New Zealand Doctor - 15 December 2010

MedlinePlus has been described as a goldmine of health information.

The medical director of the prestigious and generously resourced National Library of Medicine (NLM) in the US, Donald Lindberg states immodestly that MedlinePlus is a "goldmine of good health information from the world's largest medical library", one both health professionals and consumers can depend on for information that is authoritative and up to date.

Throughout its history, the NLM traditionally focused its programmes and services on healthcare professionals, but in the late 1990s a decision was made to reach out to the wider health community, enabled by the increasing availability of internet access. This "new" user group deserved access to reliable health information in a consumer-friendly, web-based format, and the NLM sought to meet this need with the introduction of MedlinePlus in October 1998.

After starting out with just 22 English-language health topics it has grown to around 800 health topics and also includes networked links to a variety of health information in more than 40 other languages.

he maintenance of a good quality and unbiased consumer health and medical information service does demand ongoing funding and support and the NLM via its massive Medline database and infrastructure is in a commanding position to take on such a challenge. The recent ability to also now directly link internationally recognised disease codes in a PMS system - such as from SNOMED and ICD-9 - directly in with MedlinePlus (as MedlinePlus Connect) was probably what caught my eye having been only recently enabled. Disappointingly MedlinePlus Connect is unlikely to ever be compatible with our antiquated READ codes, which after being touted with some excitement 15-20 years ago have been since left to stagnate and have remained unmapped and poorly indexed.

MedlinePlus thus claims to house extensive information from the National Institutes of Health and other trusted sources on over 800 diseases and conditions. Included also in the free website service are directories, a medical encyclopaedia and a medical dictionary, easy-to-understand tutorials on common conditions, tests, and treatments, health information in Spanish, extensive information on prescription and non-prescription drugs, health information from the media, and links to thousands of clinical trials. MedlinePlus is updated every day, has no advertising and does not endorse any company or products.

There are a few things which make Medline Plus different to other consumer health information websites apart from its disconcertingly naked lack of screen spam. It links directly to the more reputable and filtered non-profit providers of information and can also provide exceptional links to a wide range of language options for certain specific information sheets via two supporting sites at healthinfotranslations.com and the US Refugee Health Information Network.

A quick "acid-test" review of a few MedlinePlus topics noted that, within the "Meniere's" and "ENT ventilation tubes" sections, there were, however, no translated options. There was a "Korean translation" optional link under the section on Biliary Tract Disease (always such a difficult thing to explain to patients) but it simply turned out to be an information sheet on ERCP. I clicked on to the "Chlamydia" section looking for some good information but the only optional languages here were Amharic, Oromo and Spanish.

Clicking on "Pregnancy" I was interested in the current updating for combined screening for chromosomal disorders, and a link out to "Prenatal Screening" led to a US site called "Kids Health" which was unnervingly out of date and even had no references to NT scans let alone maternal serum screening.

A separate link to the American College of Obstetricians and Gynecologists fortunately gave a more up-to-date summary.

All this really just goes to show, perhaps, is how difficult it can be maintaining the highest quality of up-to-date information on the internet. Perhaps developing better and better medical translation networks will take a bit longer for MedlinePlus, but the NLM certainly has the track record and the commitment to provide an ongoing and reliable service in time.

Despite its little imperfections, I think MedlinePlus has still become one of those from a long list of medical websites which will be good enough to make its way onto the "top ten" of my Firefox toolbar next week.