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MEDLINE-Induced Blindness

Medical Director, Professor of Medicine, Israel Lung Association-Tel Aviv.

Correspondence to: Gerald L. Baum, MD, FCCP, Israel Lung Association, 16 Chovevei Zion Street, PO Box. 26401, Tel Aviv 63 346, Israel; e-mail: jbaum@post.tau.ac.il

One of the great leaps forward in medicine has been the database, MEDLINE, which has provided easy access to the world's medical literature. With the advent of the Internet, this access is open free of charge to the entire world! Well, not exactly free, as it turns out.

In the pre-MEDLINE days, all of us scanning the literature in preparation of a paper, used the Index Medicus and struggled to find the references we needed, regardless of the dates of their publication. Now, however, MEDLINE has made our tasks easier by far, but it has limited us to work published from 1966 onward. This imposes on each investigator the need to search for work done previous to 1966 or to use the bibliography of the articles retrieved via MEDLINE. It is this latter activity which seems to have been lost. Now that 33 years of literature have accumulated in MEDLINE, it appears to many that all that we need to know and quote from the literature in order to publish the current paper exists in this easy-access form. As a result, original descriptions are often not quoted, and brilliant work done more than 33 years ago, deserving of recognition even today, simply disappears.

What brought this to mind was a personal encounter with the fault. In the article by Vasquez and colleagues¹ on blastomycosis in northeast Tennessee, which appeared in the August 1998, issue of CHEST, a reference was made to the primary pulmonary nature of most cases of blastomycosis. The source of this fact was given as an article by Bradsher² from 1992. The origin of the concept, a very important one indeed, was the work of Jan Schwarz³ published in 1951 and with which I had personal involvement. At the time, this work was hotly contested, but finally accepted, and Dr. Schwarz assumed his place among the pantheon of contributors to our understanding of deep fungal diseases and the similarity, pathogenetically, of many of them to tuberculosis.

In the paper by Vasquez and coworkers,¹ the opportunity to accredit a fact to its originator was lost, perhaps due to the absence from MEDLINE of the seminal paper by Dr. Schwarz.³ I am certain that no malintent existed. It is clear, however, that the paper of Dr. Vasquez and colleagues¹ is representative of current style that does not demand of authors the same degree of scholarship that was characteristic of an earlier age.

Excuses abound; no time, too much new literature to keep up with, the seductive impact of modern technology, and others. Thus, a certain elegance in medical writing has fallen by the wayside. I personally regret this development as what success we have in medicine is based in great part on the achievements of those who preceded us. To acknowledge their work is the responsibility of all who publish. Thus, the wonder of MEDLINE has come with a price; it reduced the level of our scholarship, or at the very least, it nurtured the human tendency towards laziness, of which we are all guilty from time to time.

Being aware of the challenge to our scholarship imposed by the leap forward that MEDLINE has brought, should put this matter on the agenda of all who engage in medical publishing. I believe it behooves all of us who presume to share our experiences in research and investigation by means of publications in medical journals to make the extra effort to find the primary source of the information upon which we base our current work. After all, those earlier investigators worked harder than we do; they didn't have MEDLINE!

References

1. Vasquez, JE, Mehta, JB, Agrawal, R, et al (1998) Blastomycosis in northeast Tennessee. Chest 114,436-443[Abstract/Free Full Text]
2. Bradsher, RW (1992) Blastomycosis. Clin Infect Dis 14(suppl),882-890
3. Schwarz, J, Baum, GL (1951) Blastomycosis. Am J Clin Pathol 21,999-1029[ISI][Medline]

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This Article Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (3) Citing Articles via Google Scholar Google Scholar Articles by Baum, G. L. Search for Related Content PubMed PubMed Citation Articles by Baum, G. L.