Although the British Library is open to those who has a genuine need to use its collections, most of its electronic resources and journal collections are only available from the BL workstations within the Library's Reading Rooms and Business & IP Centre, to access this resource you need to apply for a Reader Pass.
A Reader Pass will be given if you have a legitimate personal, work-related or academic research purpose or if the specialised material you wish to use is unavailable in other public or academic libraries.
You can apply in person at the Reader Registration office at the British Library's main site, 96 Euston Road, St Pancras, London NW1 2DB
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Opening hours: 10am-8pm Monday; 9.30am-8pm Tuesday – Thursday; 9.30am-5pm Friday and Saturday
Thursday, July 18, 2013
What are open access journals?
Open-access journals are scholarly journals available online to everyone without restriction. Most of these journals are available 12 months after publication but some are available immediately.
Some major sources of open access journals in biomedicine :
Some major sources of open access journals in biomedicine :
- PubMed Central® (PMC) : A free archive of biomedical and life sciences journal literature at the U.S. National Institutes of Health's National Library of Medicine. Launched in February 2000, PMC is a repository for journal literature deposited by participating publishers as well as authors worldwide. Publishers and individual authors continue to hold copyright on their material in PMC and users must abide by the terms defined by the copyright holder.
- Europe PubMed Central :
The UK PubMed Central, mirrored on the US PMC was funded and developed by the Wellcome Trust and the British Library and available in January 2007. On 1 November 2012, it was rebranded Europe PubMed Central to reflect its wider international scope and content. This will increase the volume of open access material available to researchers, academics and the public. - BioMed Central
- Free Medical Journals Online Most titles are free 6 months after publication, some after a year.
Why we can't trust clinical guidelines - BMJ
Clinical guidelines are recommendations on the appropriate treatment and care of people with specific diseases and conditions. They are based on the best available evidence with the aim to help healthcare professionals in their work, but they do not replace their knowledge and skills.
A recent article published in the BMJ, written by a medical investigative journalist, raised the issue that despite repeated calls to limit conflicts of interests among authors and sponsors of clinical guidelines, the problem persists.
The article refers to the drug alteplase, a clot-busting drug given for acute stroke, the guideline recommendation was based on 12 studies, but only two of them found any benefit, and five of them had to be stopped early due to increased risk of brain haemorrhage or increased death rates.
Another example is the conflict between the 1990 guidelines recommending steroids for acute spinal injury and the 2013 cllinical recommendations against using steroids in acute spinal injury.
Based on a poll, the author finds that many doctors know that many guidelines are not supported by research evidence but would continue prescribing the treatment for the fear of "malpractice" or criticism by colleagues if they fail to follow the standard.
Another conflict of interest raised in the article is that many of the guideline committee members and panellists have strong ties with the industry and that their connection would have significant influence in deciding the best guidelines on good medical care and what doctors should prescribe. The author concluded that these problems are wide spread and this is the opportunity that the medical profession takes a long hard look at itself.
According to the BMJ website, this article is one of the most read and has sparkled a lot debate among the readers.
One of the responses came from the Delfini group (US) - saying that large number of physicians and others involved in health care decision-making may not understand that many research studies are not valid or reported sufficiently, they may also lack the skills to be able to critically appraise the research evidence. The remedy is ensuring the transparency in guidelines and that all guideline developers have basic critical appraisal skills.
Source : Jeanne Lenzer. Why we can’t trust clinical guidelines. BMJ 2013;346:f3998 (Published 19 June 2013) full text via Athens
Read all the responses
A recent article published in the BMJ, written by a medical investigative journalist, raised the issue that despite repeated calls to limit conflicts of interests among authors and sponsors of clinical guidelines, the problem persists.
The article refers to the drug alteplase, a clot-busting drug given for acute stroke, the guideline recommendation was based on 12 studies, but only two of them found any benefit, and five of them had to be stopped early due to increased risk of brain haemorrhage or increased death rates.
Another example is the conflict between the 1990 guidelines recommending steroids for acute spinal injury and the 2013 cllinical recommendations against using steroids in acute spinal injury.
Based on a poll, the author finds that many doctors know that many guidelines are not supported by research evidence but would continue prescribing the treatment for the fear of "malpractice" or criticism by colleagues if they fail to follow the standard.
Another conflict of interest raised in the article is that many of the guideline committee members and panellists have strong ties with the industry and that their connection would have significant influence in deciding the best guidelines on good medical care and what doctors should prescribe. The author concluded that these problems are wide spread and this is the opportunity that the medical profession takes a long hard look at itself.
According to the BMJ website, this article is one of the most read and has sparkled a lot debate among the readers.
One of the responses came from the Delfini group (US) - saying that large number of physicians and others involved in health care decision-making may not understand that many research studies are not valid or reported sufficiently, they may also lack the skills to be able to critically appraise the research evidence. The remedy is ensuring the transparency in guidelines and that all guideline developers have basic critical appraisal skills.
Source : Jeanne Lenzer. Why we can’t trust clinical guidelines. BMJ 2013;346:f3998 (Published 19 June 2013) full text via Athens
Read all the responses
Is using surgical death rates the best way to assess performance - The Lancet
The NHS England made public the mortality rates of 7 types of surgery for individual surgeons last week by publishing the data on the NHS Choices website with the aim that it would provide transparency, help patients choose their surgeons and improve the quality of care.
However a study carried out by researchers at the London School of Hygiene & Tropical Medicine, published in the Lancet, said concentrating on the death rates for individual surgeons will not spot poor performance in certain fields and could lead to "false complacency".
The researchers argued that for some specialties, the number of procedures that a surgeon does annually is low, so the chance of identifying poor performance is also low. Based on the number of surgeries performed over 3 years, they found that 75% of UK heart surgeons perform sufficient procedures to give 60% power to use death rate to identify the poor peformance, 56% perfom enough procedures to give 80% power. However, for other procedures, the number of surgeons performing enough surgeries is much lower, eg for bowel resection, only 17% of surgeons perform enough of these surgeries to give 60% power to use death rate to identify the poor peformance and no surgeons perofrm enough surgeries to give 80% power.
They also noted that experienced surgeons my be more likely to operate in high- risk cases that may have much higher risk of mortality, this does not necessarily indicate poor performance of these surgeons.
The authors recommended a number of options to assess performance more reliably including pooling death data over a longer period of time, pooling death rates within specialties or per hospital. Other patient outcomes, such as post-operative bleeding, bleeding, infection, pain , further surgery or readmission could also provide better assessment of surgical performance.
Source: Walker K, Neuburger J, Groene O, et al. Public reporting of surgeon outcomes: low numbers of procedures lead to false complacency. The Lancet. Published online July 5 2013 ( f/t via Athens)
However a study carried out by researchers at the London School of Hygiene & Tropical Medicine, published in the Lancet, said concentrating on the death rates for individual surgeons will not spot poor performance in certain fields and could lead to "false complacency".
The researchers argued that for some specialties, the number of procedures that a surgeon does annually is low, so the chance of identifying poor performance is also low. Based on the number of surgeries performed over 3 years, they found that 75% of UK heart surgeons perform sufficient procedures to give 60% power to use death rate to identify the poor peformance, 56% perfom enough procedures to give 80% power. However, for other procedures, the number of surgeons performing enough surgeries is much lower, eg for bowel resection, only 17% of surgeons perform enough of these surgeries to give 60% power to use death rate to identify the poor peformance and no surgeons perofrm enough surgeries to give 80% power.
They also noted that experienced surgeons my be more likely to operate in high- risk cases that may have much higher risk of mortality, this does not necessarily indicate poor performance of these surgeons.
The authors recommended a number of options to assess performance more reliably including pooling death data over a longer period of time, pooling death rates within specialties or per hospital. Other patient outcomes, such as post-operative bleeding, bleeding, infection, pain , further surgery or readmission could also provide better assessment of surgical performance.
Source: Walker K, Neuburger J, Groene O, et al. Public reporting of surgeon outcomes: low numbers of procedures lead to false complacency. The Lancet. Published online July 5 2013 ( f/t via Athens)
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