PERPETUALLY UNDER CONSTRUCTION
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 (the few that haven't functionally changed since 1997)
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.
|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").
|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.
Type your query into the form and hit the return key (or click the search button).
Health Organizations (also maintained by NLM)
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)
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)
Medicare (there's also a lot of compiled information on their home page)
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.
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:
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:
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).