Vivian M Dickerson

Searching biomedical databases on complementary medicine: the use of controlled vocabulary among authors, indexers and investigators

BackgroundThe optimal retrieval of a literature search in biomedicine depends on the appropriate use of Medical Subject Headings (MeSH), descriptors and keywords among authors and indexers. We hypothesized that authors, investigators and indexers in four biomedical databases are not consistent in their use of terminology in Complementary and Alternative Medicine (CAM).MethodsBased on a research question addressing the validity of spinal palpation for the diagnosis of neuromuscular dysfunction, we developed four search concepts with their respective controlled vocabulary and key terms. We calculated the frequency of MeSH, descriptors, and keywords used by authors in titles and abstracts in comparison to standard practices in semantic and analytic indexing in MEDLINE, MANTIS, CINAHL, and Web of Science.ResultsMultiple searches resulted in the final selection of 38 relevant studies that were indexed at least in one of the four selected databases. Of the four search concepts, validity showed the greatest inconsistency in terminology among authors, indexers and investigators. The use of spinal terms showed the greatest consistency. Of the 22 neuromuscular dysfunction terms provided by the investigators, 11 were not contained in the controlled vocabulary and six were never used by authors or indexers. Most authors did not seem familiar with the controlled vocabulary for validity in the area of neuromuscular dysfunction. Recently, standard glossaries have been developed to assist in the research development of manual medicine.ConclusionsSearching biomedical databases for CAM is challenging due to inconsistent use of controlled vocabulary and indexing procedures in different databases. A standard terminology should be used by investigators in conducting their search strategies and authors when writing titles, abstracts and submitting keywords for publications.

The evolution of women’s primary health care in california: the role of the obstetrician/gynecologist

The role of the obstetrician/gynecologist as the primary health care provider for women has evolved rapidly in the past decade. There has not always been agreement in the specialty about the directions in which it should proceed. In particular, a cognitive dissonance has arisen regarding the primary care role for any one physician. Just as there are strong advocates,1,2 so are there dissentients.3,4 Access to care for women and patient choice of physician are universally acknowledged as desirable and central to the issue. The often acrimonious debate derives from more theoretical constructs of subspecialty identity and integrity, economics, dilution of specialty training, and educational barriers to successful implementation. The practical, salutary implications of primary care obstetrician/gynecologists have infrequently been evaluated in any formalized fashion. Five years ago, the State of California designated obstetrician/gynecologists as primary care physicians. This paper is a retrospective analysis of how the designation was achieved and the subsequent experience of the specialty over this period of time.