Government Health Sites

Government health web sites; a primer

By Gary Bryant

All
significant medical research has one thing in common: government
participation in the form of regulation or funding, or often
both. Consequently, the Federal government should be your first
stop for health information. Most of the health information
provided by the government will come through agencies of the Department
of Health and Human Services (HHS). Through any of its major
health information gateways, you can get information on clinical
trials, research centers, medical devices, and background information
on virtually all diseases and conditions. Below is a list of the more
significant Federal sites.

FirstGov.gov
http://www.firstgov.gov/

With more than 186 million Web pages, FirstGov.gov is the gateway to
every agency, database, publication, and policy that the federal
government intends the public to see. FirstGov.com. is operated by
the General Services Administration (GSA) The home page includes a
welcome message from the President. Content is organized under
four tabs. While not specifically a medical or health site,
FirstGov.gov can provide you with resources for Medicare and Medicaid
as well as an ample supply of consumer education
material. FirstGov.gov has been in operation since September of
2000. One sub-site to note is FirstGov for Science. It is one of
several portals into the health activities of the federal government.
Be sure to check out this link. http://www.science.gov/browse/w_127.htm

National Library of Medicine (NLM) Gateway

http://gateway.nlm.nih.gov/gw/Cmd

Developed
by the Lister Hill National Center for Biomedical Communications
(LHNCBC), the NLM Gateway is part of the National Institutes of Health
(NIH). More than a health portal, the NLM Gateway is a meta search
engine that will provide access to a number of ”retrieval
systems”. (At the time of this writing, integration of the system was
not yet complete.) From the NLM Gateway you will be able to search
the following databases: MEDLINE/PubMed, OLDMEDLINE, AVs LOCATORplus,
AVs LOCATORplus, ClinicalTrials.gov, DIRLINE, Meeting Abstracts and
HSRProj.

Medlineplus
http://www.nlm.nih.gov/medlineplus/

Medlineplus
is operated by the NLM and should be considered your first stop for any
medical investigations. Working in cooperation with the NIH,
Medlineplus provides one stop access to a wide range of health
education and medical information services including medical literature
databases, direct access to research studies through
ClinicalTrials.gov, an illustrated medical encyclopedia, full text
access to detailed drug information, a medical dictionary, and
a large resource directory to help you locate hospitals, doctors,
societies, nonprofit support groups, and other health resources.

PubMed
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

PubMed
is a cooperative effort of the National Center for Biotechnology
Information (NCBI), the NLM, and the NIH. PubMed uses a search
retrieval system called Entrez, which is also used by a number of other
science databases. It is an extremely powerful text-based search
engine that can access citations in medical journals. A feature
called Linkout connects the user with the full articles of cooperating
journal publishers. In addition, PubMed provides access to the
Medline citation database of more than 4,500 journals from more than 70
countries. 

ClinicalTrials.gov
http://www.clinicaltrials.gov/

Clinical
trials are extremely important to medical research. They are required
to determine whether or not a specific drug or treatment is safe and
effective. Clinical trials are usually managed by the sponsoring
agency, which can be a university, non-profit research center, the
federal government or a private pharmaceutical
company. ClincialTrials.gov exists to provide medical
professionals and health consumers with access to clinical trial
information. The site currently lists more than 8,000 clinical
trials from more than 70 countries. Participation in a clinical trial
has advantages and responsibilities. It is an opportunity to contribute
to the body of science that may lead to health benefits for many
people. Each clinical trial listing a ClincialTrials.gov includes
a summary of the study’s purpose, the status of the study, whether it
is accepting participants, the criteria for acceptance, and specific
contact information.

On
ClinicalTrials.gov, there are a number of ways to create a search
query. You can browse through listings by disease, treatment, and
location. Your best bet, however, is to use the ‘focused search’ option
which provides a pre-formatted search form allowing you to quickly hone
your search results.

TOXNET – Toxicology Data Network
http://toxnet.nlm.nih.gov/

Wouldn’t it be great to have a single Web site where you could learn
about the impact of various chemicals on our environment, our food, and
our medicines? TOXNET is just that and more. An outgrowth of the
NIH Toxicology and Environmental Health Information Program
(TEHIP) , TOXNET aggregates the data from a number of chemical
databases under one Web site. The site includes links to consumer
information, and tutorials bibliographies. It also integrates with
the following databases.

“The Hazardous Substances Data Bank (HSDB) contains records on
over 4,500 toxic or potentially toxic chemicals.

“TOXLINE®, with over 3 million entries, lays out the effects of drugs and other chemicals.

“ChemIDplus is the chemical database version of MeSH, providing
nomenclature information to identify chemical substances cited in NLM
databases.

“The Integrated Risk Information System (IRIS) includes Environmental
Protection Agency (EPA) health risk assessment and regulatory
information on over 500 chemicals.

“The Chemical Carcinogenesis Research Information System (CCRIS),
sponsored by the National Cancer Institute (NCI) includes evaluated
data and information derived from short- and long-term bioassays on
over 8,000 chemicals.

Other
accessible databases include the Toxic Chemical Release Inventory
(TRI), GENE-TOX, a toxicity database of more than 3,000 chemicals
created by the EPA y, and the Developmental and Reproductive
Toxicology/Environmental Teratology Information Center Database
(DART®/ETIC) covering toxicology literature collected since 1950.
Users may search all databases at once or individually. Additional
resources are available including an extensive help system.

National Center for Biotechnology Information (NCBI)
http://www.ncbi.nlm.nih.gov/

The
days of a single gray-bearded scientist working in a flask-filled
basement laboratory are long gone. Today, computers, software, and
large communications networks have become integral parts of the health
landscape. From DNA sequencing to stem cell research, mountains of
medical data require Herculean efforts to organize, track, and apply.
The NCBI is the government’s hot bed of scientific discovery. The
Web site opens on a rich collection of databases, tools, and resources
that can help any serious student of medical research. Home to PubMed
Central, the NCBI Web site provides links to GenBank, a database of
nucleotide sequences from more than 130,000 organisms, a number of
molecular databases, genomes, literature databases, science tutorials,
and a download area.

Genetics Home Reference

http://ghr.nlm.nih.gov/

This
easy to use Web site provides information on genetic diseases and
conditions caused by genetic disease. As of this writing, the site has
cataloged 58 genes and 72 genetic conditions. The site also has a
very comprehensible primer on genetic science, a genetic glossary, and
links to additional genetic resources.
 
Genetics and Rare Diseases (GARD) Information Center

http://rarediseases.info.nih.gov/index.html

The
NIH is offering healthcare professionals free assistance on two fronts
in the form of its recently established GARD Information Center. Funded
by the NIH’s National Human Genome Research Institute (NHGRI) and the
Office of Rare Diseases (ORD), the center provides healthcare
professionals and their patients with immediate access to experienced
information specialists who can furnish current and accurate
information about more than 6,000 genetic and rare diseases. According
to the Web site administrators, the GARD Information Center was
established in February 2002. Since then GARD has responded to
nearly 4,000 inquiries on rare and genetic diseases. The requests
include many queries from physicians, nurses and other healthcare
professionals, as well as patients and their families who have
been directed to the site by healthcare professionals.

Medical Subject Headings (MeSH)
http://www.nlm.nih.gov/mesh/meshhome.html

This is a helpful site if you are planning detailed research using
PubMed.gov. The MeSH Web site does not have any articles,
reports or other medical data per se, but it does provide a resource
for using correct terminology to formulate your search. All of the
citations used in Medline/PubMed are indexed according to MeSH
standards.

Centers for Disease Control and Prevention (CDC)
http://www.cdc.gov/

The CDC is another mega-resource for health researchers. An HHS agency,
the CDC is focused primarily on public health issues. On your
first visit, you will notice an immediate emphasis on infectious and
emerging disease. The pages offer a wealth of statistics on
every health topic imaginable. CDCWonder, a search tool deployed on the
site, allows visitors to query a large collection of reports,
publications, and health data. While CDCWonder does have a
registration option, like all federal health Web sites, it does not
require any type of login or registration. Additionally, all
services, Web pages, and online tools are available at no cost.

Food & Drug Administration (FDA)
http://www.fda.gov/ 

More
than any other government agency, the FDA is directly involved in the
regulation of those things that affect our health. Thus, the FDA
Web site is a major source of health information. Here is a
quotation from their Web site: ”It’s FDA’s job to see that food is
safe and wholesome; that cosmetics won’t hurt us; that medicines and
medical devices are safe and effective; and that radiation-emitting
products are not harmful.”Like many other government agencies, the FDA
has gone to great lengths to provide as much information as possible on
its Web site. Although you may occasionally find yourself on a
page that was last updated several years ago, the good news is that
responses to questions are provided in fairly short order. Make
sure you visit the ‘about’ section of the FDA Web site. There is a
free Web-based course that provides an excellent overview of the
agency’s activities and responsibilities, which are addressed through
an organization of ‘centers’. Below is a list of the most
important centers related to consumer health issues.

Center for Drug Evaluation and Research (CDER)
http://www.fda.gov/cder/

The most important responsibility of the CDER is to monitor clinical
trials. Their mission is to protect the rights of participants and
maintain the integrity of the resulting data from those
trials. CDER reviews the results of clinical trials and if the
benefits outweigh the risks, they approve the drug.
The CDER Web site provides links to a number of useful resources including:

“The Electronic Orange Book  a valuable resource for obtaining patent information on pharmaceuticals

“The National Drug Code Directory  primarily a universal
identifier mechanism for prescription drugs

“Consumer Resources  a well stocked shelf of electronic brochures and
other consumer-oriented information about the safe use of drugs

“MedWatch 
a service of the FDA designed to keep the public  informed about
safety alerts on medicines and medical products that have already
entered the marketplace

Center for Devices and Radiological Health (CDRH)

http://www.fda.gov/cdrh/

Whether
it is a drug or a new procedure, the process usually involves a
delivery mechanism, which usually takes the form of a medical device.
These devices fall under the jurisdiction of the CDRH. Medical
devices play an important roll in diabetes, vision treatments,
including LASIK, CT scanning, breast implants, and more. It is easy to
see why the information provided on this site is so important.

Center for Biologics Evaluation and Research (CBER)
http://www.fda.gov/cber/

Through the CBER, the FDA addresses its responsibility for the safe
supply of blood and blood products. The CBER is also involved in
vaccines, allergens, genetic research, tissue transplantation, and host
of other health-related biological activities.

Office of Special Health Issues (OSHI)

http://www.fda.gov/oashi/home.html

With
primary focus on HIV/AIDS and cancer, OSHI provides a clearinghouse for
medical information on these diseases. OSHI also offers a patient
representative program through which patients and their families can
provide a unique perspective to the FDA regarding specific diseases.

Excerpt from Searching the Web for Health
© February 2004