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Indian Journal of Medical Sciences, Vol. 62, No. 2, February, 2008, pp. 74-83 Practitioners section E-endocrinology: An update Konwar R, Singh MM, Bid HK Endocrinology Division, Central Drug Research Institute, Lucknow - 226 001 Correspondence Address: Dr. Hemant Kumar Bid, Division of Endocrinology, Central Drug Research Institute (CDRI), Chatter Manzil Palace, P.O. No. 173, Lucknow - 226 001, India. E-mail: hemantbid@rediffmail.com Code Number: ms08014 Abstract Internet, from a long time, has opened up a myriad resource of knowledge and applications for academicians, researchers and clinicians alike in all health care professions across the globe. Basic endocrinologists are exploring through bench-top protocols to understand endocrine system and to design therapeutic interventions. Clinicians are required to continuously look for new developments relating to investigation, diagnosis and therapeutic options in their everyday practice for better quality of life of patients. All these require managing a large body of information. Now, these innovative technologies have opened up newer avenues for endocrinologists. As internet is serving the backbone for modern technologies, it is of utmost necessity to use and refine internet applications for future endocrinologists. Increasingly, easy access to internet has dramatically reduced barriers in sharing information among basic and clinical endocrinologists. Considering the growing scope for endocrinologists in the use of internet, it is necessary to understand internet as a source of information and backbone of modern applications. This review illustrates the expanding roles of the internet for endocrinologists and provides a ready-to-use compilation of useful academic, research, clinical resources, and is expected to introduce, stimulate and guide endocrinologists into the realm of WWW.Keywords: Endocrinology, internet, World Wide Web Introduction Internet, the ever-expanding storehouse of information, contains more than 800 million pages, encompassing about six terabytes of text data on over three million servers, [1] and there is exponential growth in the number of people getting access to the internet. [2] Its power is most strongly understood by scientists, as more and more information is made available through the internet, whether it is about gene sequences, experimental data, chromosome maps or complete journal papers. [3] Internet has emerged as the most powerful platform for exchange of scientific knowledge. [4] It represents significant advancements for the retrieval and dissemination of reliable scientific literature in well-organized, user-friendly formats. Immediate access to all scientific literature has long been a dream of scientists, and the internet search engines have made available a large and growing body of scientific literature and other information resources, which are accessible within seconds, as an alternative to colossal library of nineteenth century at fingertips. This is enhancing the possibilities further for endocrinologists to rapidly gain extensive knowledge of clinical and para-clinical importance. Endocrinologists too are increasingly using internet as a resource. However, unlike the basic researchers, clinical endocrinologists who use the internet for clinical practice face a number of challenges. The process of finding the required information involves sorting through an enormous quantity of database containing spurious health care information. [5] Altogether, the internet has now grown as information backbone for specialist endocrinologists, and efficient use of internet is becoming essential for quality practice of endocrinology. A Look Back at the Beginning Literature on internet is as old as the 'Galactic Network' concept of J.C.R. Licklider of MIT in August 1962, but practically internet originated in 1969 as a defence computer network (ARPANET) initiated by Advanced Research Projects Agency (APRA) of the US Defense, later known as Defence Advanced Research Projects Agency (DARPA). [6] Newer applications in biology generated with the advent of molecular biology were directly introduced in internet for availability to larger populations. A list of select websites of common interest is given in [Table - 1].Searching the Internet : Then and Now Internet has grown up into a colossal mass of information, and searching through the internet requires skills to avoid wasting time and obtain maximum relevant biomedical information. All the available search engines have their own advantages and disadvantages, and one would select a search engine on the basis of specific search requirement. A list of search engines is given in [Table - 2]. Presently, most search engines are also available as toolbars, making the search convenient for regular and specific search requirements.Endocrinology on the Present - Day Internet A basic researcher in the area of endocrinology mainly utilizes internet for searching scientific literature, biotechnology databases, and laboratory test results. Whereas clinical endocrinologists need to manage patient-related information, search for newer therapeutic modalities, sharing of specific clinical technique-related information with other clinicians as well as training programmers. Blonde et al.[7] explained a variety of potential uses of the internet by endocrinologists in their clinical, research and educator roles. Preger et al.[8] had recently described the usefulness of internet for continuing education in endocrinology. Some professional organizations related to endocrinology are listed in [Table - 3], which helps both basic researchers and clinical endocrinologists alike.Searching the Internet for Endocrinology Information A large and rapid growing volume of biomedical information can be accessed through the internet. Many databases are available on the internet, which may be very useful not only to endocrinologists but also to professionals from other streams. Presently, several biomedical databases of journals are available on the internet, which includes the index of journal citations, abstracts of articles and even full text articles. [Table - 4a, Table - 4b ] enlists a few of the preferred sites for searching scientific literature in endocrinology. An e-book is an electronic or digital version of a book. It is predicted to be the future version of books as it makes reading easier, requires less space and helps jump to relevant paragraph immediately. Internet has already become a major platform for assessing e-books. Few sites allow free access to books while most are restricted to paid members only; some websites provide CD-ROM of e-books. [Table - 5] enlists few websites of e-books. Clinicians have a wide scope for application of internet for searching information. General information available in internet for use by clinicians includes (i) disease information, (ii) drug information, (iii) clinical protocols ,(iv) internet-based tools for clinicians. Clinicians need to update themselves on the most recent outlook of a disease, and internet is a form of some reliable source to compile all the new developments for ready use by the clinicians. Some specialty-related sites of endocrinology are listed in [Table - 6]. Clinical tests are also available on the internet. Given the wide array of currently available laboratory tests used to diagnose and monitor endocrine and metabolic conditions, there are surprisingly few informational resources available on the internet; however, there is lack of reliable information about the performance and interpretation of dynamic tests. Core Endocrine Laboratory (CEL) ( http://www.hmc.psu.edu/endo/ ) is a CLIA certified, fully accredited reference laboratory that specializes in the quantitative analysis of hormones, hormone receptors, cytokines and growth factors in blood, urine, tissues and culture medium from both human subjects and experimental animals. CEL performs these tests for both diagnostic and investigative research purposes. ARUP Laboratories ( http://www.aruplab.com/guides ) is a national reference laboratory and a worldwide leader in innovative laboratory research and development in endocrine testing. Specialized Medical Search Engines and Directories Basic endocrinologists need to carry out homology search in genomic databases very frequently. It is a critical tool for all molecular biologists. Basic Local Alignment Search Tool (BLAST) represents a family of programs for databases for similarity searching. BLAST programs embody a fast algorithm for sequence matching. Clinicians can use the following search tools for simpler, extensive but relevant results. Open Directory Project (DMOZ) ( http://dmoz.org/ ): It is the largest, most comprehensive human-edited multilingual directory on the internet. This directory is developed and managed by Netscape Communications Corporation, was founded in the spirit of the open source movement and is the only directory that is 100% free. Websites of this directory are selected, uploaded, evaluated, described, edited and organized by open editors/contributors. HealthCyberMap ( http://healthcybermap.semanticweb.org ): HealthCyberMap is a semantic web project that aims at mapping selected parts of health information resources in the cyberspace in novel semantic ways to improve their retrieval and navigation. [9] CAT Crawler: Critically Appraised Topics (CAT) Crawler is a search engine specialized in the retrieval of critically appraised topics and a useful tool that helps physicians to make clinical decisions as the healthcare moves towards the practice of evidence-based medicine (EBM). [10] MARVIN: MARVIN (Multi-Agent Retrieval Vagabond on Information Networks), developed by Health On the Net Foundation and Molecular Imaging and Bioinformatics Laboratory at Geneva University Hospital, is a robot that searches sites and documents specifically related to a given specialized field. [11] Training of Endocrinologists on the Internet The trend towards more information, more connectivity and more patient-oriented information provides many new services for physicians who incorporate the internet into their practices. They are also used for recording patient history, writing prescriptions, maintaining the treatment history, accounts and billing, scheduling appointments and managing correspondences. Now, older health information system has been converted to internet platform, and all such information of the hospital is accessible through the internet for members from distant locations at any time. Combining this facility with a wealth of already discussed resources, internet is playing a major role in educating endocrinologists. The importance of internet can be gauged by the fact that health is the second most searched topic on the internet. Guidelines to evaluate health-related websites and health information have been included in [Table - 7].Clinical Practice on the Internet Virtual Medical Centre: Presently, several virtual medical centres as well as specialty medical centres have come up in internet. The Virtual Medical Centre ( http://www.virtualmedicalcentre.com/ ) is Australia's leading online health information resource, which delivers up-to-date, accurate health information twenty-four hours a day, seven days a week. Medweb ( http://www.medweb.org ): Medweb's platforms facilitate electronic acquisition, viewing, communication/transmission, publishing and storage of medical data captured by numerous modalities and devices and associated with a variety of medical subspecialties including radiology, orthopaedics, dermatology, ophthalmology, dentistry and general exams. Internet-based long-distance image transmission technology has already been recognized for its possible application in more home-like health services of distant battlefield. [12] Development of web-based management system using short message service (SMS) for diabetes patients as well as application of patient-oriented education system for diabetes management are few examples where internet can play a major role. [13],[14] Limitations of the Internet Internet is undoubtedly a rich source of valuable biomedical information and recent developments in the fast-moving disciplines of endocrinology. However, reliability, confidentiality and security will be the major concerns for application of internet in endocrinology. Various anti-viruses like Norton-Antivirus ( www.symantec.com ), f-prot ( www.f-prot.com ), Thunder-BYTE ( http://www.thunderbyte.com/) and McAfee ( http://www.mcafee.com ) are available, which can be effectively utilized not only for repairing infected programs but also for checking virus entry and enhancing cyber security. Regarding reliability of information, websites dealing particularly with these critical health issues would be expected to require strict prior certifications in future. A general consensus for need of reliable information in internet could be seen in the form of frequent tagging of website with HONcode ( www.hon.ch ). Clinicians must make themselves aware to explore and accept new technologies flowing in internet and to harvest their enormous potential skillfully. CDRI communication no 6890. References
Copyright 2008 - Indian Journal of Medical Sciences The following images related to this document are available:Photo images[ms08014t5.jpg] [ms08014t4a.jpg] [ms08014t3.jpg] [ms08014t7.jpg] [ms08014t6.jpg] [ms08014t1.jpg] [ms08014t4b.jpg] [ms08014t2.jpg] |
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