health questions shouldn't hurt

Health Questions Shouldn’t Hurt

Washington Library Association

April 21, 2006

Tacoma, WA

Gail Kouame – Consumer Health Coordinator – NN/LM, PNR

Why Is Health Information Unique?

Medical Terminology

Scary!

Highly Emotional

Medical Terminology - Deciphering “Medspeak” Mostly Greek or Latin origins

Diagnosis and Surgery – GreekAnatomical terms – Latin

Medical terms are formed from word:RootsPrefixesSuffixesCombining vowels/forms

Medical TerminologyDeciphering “Medspeak” Root – the foundation of the word, can be combined with

a prefix or suffix

Prefix – place before the root to modify its meaning

Suffix – placed after the root to modify and give essential meaning to the root

Combining form – root with a combining vowel attached (e.g. lip/o-); o is the most common combining vowel

Medical TerminologyDeciphering “Medspeak” In deciphering medical terms, it is best to look first at the

meaning of the suffix, then at the meaning of the root and prefix

Example:hyperlipoproteinemiahyper- (prefix) – excessivelip- (root) – fato (vowel used to create a combining form, lipo-)protein (root) – protein-emia (suffix) – blood condition

Hyperlipoproteinemia – a blood condition, characterized by an excessive amount of fat and protein

Medical TerminologyDeciphering “Medspeak”Example:

pericarditis

peri- (prefix) – around

cardi (root) – heart

-itis (suffix) – inflammation

Pericarditis literally means “inflammation around the heart” but the dictionary states that this term means inflammation of the pericardium (-ium is a suffix meaning tissue), the sac that encloses the heart

Medical TerminologyDeciphering “Medspeak”

Using a medical dictionary

When the exact word for which you need a definition is not in the dictionary, look up the root word. Medical dictionaries use sub-entries heavily. You may find the exact word you are looking for listed under its root

Medical TerminologyDeciphering “Medspeak”

Example from Dorland’s Illustrated Medical Dictionary. Note the sub-entries.

Kidney (kid´ ne) [L. ren; Gr. nephros] [MeSH: Kidney] either of the two organs in the lumbar region that filter the blood…The kidney consists of a cortex and a medullaabdominal k., an ectopic kidney situated above the iliac crest with the hilus adjacent to the second lumbar vertebraflea-bitten k., a kidney which has a small, randomly scattered petechiae on its surface, sometimes seen in bacterial endocarditis.

Medical TerminologyDeciphering “Medspeak”

If the exact word you were looking for isn’t a sub-entry, look up the word’s prefixes and suffixes. Common medical prefixes and suffixes will have main entries.

Pop Quiz

On page 2 of your Medical Terminology handout, there are some exercises.

Using the tables of prefixes, suffixes, and roots on the following pages find the meanings of the words on the bottom of page 2.

Medical Reference Interactions

In Public Libraries…

NLM discovered during a pilot project that 6-20% of reference requests were health-related

Even when the number of reference requests was low, the health-related requests tended to be among the most time-intensive

Many Hospital Libraries…

Are not open to the public Do not have information that is written for

the general public – information is not at a level that the average consumer can understand

Many members of the general public do not know that there is such a thing as a hospital library

What are some of the issues for patrons who come to the library for health information?

No library or research skills Expecting to find information that addresses

their own unique problems Come in with misinformation or inadequate

information Difficultly interpreting conflicting information No skills in evaluating the quality of information

What are some of the issues for patrons who come to the library for health information?

Exhibiting intense emotion Inability to present the problem clearly Unreasonable expectations regarding the

information that can be provided Confusion about the library’s role Others...

What are the issues for library staff in providing health information? Not always familiar with resources that would

best answer the question Language/vocabulary in medical texts might be

too difficult for patrons to read/understand Time-consuming Afraid of giving the wrong answer Afraid of giving “medical advice” Others…

The Reference Interview

Provide a “safe”, private place for your reference interviews

Use terms like “You must be worried,” or “This must be difficult”

Maintain confidentiality Know the limits of your collection Do not interpret medical information Do not speak from personal experience or

knowledge

3 Little Words

I Don’t Know Or, I can’t get that information for you Don’t be afraid to refer the person back to

his/her health care provider

Drugs, Supplements, and other fancy stuff

MedlinePlus.gov is a great starting place!

Drugs, Supplements, and other fancy stuff www.eckerd.com

FREE access to the Multimedia Gold Standard database

Includes drug interactions Includes pill images Includes herbal supplementsGo to the “Drug Advisor” section

Drugs, Supplements, and other fancy stuff www.drugdigest.com

Similar to Eckerd, but less “commercial” feeling

Includes both drugs and herbsHas interactions and pill imagesAdded feature – drug comparisons

Drugs, Supplements, and other fancy stuff www.labtestsonline.com

A slightly different angleProduced by a collaboration of professional

societies in the lab communityPeer-reviewed, non-commercial, patient-

centeredSearch by test or by condition

What about those news stories your patrons are hearing and

reading?

Be careful about reading health books. You might die of a misprint.

--Mark Twain

Health Care Journalists

Special thanks to Sanjay Bhatt, staff writer at the Seattle Times, for helping to provide information for this

presentation!

The Challenges for Journalists

Understanding the clinical science and epidemiology Dealing with powerful vested interests

Sometimes treatments are overplayed as “cures” or as better than older, less expensive medicines

Misleading with statistics – absolute risk vs. relative risk (we’ll talk about this later)

Reporting on a researcher announcing a breakthrough on a research project – find out later researcher is a paid consultant for a drug co.

The Challenges for Journalists

Have to rely solely on what the scientists are telling them or on a PR agency that is providing information (in a press release, for example)

Commercial pressures and deadlines that give little time to reflect on stories, many of which are written on the same day as a press release

Where Do Librarians Fit In?

At bigger newspapers and news agencies, there are librarians on staff

Help with research to find resources to prove or disprove a theory

Provide access to studies/articles that reporter may have heard about

There’s Hope! Association of Health Care Journalists

www.ahcj.umn.edu Serve as a training arm for reporters and editors Advocate for greater access to information that will

serve the public Hold national conferences yearly – 2006 meeting will

include a librarian on a panel! Hold workshops and produce reporting guides

throughout the year Developing a starter’s guide for journalists new to

health

The Scientist’s Point of View

Derived from a lecture by Maynard Olson of the Fred Hutchison Cancer Research

Center:

“The Social Responsibility of Science”August 11, 2005

The Scientist’s Point of View

“Hype, Hope, and Money” – How do they interact?Our culture loves triumphs (hope) as well as

controversy and scandal (hype)Most of science fall into neither of these

categoriesHowever, the media will almost invariably crowbar

stories about science into one of these worlds -- or better yet a combination of them

The Scientist’s Point of View

Show me the money!

Public/private competition speeds things up, but one effect is that the public’s expectations about the short-term practical pay-off of basic research becomes distorted.

The Scientist’s Point of View How do scientists communicate with the

larger public?How to communicate a realistic message to

society about the limitations -- maybe even the failures -- of science to alleviate problems about which people are deeply concerned.

The business of science is to provide reliable, accurate descriptions of the natural world, not to deliver good or bad news.

The Scientist’s Point of View

On the other hand, “Scientists shouldn’t be jerks.”

One issue in reporting on science is that an entire interview gets boiled down to a few words.

Keeping All This In Mind…

How can we “read between the lines?”

What to Watch For…

Headlines are intended to draw attention to an article, not to summarize conclusions

Look for the names and affiliation of the scientists responsible for research

Does the article mention where and when the study has been or will be published?

Who funded the study? (This is important!) Are results from animal studies?

What to Watch For…

Reports from medical conferences – be cautious!

“At conferences, researchers often present preliminary findings that can be quite tantalizing, but that may or may not pan out”

Source: “How to Get Beyond Headlines and Hype

to Find Answers You Can Use”

Lifetime Fitness, November/December 2003

Go Back to the Source! Many articles draw from mainstream

medical journals such as JAMA New England Journal of MedicineAnnals of Internal Medicine

Most of these are available through the databases many of you most likely subscribe to:

Health & Wellness Resource Center (Gale) ProQuest EBSCOhost

Health Stories in the Media

Accuracy Is there a discrepancy between the claim and

the research?

(ex: “Stem Cells Cure Arthritis!” vs. “Stem Cells Put Women’s Arthritis in Remission”)

Are there footnotes, bibliographies, or references so that you can verify the information?

Health Stories in the Media

AccuracyDoes the report give numbers and statistics in

context so you can determine their relevance?Has this study been repeated by anyone

else?Does the story state the evidence upon which

the material is based?Are opinions or advice presented as

“evidence based?”

Health Stories in the Media

AuthorityWas the article published in a peer-reviewed

journal? If so, it has more credibility than when posted on a website or a brochure.

Use PubMed to find other articles published by researchers being quoted – are they an expert?

Health Stories in the Media

CoverageHow many people participated in the study?

What kinds of people were in the study?

How long was the study? Has there been time to determine possible side effects?

Health Stories in the Media

Types of articles:

Case studies – Describe and discuss the clinical aspects of an individual with a disease. Such articles may also present unusual or unexpected cases.

Health Stories in the Media

Types of articles

Research articles– Discuss the effects in humans of various interventions that have been tested. May be about many different types of studies that are conducted on humans (or animals).

Review articles – Present the information known to date about a disease. Author has reviewed the literature and provides a summary article.

Go Back to the Source!

When you need to track down the full citation of an article, use PubMed!

Single Citation Matcher is just the ticket!

Health Stories in the Media

Hot off the press!www.HealthNewsReview.org

Free and open to consumers. Created by University of Minnesota journalism

professor Gary Schwitzer. Reviewers will monitor top newspapers, magazines

and other media outlets, including The Associated Press, and rate their coverage of health issues.

Health Stories in the Media

To get more information go to:MedlinePlus – Health Topic “Understanding

Medical Research”medlineplus.gov

National Institute on Aging – “Understanding Risk: What do Those Headlines Really Mean?”www.niapublications.org/engagepages/risk.asp

Glossary of Clinical Trials Termswww.clinicaltrials.gov/ct/info/glossary

Thank You!

Gail Kouame

gmarie@u.washington.edu

(206)221-3449