Delivering Biomedical Information Services In FY17, NLM greatly expanded the quantity and range of high quality information and data available to researchers, health professionals, and the public. Among the NLM's intramural programs that contribute to its national biomedical information services are: PubMed: PubMed, which incorporates MEDLINE, is NLM's premier bibliographic database with over 27 million references to biomedical journal articles. Articles are indexed by experts using the Medical Subject Headings (MeSH) controlled vocabulary, updated annually. In FY17 over 850,000 new indexed citations were added. PubMed Commons, which enables authors to share opinions and other information about scientific publications, potentially helping to improve reproducibility, added comments on nearly 1,400 PubMed records. NLM also expanded use of automated indexing technology to increase efficiency. PubMed Central (PMC): The PMC archive of over 4 million full-text journal articles is central to the effort to make published results of NIH-supported research publicly accessible. As of FY17, PMC also enables public access to published results of research supported by 8 other federal agencies, as well as private and international research funders. MedlinePlus and MedlinePlus en espanol: These consumer health information resources cover over 985 topics, with selected materials in more than 40 languages. In FY17 HealthReach was added to increase coverage of non-English materials. MedlinePlus Connect links electronic health records to patient education information from MedlinePlus by leveraging standardized codes and vocabularies required for meaningful use. Clinical Trials: clinicaltrials.gov covers over 250,000 clinical research studies in 200 countries, with hundreds added weekly. It also contains summaries of trial results, including adverse events. in accordance with the FDA Amendments Act of 2007 (PL 110-85) and the regulations (42 CFR Part 11) implementing PL 110-85. In FY17, about 24,000 new trials were registered. Summary results for nearly 5,500 trials were added, bringing the total to nearly 28,000. NLM staff also assisted NIH in implementing 42 CFR Par 11 and a new policy covering registration and results submission for all NIH-funded trials. Environmental Health and Toxicology: TOXNET is a primary reference for toxicologists, poison control centers, public health officials, physicians and environmental health professionals, and includes databases such as TOXLINE, Toxics Release Inventory, Hazardous Substances Data Bank, ToxMap and Haz-Map. K-12 resources include an environmental health website and the GeneEd resource to support genetics education. Drug Information Resources: These include Drug Information Portal, DailyMed, Pillbox, LiverTox, and LactMed. The portal provides information on drugs from clinical trial to the marketplace. DailyMed provides drug labeling information from package inserts for nearly 90,000 marketed drugs, with improved mobile access; Pillbox enables rapid identification of unknown solid-dosage medications based on physical characteristics and images. Both are linked to NLM's RxNorm standard drug names. LiverTox provides comprehensive clinical, diagnostic and research information and case registry on liver injury due to drugs, herbals and dietary supplements. LactMed is a database of the effects of drugs on breastfeeding mothers and their nursing infants. In FY17 NLM developed a guide to web resources the opioid addiction and treatment. Disaster and Public Health Emergency Preparedness and Response: NLM's Disaster Information Management Research Center (DIMRC) provides access to disaster information, promotes use of libraries in disaster preparedness and response, and supports uninterrupted access to critical health information resources when disasters and public health emergencies occur. DIMRC produces WISER, CHEMM, and REMM, emergency responder tools for hazardous materials and chemical, biological, radiological, and nuclear 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, PubChem, Genetic Testing Registry, and ClinVar. Continuing areas of emphasis include addressing the impact of enormous quantities of data from high throughput sequencing and microarrays; organizing phenotypic and genotypic data from genome-wide association studies; and enhancing interfaces to journal literature retrieval to facilitate search and discovery. In collaboration with CDC, FDA, and USDA, NCBI is using high throughput sequencing to more rapidly and accurately identify pathogens causing food-borne illnesses; similar technology is being applied to develop resources to combat antimicrobial resistance. Outreach Promoting Public Awareness and Access: Consumer health websites and the NIH MedlinePlus Magazine, in English and Spanish, convey the latest useful research findings in lay language. NLM outreach programs, many achieved through the National Network of Libraries of Medicine, enhance awareness of its information services through dozens of library- and community-based projects funded annually, with emphasis on underserved populations. In FY17, the Network started a 3-year outreach effort to support the NIH All of Us Research Program. Health Services Research: NICHSR promotes access to public health and health services research information. ONESearch was introduced in FY17, offering a uniform interface to the databases HSRProj, covering over 33,000 health services research projects-in-progress from over 300 funding sources, and HSRR for research datasets, instruments and software relevant to health services research, and the PHPartners.org and HSRInfo_Central web portals. Structured search queries are developed to aid in searching PubMed for published research on topics such as comparative effectiveness, population health, health disparities, and Healthy People 2020 objectives. Advanced Information Systems and Research Tools: LHNCBC and NCBI continued to conduct research and development in biomedical informatics and computational biology, tested informatics interventions, and developed new scientific computing tools. For example, researchers enhanced tools that support standards-based electronic health records; improved tools to detect tuberculosis in chest x-rays and count malaria parasitic cells in blood smears; improved and extended Open-I for integrated search and discovery of biomedical images and text; and developed automated summarization system for medical articles. Health Data Standards: As the HHS central coordinating body for clinical terminology standards, NLM provides essential tools for meaningful use of electronic health records (EHRs) and health system interoperability. NLM develops, supports, or licenses for free U.S.-wide use the key clinical terminologies (RxNorm, LOINC, SNOMED CT) designated as standards for U.S. health information exchange. The Unified Medical Language System Metathesaurus, with more than 13 million concept names from nearly 200 vocabularies, is a distribution mechanism for standard code sets and vocabularies used in health data systems. In FY17 the AccessGUDID database that links FDA and SNOMED codes was augmented for over 500,000 implantable devices, in support of a 2018 requirement for certified EHRs, and the SNOMED CT to ICD-10-CM map was updated in the I-Magic (Interactive Map-Assisted Generation of ICD Codes) tool that supports interoperability and quality assurance in EHRs. The Value Set Authority Center (VSAC) deepened support of CMS clinical quality measures, and the Common Data Element Repository was augmented with tools and content to facilitate data sharing, aggregation, and
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