What will you be able to prove with the medical literature in 2002?

Of the 847 new search terms that are available this month for
searching the medical literature on the U.S. National Library of
Medicine databases, there are collections of new search terms in
several subject areas of particular interest to trial lawyers.  These
subject areas include ethics issues, genetics, alternative therapies,
drug resistance, and a couple of other search terms that you
might want to flag for special attention.

What you will be able to prove with the medical literature from
year to year depends on what concepts are being indexed and
cataloged now. Indexers and catalogers at the U.S. National
Library of Medicine go through a complex decision-making
process each year to decide what search terms will be added,
modified, or dropped. What they decide determines what you will
find online.
 
Those decisions are made public in the middle of December each
year when documentation for the new version of MEDLINE is
published and it debuts on the National Library of Medicine
computer systems and web site. You may search the MEDLINE
database directly by going to its Internet interface
PubMed, at http://www.ncbi.nlm.nih.gov/PubMed.

Ethics Issues

Among the new search terms (here noted in ALL CAPITAL
LETTERS so that you know the reference is to the search term)
this year are several dealing with reviewing institutions
and with ethical concepts. Terms covering reviewing institutions
include ADVISORY COMMITTEES, CLINICAL ETHICS COMMITTEES, and RESEARCH
ETHICS COMMITTEE. Ethical concepts added to the database
this year include PRINCIPLE-BASED ETHICS, WITHHOLDING TREATMENT,
MORAL OBLIGATIONS, BIOETHICAL ISSUES, PROFESSIONAL MISCONDUCT,
PROFESSIONAL ROLE, BENEFICENCE, ETHICAL ANALYSIS, ETHICAL REVIEW,
ETHICAL RELATIONISM, ETHICAL THEORY, ETHICISTS, CLINICAL ETHICS,
VIRTUE, VALUE OF LIFE, and THEOLOGY. This collection of terms
suggests real growth in the medical ethics literature.

Genetics

With the focused public interest and concern about genetics
in therapies and food processing, we can forsee regulation and
litigation that will require our understanding of genetics.
Helping us in this understanding will be these search terms:
GENETIC PRIVACY, GENETIC ENHANCEMENT, INFANT GENETIC DISEASES,
TISSUE ENGINEERING, GENETICALLY MODIFIED ANIMALS, GENETICALLY
MODIFIED FOOD, GENETICALLY MODIFIED ORGANISMS, and GENETICALLY
MODIFIED PLANTS.

Alternative Therapies

You may be surprised at some of the new search terms covering
alternative therapies. We start with some that you probably
would expect--ACUPUNCTURE, OSTEOPATHIC MANIPULATION, CHIROPRACTIC
MANIPULATION, MUSCULOSKELETAL MANIPULATION, and TAI JI (which some
people spell "tai-chi"). MIND-BODY AND RELAXATION TECHNIQUES, HERBAL
MEDICINE, SPIRITUALITY and SPIRITUAL THERAPIES are new additions
to the database. Even FAITH HEALING and LAUGHTER THERAPY will now
be worthy of serious scholarly attention.

Drug Resistance

The recent threats using biological, chemical, and viral agents may make
these terms more important than they may have been when the decision
was made to include them. Now available for searching and retrieval are
the terms BACTERIAL RESISTANCE, FUNGAL RESISTANCE, and VIRAL RESISTANCE.
In addition, separate search terms-MULTIPLE BACTERIAL RESISTANCE,
MULTIPLE FUNGAL RESISTANCE, and MULTIPLE VIRAL RESISTANCE-include
exposures
from many sources.

For Special Attention

Some search terms are worthy of special attention from lawyers because
they suggest future trends and procedures to watch. SECOND-LOOK SURGERY
is "a followup operation to examine the outcome of the previous surgery
and other treatments, such as chemotherapy or radiation therapy."
COMPUTER-ASSISTED SURGERY consists of "surgical procedures conducted
with the aid of computers. This is most frequently used in orthopedic
and laproscopic surgery for implant placement and instrument guidance.
Image-guided surgery interactively combines prior CT [computerized
tomographic]
scans or MRI [magnetic resonance imaging] images with real-time video."
 

You can check the definitions of all of these terms online by
accessing the Medical Subject Heading list (it is referred to as
"MESH"). If you are using the U.S. National Library of
Medicine's web site on the Internet, look for the "MESH Heading"
hyperlink and click on it (or check your system documentation for
how to access the file). It is important to use that file to make sure
that you have used every permutation of your search term in your
search strategy. The Medical Subject Heading file will tell you
how your recently-added concept was indexed in earlier portions
of the database. MEDLINE started in 1966 and has changed along
with the changes in terminology. Being aware of these changes
and compensating for them in your search strategy will make your
search more complete and will give you more confidence in the
search result.