Reaching Back to the Future of Online Journals
October, 2010
With so much information available online today, literature review is increasingly part of day-to-day practice for doctors and scientists keen to stay abreast of the latest developments in their fields. To help them, librarians at Cornell, Ithaca, WCMC-NY and WCMC-Q recently secured access to one of the deepest, most trustworthy wells of medical information available online—198 years of the New England Journal of Medicine, dating back to January 1st, 1812. That’s five months before Napolean invaded Russia!
“The idea is to make sure that all Cornellians continuously have access to important information,” says Ellen Sayed, director of WCMC-Q’s distributed e-library.
The robustness of the NEJM archive—searchable PDFs with HTML and downloadable graphics available after 1945—challenges the imagination, and at the same time begs a question: with so much focus on the cutting edge of information, why is it important to have such comprehensive access to medical history?
“An understanding of historical disease models and philosophies on the body and illness promotes big picture thinking,” said Alan Weber, PhD, a writing professor at WCMC-Q whose research focus involves history, social and cultural dimensions of science and medicine.
Historical information serves medical students and practitioners in a variety of ways, Weber explains. The ability to look at treatment trends related to specific symptoms is an obvious example, and keyword results produce these in the blink of a well-trained eye. Less obvious, yet equally important, reasons for digging into medical history involve ethics and exploring, through concrete journal examples, changes in thinking over the years.
For example, U.S. Department of Health physicians in a horrific medical study ending in the 1970s prevented 400 black males in Alabama from obtaining proper treatment for syphilis in order to study the natural progression of this debilitating and sometimes fatal disease. It is important to study the historical and cultural conditions that produced this ethical lapse so that history does not repeat itself.
“The way doctors conceptualize disease has a great impact on their clinical practice,” Weber says. “In previous times, disease was seen as a punishment for sin. Even today, if a practitioner believes there is a moral foundation for a patient’s disease, even in the back of their mind, this impacts care and we see that happening even now—patients getting unfairly bumped down on transplant lists for social or economic reasons, etc. It’s a difficult issue with a lot of factors to weigh.”
In medical research, the availability of online journal resources has a direct impact on investigators’ productivity, says Sayed. “There is a model to measure return on investment for library grants, and research results show an organization’s published papers increase in direct relationship with the investment in online resources for its researchers.”
Researchers need significantly less time to conduct background and design studies when full-text resources are at their fingertips, Sayed says. Additionally, research designs supported by thorough background study are built on a much broader understanding of the research field—what has been tried, gaps in knowledge.
“The history of old theories reminds the scientist of the fundamental truth that his own theories are bound to be superseded by new and better theories just as were those of his predecessors,” wrote Erwin Ackerknecht in 1947 in an article in the Bulletin of the History of Medicine.
By Emily Alp
