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PubMed for Handhelds

PubMed for Handhelds ( http://pubmedhh.nlm.nih.gov ) research brings medical information to the point of care via devices like smartphones. This includes developing algorithms and public-domain tools for searching by text message (askMEDLINE and txt2MEDLINE), applying clinical filters (PICO) and viewing summary abstracts (The Bottom Line and Consensus Abstracts) in MEDLINE/PubMed, and evaluating the use of these tools in Clinical Decision Support.

PubMed4Hh has six components:

askMEDLINE

askMEDLINE is a free-text natural language query tool to search for and retrieve relevant citations in MEDLINE/PubMed. askMEDLINE research is developing this search tool for users who may not know specialized medical vocabularies.

txt2MEDLINE

Research in txt2MEDLINE is developing a text messaging system for processing incoming Short Message Service (SMS) queries, retrieving medical journal citations from MEDLINE/PubMed, and returning results to the user in text message format.

PICO (Patient, Intervention, Comparison, and Outcome) 

PICO research and development are enabling the search of MEDLINE/PubMed for information about conditions and diseases, interventions, comparisons of interventions, and outcomes. PICO lets the user structure clinical questions via a fill-in-the-blank and menu format. It can also be used to structure literature searches.

A health care provider or a consumer inputs a patient's condition or disease and selects an intervention or treatment, other interventions or treatments for comparison (optional), and desired outcomes (also optional). A dropdown menu prompts for publication type from among clinical trial, meta-analysis, randomized controlled trial, systematic reviews, reviews, and practice guideline, or, if none is specified, any of the above. PICO returns MEDLINE/PubMed articles responsive to the input.

The Bottom Line

The Bottom Line (TBL) research and development are enabling the summarization of journal abstracts for quick reading or text messaging. TBL results are derived by applying computer algorithms, not by summarizations performed by humans. TBLs were originally created to shorten abstracts sent as SMS text messages. The Conclusion section in structured abstracts is used as the TBL. If an abstract has no Conclusion section, TBL results are derived by using a word counting algorithm plus the last two sentences of the abstract.

Consensus Abstracts

Consensus Abstracts research and development are creating a Web application formatted for wireless mobile devices (for example, cell phones, smartphones, and tablet computers), whereby health care providers and consumers can search for current medical literature from MEDLINE/PubMed.

Either askMEDLINE or PICO can be used to initiate a search.

With askMEDLINE, a health care provider or a consumer can search using free-text, natural language terms. An example is “For a child with acute abdominal pain, will analgesics mask the diagnosis of acute appendicitis?” The search algorithm parses the query then sends it to the MEDLINE/PubMed database.

Consensus Abstracts retrieves relevant MEDLINE/PubMed articles, which are displayed as a list of journal citations (author, title, publication date, PubMed ID). A checkbox next to each item allows the searcher to choose citations of interest or, if the first series of articles are deemed relevant, those articles can be selected for display through a "Submit" button. The exact number of articles can be entered in an input box.

Consensus Abstracts presents on a results Web page the summaries of each abstract found by The Bottom Line (TBL); the search terms and publication types are also displayed. TBL results and full abstracts can also be displayed on the results page by clicking on links, so a searcher doesn't need to leave that page. Full-text articles, if available, and lists of related articles can be retrieved through links from citations.

Clinical Decision Support

Physicians and researchers can have difficulty keeping up with the continuing expansion of medical information, novel diagnostic tools, and therapeutic discoveries reported in the medical literature. They need to access relevant information when they need it and where they are -- for example at the point of care. Studies have shown that although they perceive the need to be high, they seek current information only when it is easily accessible. Medical information from MEDLINE/PubMed accessed through mobile devices and the above-mentioned components of PubMed for Handhelds can help inform clinical decisions.

Publications/Tools: 
Goldbach H, Chang AY, Kyer A, Ketshogileng D, Taylor L, Chandra A, Dacso M, Kung SJ, Rijken T, Fontelo P, Littman-Quinn R, Seymour AK, Kovarik CL. Evaluation of generic medical information accessed via mobile phones at the point of care in resource-limited settings. J Am Med Inform Assoc. 2014 Jan-Feb;21(1):37-42. doi: 10.1136/amiajnl-2012-001276. Epub 2013 Mar 27.
Fontelo P, Gavino A, Sarmiento RF. Comparing data accuracy between structured abstracts and full-text journal articles: implications in their use for informing clinical decisions. Evid Based Med. 2013 Dec;18(6):207-11. doi: 10.1136/eb-2013-101272. Epub 2013 Jun 20.
Fontelo P, Liu F. Mobile app versus Web app: a comparison using 2008-2012 "PubMed for Handhelds" server data. AMIA Annu Symp Proc. 2013 Nov 16;2013:445-50. eCollection 2013.
Sheets L, Liu F, Sarmiento RF, Gavino A, Fontelo P. Optimizing the txt2MEDLINE search portal for low-resource clinical decision support. AMIA Annu Symp Proc. 2013 Nov 16;2013:1277-81. eCollection 2013.
Fontelo P. Web Interface: The Bottom Line.
Marcelo A, Gavino A, Isip-Tan IT, Apostol-Nicodemus L, Mesa-Gaerlan FJ, Firaza PN, Faustorilla JF Jr., Callaghan FM, Fontelo P. A comparison of the accuracy of clinical decisions based on full-text articles and on journal abstracts alone: a study among residents in a tertiary care hospital. Evid Based Med. 2013 Apr;18(2):48-53. doi: 10.1136/eb-2012-100537. Epub 2012 Jul 10.
Johnson HL, Fontelo P, Olsen CH, Jones MKD, Gimbrel RW. Family nurse practitioner student perception of journal abstract usefulness in clinical decision making: A randomized controlled trial. J Am Acad Nurse Pract. Epub 2013 Mar 6. DOI: 10.1111/1745-7599.12013.
Sarmiento RF, Liu F, Fontelo P. A Cross-Language Mobile Resource for Accessing MEDLINE/PubMed Based on an Open-Source, Crowdsourced Controlled Medical Vocabulary for the Philippines. Journal of Mobile Technology in Medicine. 2012 Dec;1:4S:28. DOI: 10.7309/jmtm.50.
Fontelo P, Liu F. An Analysis of "PubMed for Handhelds" Server Utilization. AMIA Annu Symp Proc [Proceedings of the American Medical Informatics Association Annual Symposium]; 2012 Nov 3-7; Chicago. p. 1736.
Gavino A, Marcelo A, Isip-Tan IT, Apostol-Nicodemus L, Mesa-Gaerlan FJ, Firaza PN, Faustorilla JF Jr., Fontelo P. Email2MEDLINE Use by Rural Health Physicians in Remote Areas of the Philippines. AMIA Annu Symp Proc [Proceedings of the American Medical Informatics Association Annual Symposium]; 2012 Nov 3-7; Chicago. p. 1746.

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