MEDLARS and Health Information Policy

The objectives of this technical memorandum are 2 fold: to examine the US National Library of Medicine's (NLM) role in the creation and distribution of computerized health related bibliographic information in light of the private sector's presence in this field and the public interest; and to examine MEDLARS' effectiveness in disseminating bibliographic health related information. 5 chapters describe the development, current status, and future plans for MEDLARS databases and online services; discuss system issues related to the effectiveness of MEDLARS in disseminating bibliographic health related information; review private sector health related databases and commercial information services; focus on the considerations underlying the current debate on the appropriate role of the government in information transfer; and analyze the domestic and international implications of changing the range and pricing structure of MEDLARS computerized products and services. Since its inception, MEDLARS has become more sophisticated, accessible, and inclusive, and MEDLARS 2, the library's current system, is utilized more than any other system by health communities in the US and abroad. The development of MEDLARS parallels the evolution in medical bibliography that began in the 1950s with the 1st attempt to apply computer technologies to information processing. The system's 1st database, MEDLINE, was a byproduct of the computerized production of the printed "Index Medicus." "Index Medicus" continues to provide physicians and other health professionals the major access to biomedical literature worldwide. NLM is continuously refining MEDLARS 2 to extend its capabilities. The system has evolved into a complex multiprocessing system that maintains data files, provides online retrieval services, and produces computer photocomposed publications. MEDLARS 2 contains almost 20 databases. The machine readable data tape that is the source of data for MEDLINE is used to produce "Index Medicus" and other publications. MEDLINE, with its related backfiles, is the largest database in MEDLARS and is the most extensively used. Literature selection is used as a quality filter for the indexed biomedical literature database. The selection process is highly structured and involves a critical review of the literature by a panel of expert consultants. In fiscal year 1981, NLM conducted over 2 million online searches, fully 1/3 of all such searchers performed in the US. MEDLARS 2 allows for direct communication with the computer in online, interactive fashion.