Delivering Biomedical Information Services In FY13, NLM expanded the quantity and range of high quality information available to researchers, health professionals, and the public. Among the NLM's intramural programs that contribute to its national biomedical information services are the following examples: PubMed/MEDLINE: PubMed, which incorporates MEDLINE, is NLM's premier bibliographic database with over 23 million references to biomedical journal articles. MEDLINE articles are indexed by experts using the Medical Subject Headings (MeSH) controlled vocabulary, updated annually. In FY13, more than 700,000 new indexed citations were added. Also in FY13, NLM expanded the use of automated indexing technology to increase efficiency. PubMed Central: The PubMed Central archive of over 2.8 million full-text journal articles is central to the NIH effort to make accessible the published results of research it supports. In FY13, NLM introduced PubReader, an innovative interface designed to enhance readability and navigation of articles in PMC, particularly on tablet and other small screen devices. MedlinePlus and MedlinePlus en espanol: These consumer health information resources cover more than 900 topics, in more than 40 languages. MedlinePlus Connect, linking electronic health records to MedlinePlus drug information and health topics by leveraging standardized codes and vocabularies required for meaningful use, was expanded in FY13. Clinical Trials: ClinicalTrials.gov covers more than 150,000 clinical research studies in nearly 180 countries, with hundreds added weekly. It also contains summary information about trial results, including adverse effects, in accordance with the FDA Amendments Act of 2007 (PL 110-85). In FY13, more than 18,500 new trials were registered. Summary results, including adverse event information, of more than 2000 trials were also added, bringing the total summary results to more than 10,000. Toxicology and Environmental Health: Toxicology Data Network (TOXNET) is a primary reference for toxicologists, poison control centers, public health administrators, physicians and other environmental health professionals, and includes databases such as TOXLINE, GENE-TOX, Toxic Release Inventory, Hazardous Substances Data Bank (HSDB), and LiverTox, produced with NIDDK. In FY13, NLM continued efforts to expand information about the effects of nanomaterials. Drug Information Resources: Drug information resources include DailyMed and Pillbox. DailyMed provides medication content and labeling information from medical package inserts for more than 55,000 marketed drugs. Pillbox enables rapid identification of unknown solid-dosage medications based on physical characteristics and high-resolution images. Both are linked to NLM's RxNorm standard drug names. Disaster Preparedness and Response: NLM's Disaster Information Management Research Center facilitates access to disaster information, promotes effective use of libraries and disaster information specialists for disaster management, and supports initiatives to ensure uninterrupted access to critical health information resources when disasters occur. A continuing collaboration with the Bethesda Hospital Emergency Preparedness Partnership (BHEPP) provides backup communication systems and tools for patient tracking, information access, and responder training. DIMRC produces WISER, CHEMM, and REMM, emergency responder tools for hazardous materials (Hazmat) and chemical, biological, radiological, and nuclear (CBRN) incidents. Molecular Biology, Bioinformatics, and Human Genome Resources: NCBI resources include more than 40 integrated molecular biology databases and bioinformatics software tools such as GenBank, Entrez, BLAST, RefSeq, dbGAP, Genomes, Genetic Testing Registry, the NCBI software toolkit, and MedGen released in FY13. NCBI also provides access to PubMed, PubMed Central, and the Books database. Continuing areas of emphasis in FY13 included addressing the impact of enormous quantities of data emanating from high throughput sequencing and microarrays;improving methodology for representing mammalian genome assemblies;organizing data from genome-wide association studies;and enhancing the interfaces to journal literature retrieval to facilitate search and discovery. NCBI also began pilot projects with CDC and FDA to apply whole genome sequencing for real-time monitoring and investigation of outbreaks of food borne illness. Outreach: Promoting Public Awareness and Access Consumer health websites and the NIH MedlinePlus Magazine, in English and Spanish, transmit the latest useful research findings in lay language. NLM outreach programs enhance awareness of its information services, with emphasis on underserved populations, including African American, Hispanic, and Native American communities, as well as health professionals serving minority populations and practicing in rural and inner city communities. In FY13, dozens of community-based projects were funded. Health Services Research NICHSR promotes access to public health and health services research through such information systems as: HSRProj, a database of more than 9000 health services research projects from more than 110 funding organizations;HSRR, a database of research datasets, instruments and software relevant to health services research;and HSTAT, a full-text database of high quality evidence reports, guidelines, technology assessments, consensus statements, and treatment protocols. Structured search queries are developed to aid in searching PubMed, ClinicalTrials.gov, and HSRProj for information on health services research, comparative effectiveness, health disparities, and HealthyPeople 2020 objectives. Advanced Information Systems and Research Tools In FY13, LHC and NCBI continued to conduct research in biomedical informatics and computational biology, tested the effectiveness of medical informatics interventions, and developed new scientific computing tools. To cite a few examples, intramural researchers developed tools that support standards-based personal health records;released a new set of high resolution pill-images for use in advanced imaging research;applied natural language processing methods to extract information from biomedical literature and to triage and answer certain types of inquiries from the general public;designed improved methods for integrated search and discovery across multiple databases;and provided expertise for the trans-NIH Big Data to Knowledge (BD2K) initiative to increase data sharing make research data more broadly available, useful, discoverable, and linked to the scientific literature. Health Data Standards: As the central coordinating body for clinical terminology standards within HHS, NLM supports nationwide implementation of an interoperable health information technology infrastructure and provides essential tools for meaningful use of electronic health records (EHRs). NLM develops, supports, or licenses for free US-wide use the key clinical terminologies designated as standards for U.S. health information exchange. The Unified Medical Language System Metathesaurus, with more than 11 million concept names from more than 160 vocabularies, is a distribution mechanism for standard code sets and vocabularies used in health data systems. NLM also produces RxNorm, a standard clinical drug vocabulary;supports the LOINC nomenclature for laboratory tests and patient observations;and promotes international adoption of the SNOMED CT clinical terminology. In FY13, In FY13, NLM released a new Value Set Authority Center that to provide ready access to vocabulary value sets for CMS-required clinical quality measures, expanded drug class information released with RxNorm, released a new US edition of SNOMED CT that combines the international
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