and all). They didn't notice that their model predicted none of the cases living below the poverty level correctly.
Finally, keep in mind the old (and not totally undeserved) description of a medical research: a third of the patients got better, a third got worse, and the other rabbit ran away: Caveat Emptor.

When push comes to shove though, I'm more confident in non-commercial, federal even, medical search results than I am in those from the sellers of soap, sleazeballs, and true believers. Caveat Emptor. nevertheless.

  4 And it's not just medical "research" that can pose problems: The original version of this page was long ago listed in the Open Directory (it's the first of 12 in the "Medical" category; its entry states that "Dr. Claudia Krenz provides search boxes and instructions for eleven specialist search tools, mainly maintained by the National Library of Medicine; its URL is http://www.srv.net/~msdata/US_medsearch.html--the URL is, alas, to an earlier, dated version of this page, to a file that no longer exists): Caveat Emptor. And, although no longer online, one M.D.--I am Ph.D.--thought it fit to plagiarizes an earlier version of this page, copying the code I had laboriously generated and substituting his name for mine as the author-- and, adding insult to injury, gummied up the substantive content with dancing Asclepiuses. Sheet. In another example, learningmedicinedotcom/about.html shows a better formatted--all my work makes obvious the fact that I am not a web "designer"--version of an earlier version of this page (my name is not listed on the main page although there is a link to an earlier, dated version of my resume, which includes my name, as well as dated physical and email addresses). Caveat Emptor.

The point, again, is Caveat Emptor. Especially when it comes to health information. If it looks and quacks like a duck, it might be a duck, even with an "m.d." or "ph.d" appended. Consider the Crick, Watson, and Rosalind Franklin triad: she's fortunate in their only have stolen her ideas--she played Tesla to their Edison, Marconi, et al. In a way this can be explained as yet another footnote to--it was already implied in--Kuhn: the actual conduct of inquiry is a more-and-less messy business: Early 20th century U.S.S.R. biologist Lysenko had those disagreeing with him on some question of genetics, imprisoned. That the U.S.S.R. is no longer does not mean that crap like that doesn't still occur. Take T-PI at any institution, rearing up, roaring, slashing, fighting over the dwindling pile of grant carrion. And you should not be surprised that the funded research--which the peer-reviewed medical literatures is about--is unlikely to contain contemporary studies of long out-of-patent drugs. Does that mean pharamceuticals with the most recent pedigree are necessarily the best (don't assume "yes"). Caveat emptor--but usually searches of this kind of knowledge base provide more useful results than what the soap sellers and stars have to say.

  5 When I posted the first version of this page, information was ascendent. Now it is descendent (and sometimes devolving). Like many, this page was a small contribution ... There is no question that there were some things online that should not have been--and similarly for things that weren't but should have been public (very basic issue of the essential accountability of any government to its sovereign, the people--a relationship that's been flipped on its head in 2003: U.S. Sites are disappearing for no logical--nothing pertaining to "providing for the common defense" or protecting the water supply--reason. One example was the old U.S. FDA adverse reactions online database (here's its current form). The page clearly stated that it was an unordered list of adverse responses that had been reported to this and that; the page made no knowledge claims; the page was of potential public use--we are not all wired exactly the same and people do have, on occasion, strange reactions. The modern problem isn't limited to the actual conduct of inquiry being a footnote to Kuhn (logic-in-use, reconstructed logic (Kaplan); "sir karl, sir ronald, and the slow growth of soft psychology" (Cronbach and Meehl). There are other caveats to bear in mind besides eliminating references to condoms on a CDC HIV/AIDS "programs that work" page and stacking peer review with innumerates whose only qualification is ideological affiliation. And, of course, the normal publication lag means you'll never find anything cutting edge at its time in the peer-reviewed medical literature.

In an anonymous essay released Oct. 20, 2003, a senior NIH scientist details the political interference in the scientific process of the institution. Under the watch of the Bush Administration, nominees for scientific panels face political loyalty tests, scientific manuscripts are reviewed by bureaucrats for findings embarrassing to the Administration, and NIH employees face losing their jobs--whistle blowing is another tried-and-true- method--as part of the President's outsourcing initiative. This senior scientist revealed that "staff morale at NIH is rock-bottom and the institution needs help" (Rep. Henry A. Waxman, Ranking Member, Committee on Government Reform, U.S. House of Representatives).



"No matter what country we live in, people who believe in free inquiry and the power of reason are all part of the same tribe" (Lowe, 2002).

I was recently surprised to receive a snail mail question pertaining to this page (addressed to me simply as dr. krenz@ Nikiski, AK 99635). I answered it and thought to mention it here. U.S. citizens have a legal right to see their own medical records; physicians are though typically loath to turn them over to anyone but other physicians. For those without lawyers to enforce their rights, here's a strategy that once worked for me: I typed a request for my records from a recalcitrant physician and then had my bank notarize my signature. The notary's seal did not change the substance of my request; it simply made my request appear more official--enough that I did get copies of those records ... It would have been nice if the internet had turned out the way that seemed possible a decade ago. But it didn't. So, when you're searching for personally relevant health information, view what you find skeptically.
QQ Prescription Drug Project the Integrity in Science Database of the Center for Science in the Public Interest (Haig, S., When the Patient Is a Googler, Time, Some physicians disdain "medical gooling (Parker-Pope, T., A DoctorÕs Disdain for Medical ŌGooglersÕ, The New York Times, 19 Nov 07): patients come to their offices with too much information and don't know how to sort the relevant from the irrelevant, the accurate from the inaccurate, the outdated from the modern approaches to medicine. physicians ignore 'medical googlers' at their own peril ==== OCR laid off 90 and now outsources copy editing to Idia (Brasch, W., ItÕs Still the Economy, Stupid, Scoop Independent News, 17 July 08)