Factual Databases In Biomedicine

Nandita Kapila

National Informatics Centre, New Delhi - 110003

Advances in biomedical research and computer & communication technologies have led to the development of a plethora of databases of all types in the area of biomedicine. Factual databases comprise non-bibliographic databases and those full-text databases which are not derived from published literature. Several such databases are availabie in biomedicine. Typical among them are directories, encyclopedias, drug indexes and sequence databases. These information bases are available on CD-ROM, online from various hosts and via e-mail over Internet. Multimedia databases and expert systems are amongst the latest developments. Factual databases in biomedicine constitute a rich source of information for practitioners and lay users.


In the last few decades, revolutionary advances have been continually made in the field of biomedicine. Basic human instinct drives researchers to seek avenues to disseminate the results of their work. Information seekers in turn have always sought newer and newer information sources. Till recent years, the distribution of information was constrained by lack of large scale communication techniques, with the exception of print media.

The coming of age of information technology has revolutionized the storage and dissemination of massive volumes of information. The convergence of these two technologies _ biomedical research and computers and communications_has manifested itself in the proliferation of computerized databases in the biomedical area. This has provided an extremely effective solution for information providers and seekers alike.

A powerful tool, of immeasurable value, that aids in strengthening health support systems us the access to various types of computerized information bases. These databases are available bith online and on CD-ROM.

What is a Database?

A database is a collection of interrelated data of different types. The data is stored in a manner which enables efficient storage and retrieval. The difference between a database and a `file' is analogous to the difference between a thoroughly cross-referenced set of files in cabinets in a library or in an office and a single file in one cabinet that is not cross-references with any other file. The important difference between a computerised database and a thoroughly cross-referenced set of files is that the `database' must be stored on a direct access storage device in order for the computer's central processing unit (CPU) to be able to utilize the cross-references.

Types of Databases

Bibliographic databases are those that contain bibliographic references of citations, with or without abstracts, to published literature sources such as journals, books, newspapers, reports, patents and theses. Non-bibliographic databases contain textual, statistical or numerical data.

A third type of databases are the full-text databases which provide full-text retrieval. Full_text databases may either provide articles from journals, books, etc or facts in a certain area of knowledge. These facts could include value-added information which is derived or culled, by experts, from different sources and presented, unlike information in bibliographic databases which is a simple reproduction of published material. Full-text databases, which deal with facts can be categorised under `Factual' databases. Non-bibliographic databases also fall into the category of `Factual' databases. These databases are becoming increasingly important in biomedicine and librarians and health professsionals alike need to keep themselves abreast of the availability of databases of this type.

Mode of Access

Factual databases, in the area of biomedicine, can be categorised on the basis of mode of access as follows:

Databases Available on CD-ROM

CD-ROM is a cutting-edge technology for the dissemination of large volumes of information. It is used for the storage and retrieval of machine-readable (digitally encoded) information. The use of lasers allows a CD-ROM disk to function as a high-density, compact, portable and easy-to-use computer storage device.

Databases Available Online

A unique collection of networks with vast proportions of its own kind, Internet is a global information highway. Through this single channel, tens of millions of scholars, scientists, businessmen, librarians, journalists, artists and software developers are woven into a `Global Village'.

World Wide Web (WWW) is the most advanced browsing and searching system deployed on the Internet based on the hypertext paradigm. WWW allows one to explore a seemingly unlimited worked wide digital `WEB' of human knowledge.

National Informatics Centre (NIC) has established C-WEB (Centre for World Wide Web service over NICNET) an advanced server through BASIS Web server, the first of its kind in the country. C-WEB adds a new dimension to Internet services over NICNET. It facilitates access to 25,000 Web servers around the world.

The MEDLARS (Medical Literature Analysis and Retrieval Systems) family of databases, available online from Natiional Library of Medicine (NLM), USA constitute the most extensively used biomedical information system in the world. Several factual databases are part of this family.

In addition, many public domain factual databases are available on the Internet, some of them on Biomedical Web servers. Factual databases also feature on international information networks like DIALOG.

Databases Available through E-mail over Internet

Several factual databases can be searched by sending a specially formatted mail message, containing the query, to an e-mail server on the Internet. A search is then performed against the specified database and the results returned in a mail message.

Databases in all three categories above are discussed in succeeding paragraphs.


There is a fundamental difference in the way information from bibliographic and factual batabases is accessed and used. Bibliographic databases are used largely for research. The researcher searches the database and after obtaining the desired bibliography, seeks out the full-text of the referenced articles. Eventually he moulds the information into a thesis or reference paper which is then read by others. Factual databases are accessed by physicians or lay persons (home users) and other end-users who put the information to immediate use.

For a large number of factual databases there is apparent meaninglessness of the `relevance'concept and of recall/ precision measures. A data item is either present or not and, in principle, there ought not to be a dispute as to whether it is required or not. This attribute of factual databases makes them suitable for searching by automated methods such as through e-mail. Factual databases lend themselves well to this kind of non-interactive search, as the degree of discretion required to search is very limited and therefore automated query and response can be very efficient.

Some Factual Databases

Factual databases available internationally, provide truly comprehensive coverage. They augment the information available in the plethora of bibliographic databases being published the world over. A rich variety of different aspects of non-bibliographic data are catered to. Purely textual or statistical data is, in many cases, complemented by the inclusion of images, audio and video clippings, graphics to constitute multimedia databases. Images and video are of obvious value in the study of human anatomy, physiology and the physical manifestation of diseases.

The databases may be subsumed under several major heads as given below.

Textbooks, Yearbooks, New Bases and Lectures

a) On CD-ROM

* Yearbook Series. Contains the complete text of 33 yearbooks from Mosby Year Book Inc.
* Complete Yearbook Collection on CD
* Instructional Course Lectures on CD-ROM.
* Oxford Textbook of Medicine on CD-ROM.

b) Online on Internet

* Access cases, online teaching modules, materials and textbooks.

c) Online from DIALOG

* Health News Daily. Provides specialized, in-depth business, scientific, regulatory and legal news.
* Pharmaceutical and Healthcare Industry News Database.

Directories of Biomedical Professionals, Organizations, Books, Products

a) On CD-ROM

* American Medical Association Directory of Physicians in the United States.

* Book Find - CD Medical & Healthcare:
Covers all fields of medicine and other subject areas, likely to be relevant to a medical bookseller or library. Content ranges from single-line summaries (including a convenient order list format) through bibliographic details to full-scale information sheet with descriptions and contents list.

* Diogenes - FDA Medical Devices.

* Healthcare Product Comparison System
Provides health care personnel and those involved in the planning and design of healthcare facilities with objective brand name product comparisons.

* Medical Directory CD-ROM
Instant on-screen display of the latest information on 120,000 doctors, including GPs as well as medical organisations, such as health authorities, trusts, family health services authorities and hospitals.

b) Online from NLM

Directory of information resources including organisations, research resources, projects, databases and electronic bulletin boards concerned with health and biomedicine.

c) Online from DIALOG

* Diogenes
Contains news stories and unpublished documents related to the U.S. regulation of pharmaceuticals and medical devices.

* Health Devices Sourcebook.
Contains current address and marketing information on the North American manufacturers anmd distributors of medical devices.

Information on Drugs, Chemical Agents

a) On CD-ROM

* Antimicrobial Agents and Chemotherapy
A major forum for current research relating to antimicrobial, antiviral, antiparasitic, and anticancer agents and chemotherapy.

* British Pharmacopoeia on CD-ROM.

* Derwent Drug File on CD-ROM
Covers all aspects of the scientific literature on drugs, from chemistry and synthesis, through pharmacology and toxicology to clinical application.

* Harbalist Multimedia CD-ROM
Introduces the skilled use of herbal medicines within a holistic perspective.

* Martindale - The Extra Pharmacopoeia
Full text database containing evaluated information on drugs and medicines in clinical use throughout the world, and also on investigational drugs, compounds liable to abuse, and ancillary substances including diagnostic agents, pharmaceutical adjuvants, and toxic substances. The information is arranged for each substance with evaluative text supplemented by bibliographic citations, often with abstracts.

b) Online from NLM

Descriptive information about agents being tested in AIDS-related clinical trials.

Directionary of compounds of regulatory and biomedical interest.

Interactive chemical dictionary file.

Contains references on biologial, chemical and physical agents that may cause birth defects.

A database of chemicals tested for mutagenicity.

c) Online on Internet

* Drug Index

d) Online from DIALOG

* Derwent Drug File

* Derwent Drug Registry
Coverage includes information on the chemistry, biochemistry, pharmacology, therapeutic effects, and toxicology of drugs.

* Drug Information Fultext.

* Registry of Toxic Effects of Chemical Substances.

Information on the Management of Diseases

a) On CD-ROM

* Cancer
This multimedia tool brings to life the story of cancer, hopes for cures, treatment options, and the psychology of living day to day with these diseases.

* CD-Derma - General Dermatology
Provides images to visualise skin pathologies, and offers sohphisticated browsing methods to ease the process of differential diagnosis, and the retrieval of other related information.

* Chronic Disease Prevention
A collection of six databases covering - Health Promotion and Education, AIDS School Health Education, Cancer Prevention and Control, plus a Chronic Disease Prevention Directory and State Profiles.

* Clinical and Diagnostic Laboratory Immunology
Devoted to the study of all aspects of human immune response assessment, including indications for testing, methods, and interpretation of results.

A database for computer aided diagnosis (decision support system). The user may look into the full text of the suggested diseases in order to decide the next steps of the examination. The user can also consult the laboratory values of clinical significance.

* Health and Drug Information Library
A comprehensive collection of full text patient information covering over 6,000 topics. Includes information on infant, child and adolescent health, women's health, adult health and medications. The Library includes a number of illustrations to augment the text.

* HIV / AIDS Resource Guide
An encyclopedia of information on HIV and AIDS laws, rights, and responsibilities, state statutes and regulations, federal laws and regulations case law, HIV+ legal issues individual's rights, employers' responsibilities, government responsibilities, and CDC reports. A guide developed for employers, educators, government agencies, health care professionals, legal professionals, individuals who are HIV positive, their friends and families.

* Interactive Atlas of Transesphageal Color Doppler Echocardiography and Intraoperative Imaging
Complete introduction to the new field of TEE.

* MICROMEDEX Healthcare Series
The MICROMEDEX Healthcare Series, designed for health care professionals, provides a library of peer-reviewed, referenced information on toxicology (clinical and industrial), drug therapy, and emergency medicine. Patient instructions and dosing programs are also available. The Healthcare Series consists of the following databases—POISINDEX (emergency poison identification and management information), IDENTIDEX (tablet and capsule indentification), EMERGINDEX (emergency and acute care information,), DRUGDEX (referenced drug information), TOMES (industrial medical and hazard information), and Martinadale — The Extra Pharmacopoeia. The databases are separate products and subscribers can either choose the whole system or subscribe to one or more of the databases inidvidually.

b) Online from NLM

A physicians data query system designed to assist physicians in the treatment of cancer patients.

c) Online on Internet

Interactive AIDS and Epilepsy documents, simulated conversations.

* AIDS Clearinghouse.

Encyclopedias, Dictionaries

a) On CD-ROM

* Health Encyclopedia.

Health Information for the Home-user

a) On CD-ROM

* Consumer Information
Consists of a majority of books, manuals, pamphlets, fact sheets, and other information publications from the Federal Government's Consumer Information Center at Pueblo, Colorado.

* Family Doctor:
Dr. Allan Bruckheim is a nationally recognised physician and syndicated columnist who answers nearly 2,000 of the most frequently asked health questions in plain English. Combines full-colour charts illustrating many of these answers.

* Health For All-Primary Care and Consumer Information/AIDS Information and Education Worldwide
Contains international and country based full text publications (500 titles), public health, state, national and federal committee reports, training materials from the following sources — WHO, Pan American Health Organization, US Agency for International Development, US Centers for Disease Control, International Planned Parenthood Federation, and World Federation of Public Health Organizations.

* Health Today
A comprehensive compilation of interactive health programs directed at the home-user. Instructions in preventive measures, as well as information on diseases and treatments.

* Personal Medical Advisor
Contains the full text and images of several books such as Complete Guide to Sports Injuries; Complete Guide to Symptoms, Illness and Surgery.

b) Online on Internet

* Information on communicable diseases, consumer health information, etc.

History of Medicine

a) On CD-ROM

* Medicine History:

Clinical Trials

a) Online from NLM

Detailed information on AIDS-related clinical trials.

Releases significant findings of National Institute of Health, USA, funded clinical trials where such release can effect morbidity and mortality. This is full text data describing the clinical application which includes chart and tables.

Sequence Databases

a) On CD-ROM

* Molecular Structures in Biology:
This database contains the January 1990 release of the Brookhaven Data Bank, with complementary graphics, image, database, and text programs linked by extensive use of hypertext, to provide anyone working with biomolecular structures with a unique and powerful reference tool.

b) Online from NLM

Gene, DNA, protein, vector subset, and nucleotide sequence databases plus eukaryotic prompter and transcription databases of National Centre of Biotechnology Information, NLM.

c) Through E-mail

* GenBank
DNA Sequence database.

* SwissPort
Protein database.

d) Online on Internet

* Molecular Modelling database.


a) Online from NLM

Database of on-going dental research projects.

b) Online from DIALOG

* Pharmaprojects
Reports on the progress of new pharmaceutical products at all stages of development.

Database for Practioners

Two databases, in particular, merit special treatment. Both of these are rich reference sources for practicing physicians. The two databases are the Computerised Clinical Information System (CCIS) from Micromedex (Micromedex Healthcare Series) and Physicians Data Query (PDQ) from NLM.

CCIS - Micromedex Healthcare Series

For a given drug, the database may be queried by providing the age, weight of a patient to which it responds with the dosage that is required to be administered. In addition, emergency care measures are described in detail for most important ailments such as malaria, plague, heart attacks and so on. The availability of this database, online, in a patient care environment such as hospital wards, can prove extremely functional in cases where the physician is not available, especially in emergency situations.


This database constitutes an `Expert System on Cancer'. The knowledge of thousands of reputed physicians has been fed into the database. Other physicians may query the database for information regarding all aspects of diagnosis, treatment and management of cancer and receive expert consultation necessary to deliver effective health care.

PDQ offers `Treatment Summaries for Health Professionals and Patients' separately.

The list of databases mentioned above is by no means exhaustive, but rather attempts to give the reader a feel for the types of information available in factual databases. It is only a sampling of the entire collection of such information bases in the field of biomedicine.


A study of the content of factual databases in biomedicine reveals the latest trends in information dissemination. As user demand for multimedia databases grows, information providers are increasingly adding graphics, images, audio and video to the textual content of the databases. Multimedia elements are of indisputable value in the study and practice of medicine. There is also a massive demand for expert knowledge in the different areas of medicine and information providers are gearing up to meet it with the development of expert and consulting systems. In addition, discussion groups on the Internet are gaining popularity rapidly. Through these groups lay persons with access to Internet can obtain the expert advice of specialists in different fields. There are several biomedical servers on the World Wide Web, many of which offer factual information.

Coverage for diseases and issue important in the Indian milieu is sadly lacking. However, the existing collection of factual databases in biomedicine do provide coverage for a large number of essential aspects of biomedicine and health care and constitute an effective support source for purely bibliographic information or full-text reproduced from published literature. They cater to the information needs of professionals and lay persons alike.


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