Online Medical Databases

The archetypical online medical database portal is Entrez, established and maintained by the National Center for Biotechnology Information or NCBI (Figure 3). Entrez is a good example of a useful portal to online medical database because the data are referenced, the site is free of commercial influence, it's run by a government agency with academic oversight, it's easy to use, it's updated daily, and, fortunately, it's free.

NCBI's Entrez portal home page. Entrez is easily the most often used online medical database portal. PubMed, the biomedical literature database is one of the clinically useful databases within Entrez.

Although Entrez serves as a portal to the bioinformatics and molecular biology research community, it also provides access to 6 very useful clinical databases, PubMed, OMIM, Books, Journals, PMC, and NCBI Web site, as listed in the Table below. In addition to more research-oriented databases, Entrez provides access to several key clinical databases.

Most readers are probably familiar with PubMed, which can be used to search for a publication by author, journal, topic, or date. However, less well known but worth visiting is OMIM, the Online Mendelian Inheritance in Man database. The OMIM database is a catalog of genetic disorders authored by physicians and scientists at Johns Hopkins University, Baltimore, Maryland, and elsewhere, and developed by NCBI. The database contains heavily referenced review articles that are links to the biomedical literature and additional related resources on the Web.

Two relatively new additions to Entrez are PMC (PubMed Central) and NCBI Web site. PMC is the US National Library of Medicine's digital archive of life sciences journal literature. Access to the full text of articles in PMC is free, except where a journal requires a subscription for access to recent articles. Most of the articles can be downloaded as either text files or as formatted PDF documents. The latter requires the installation of a free Adobe Acrobat reader. NCBI Web site is a database of the home pages available within Entrez. For example, a search for "diabetes" returns 41 home pages within Entrez that contain information relevant to diabetes.

Entrez differs from most other online database systems in the degree to which the databases within the system are linked. That is, instead of constantly re-entering a search term every time a different database is searched, most of the databases within Entrez "remember" the current search thread and continue with it throughout the search. Linked databases save time, effort, and reduce errors due to miskeying search terms on subsequent searches. Entrez is also unique among most online medical databases in that it is configured to facilitate knowledge management. Researchers with new gene sequence data associated with a publication, for example, can upload the data to the appropriate national databases within Entrez. Once in the system, the data are validated and included in the appropriate database.

In addition to online databases sponsored by the government and academia, such as Entrez, there are hundreds, if not thousands, of databases established by pharmaceutical companies, physician boards and other specialty organizations, print publications, and medical students and residents with varied levels of expertise. These sites vary considerably in quality of content, amount of peer review, and the bias of the firm or individual hosting the service. A few of the many notable clinical sites worth visiting, in addition to Medscape from WebMD, are:

These sites range from conservative, advertisement-free services (eg, BMJ) to heavily advertised sites (eg, MedicineNet). The URLs for these and other databases are listed near the end of this document.

Dr. Melody McCloud’s new book is about healing the entire Black family

Dr. Melody McCloud is committed to advising the Black community on how they can live healthier in 2023. In January, she published Black Women‘s Wellness: Your “I’ve Got This!” Guide to Health, Sex, and Phenomenal Living, a book about sexual health and other challenges like menopause.

Recently, McCloud sat with rolling out to discuss the book.

What is your new book about?

I do have a new book, and it is called Black Women’s Wellness: Your ‘I’ve Got This!’ Guide to Health, Sex, and Phenomenal Living. I’m happy to say that it has been endorsed by our beloved queen, Pauletta Washington, [she] is a wife and she’s a great actress and musician. Also some other people, Dr. Jen Ashton from “Good Morning America,” Dr. Jeff Gardere, a psychologist does a lot of TV … even with “Real Housewives” and Dr. Cedric Alexander endorsed it. He’s a psychologist and also does a lot of public safety. So yes, it’s a brand new book for Black women and men, head to toe.

When we first open this book, where should we go first as a family?

That’s a very good question. Because, quite honestly, on page 15, at the very beginning of the book, I actually have a family medical history checklist because it’s important for us to know what we come to the table with. We need to know the grandma, granddaddy, my daddy, sisters, brothers, cousins, whatever. If they had heart disease, if they had diabetes, if they have certain cancers, if they have sickle cell, if they have multiple sclerosis, so I have all that at the beginning of the book.

So, we will check your family history. Then, at the end of the book, I have a personal checklist. … It’s important for people to know the family history so you know where you’re starting, what you’re already at risk from just by being born into your family, and then gain more information in the book and talking to your doctor.

Book review: Just what the doctor ordered

J. KEMPER CAMPBELL For the Journal Star

“How Medicine Works and When It Doesn’t: Learning Who to Trust to Get and Stay Healthy” by F. Perry Wilson, Grand Central Publishing, 304 pages, $29.

Dr. F. Perry Wilson is a practicing internal medicine specialist, epidemiologist and researcher at Yale University who has appeared on CNN, NPR and numerous social media sites. Thus, he is eminently qualified to assess the impact of the interminable COVID-19 pandemic on the trust in our medical establishment.

His book, “How Medicine Works and When It Doesn’t,” provides both physicians and patients with a sensible approach to evaluating medical research and improving medical care in the United States. He is also a cousin of Buck Kiechel of Lincoln’s Kiechel Fine Art Gallery.

Instead of the abundance of dry statistics, pie charts and graphs anticipated by the title, the author supplies vignettes from his training. These personal patient encounters enliven the book and are used to illustrate his salient points.

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His criteria for separating valid medical research from the background noise provided by infomercials, popular news media headlines and the internet should help readers make educated decisions on their own health care.

He introduces the term “motivated reasoning” to illustrate a common mistake both patients and researchers make, the inadvertent misinterpretation of data to arrive at a desired conclusion. This concept resulted in the initial misuse of the cheap and readily available drug hydroxychloroquine to treat the COVID virus. Later, carefully constructed studies showed no statistically demonstrable effect on the disease’s outcomes.

“Inferred causality" — believing a result happens because of an unrelated circumstance — is another common error that can’t be scientifically proven. Fortunately, application of this principle will allow the reviewer to change his underwear without disturbing the Red Sox’s latest winning streak.

Certainly, Wilson’s strict adherence to the need for randomized, double-blind trials can seem agonizingly rigid when it encroaches upon personal beliefs such as the value of daily vitamin D supplements. However, he neither exudes infallibility nor claims to be the indisputable voice of “Science.” (In the spirit of full disclosure, the reviewer plans to continue his use of vitamin D even if it is a harmless superstition.)

Even more cogent advice is that patients must remember that a physician’s recommendations are based upon large population studies that may not be applicable to a single patient. The astute doctor will use his or her knowledge to help each patient make the proper choice of treatment.

Finally, the author outlines the shortcomings of our present health system. Since 70% of today’s physicians are employed by hospitals or corporations, they are now considered part of the labor force rather than management. Since there are 10 administrators for each physician, the overall cost of care expands exponentially. Insurance companies, direct advertising by pharmaceutical companies and extensive lobbying expenses for politicians also add to the cost of treatment.

In summary, readers who desire an understandable appraisal of epidemiologic methods and a reasonable path toward improving medical outcomes in the United States by an experienced and compassionate caregiver should peruse Wilson’s book. If some of his suggestions are implemented, another disastrous pandemic may be ameliorated.

J. Kemper Campbell, M.D., is a retired Lincoln ophthalmologist who had two articles published in peer-reviewed journals.

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