Url

UpToDate

uptodate.com

First Consult

firstconsult.com

MD Consult

mdconsult.com

InfoPOEMs

infopoems.com

WebMD

webmd.com

(including other technical summaries, guidelines, primary literature, and drug information). Such summaries may include information about authors, document status, and the last modification date. Free technical summaries can be found in the PDQ section of Cancer.gov (http://cancer.gov/pdq). Technical summaries related to cancer genetics can be found in the Online Mendelian Inheritance in Man (http://www.ncbi.nlm.nih.gov/OMIM). Appending "AND review[Publication Type]" to a PubMed query restricts the search to review articles.

Guidelines. Computer interpretable guidelines7-11 can provide formal and compact support for evidence-based decision making. Freely available cancer diagnosis and treatment guidelines are available at NGC12 and NCCN.5

Directory. Users unfamiliar with the model of data in a clinical knowledge base benefit from manually curated sets of links to information resources. For example, the Physician Data Query (PDQ)13,14 home page points to cancer information summary classes (adult treatment, pediatric treatment, supportive care, prevention, genetics, etc.) and clinical trials resources (search page, user's guide, or support for clinical trials submission) as well as help documentation that includes an annotated directory (which has extensive text along with headings).

Index. Most cancer information knowledge bases include a search box. After users enter a text string in a search box, a formal query is constructed, the formal query is compared against the documents in the database, and the matches are ordered. Formal queries may be constructed by interpreting "and" or "or" as Boolean operators rather than keywords, by default addition of Boolean operators, by stemming15 words (so that, for example, "neoplasms" will match "neoplasm"), identifying approximate matches that catch spelling errors (for example, "endometril cancer" will match "endometrial cancer"), considering the semantic role of the words (for example, interpreting "Li" as an author name or as an element), expanding queries based on synonyms (so that, for example, "tumor" will match "neoplasm"), or expanding queries based on generalization/specialization relationships among vocabulary words (so that, for example, "surgery" in a query will match "mastectomy" in a document). Some resources allow subsequent queries to be applied only to the current results.

Drug information. Knowledge bases should include information on dosage, drug-drug interactions, and side effects. The U.S. Food and Drug Administration maintains a database of approved cancer drugs16 that includes generic drug name, trade name, sponsor, pointers to sudy details, and dosage. Some PDQ entries are indexed by drugs; for example, entering "tamoxifen" in the search box returns a variety of relevant documents.

Clinical trials. It is important to access clinical trials databases to identify trials for which a patient is eligible and evidence bearing on treatment (evidence that may be preliminary from an ongoing study or final). http://clinicaltrials.gov supports identification of ongoing clinical trials based on facility, location, disease, and age group. Appending "AND clinical trials[Publication Type]" to a PubMed query restricts the scope of the search to reports on clinical trials.

Documents for laypersons. Although several knowledge bases for laypersons are described previously, a clinician's knowledge base should provide direct links from pages aimed at specialists to documents directed at laypersons.

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