Delivering Biomedical Information Services In FY14, NLM greatly 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: PubMed: PubMed, which incorporates MEDLINE, is NLM's premier bibliographic database with over 24 million references to biomedical journal articles. MEDLINE articles are indexed by experts using the Medical Subject Headings (MeSH) controlled vocabulary, updated annually. In FY14, over 760,000 new indexed citations were added. NLM released PubMed Commons to enable authors to share opinions and additional information about scientific publications, as a potential aid to improving reproducibility of experiments. Also in FY14, NLM expanded use of automated indexing technology to increase efficiency. PubMed Central (PMC): The PMC archive of over 3.2 million full-text journal articles is central to the effort to make published results of NIH-supported research publicly accessible. In FY14, four other U.S. agencies committed to using PMC to provide public access to published results of research they support. MedlinePlus and MedlinePlus en espanol: These consumer health information resources cover over 900 topics, with selected materials 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 to include linking to content in Genetics Home Reference. Clinical Trials: ClinicalTrials.gov covers over 175,000 clinical research studies in more than 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 FY14, more than 22,000 new trials were registered. Summary results of more than 3,600 trials were added, bringing the total to over 14,000. 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, ToxMap and HaxMap. Drug Information Resources: Drug information resources include DailyMed and Pillbox. DailyMed provides medication content and labeling information from package inserts for more than 66,000 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 for disaster management, and supports initiatives to ensure uninterrupted access to critical health information resources when disasters occur, such as the Ebola outbreak in FY14. DIMRC produces WISER, CHEMM, and REMM, emergency responder tools for hazardous materials (Hazmat) and chemical, biological, radiological, and nuclear (CBRN) incidents. DIMRC also continued collaborations to develop tools for redundant communication systems, adverse event reporting, and family reunification. The FaceMatch project supports family reunification initiatives by providing near-duplicate image detection for photos of variable quality. 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 ClinVar. Continuing areas of emphasis included addressing the impact of enormous quantities of data emanating from high throughput sequencing and microarrays;improving methodology for representing mammalian genome assemblies;organizing phenotypic and genotypic data from genome-wide association studies;and enhancing interfaces to journal literature retrieval to facilitate search and discovery. NCBI also is a key participant in the food pathogen project with the CDC, FDA, and Dept. of Agriculture, developing the database and analytic tools to use high throughput sequencing to more rapidly and accurately identify pathogens causing food-borne illnesses. OutreachPromoting 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 FY14, 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, covering nearly 10,000 ongoing or recent health services research projects from nearly 150 funding organizations;HSRR, a database of research datasets, instruments and software relevant to health services research;and HSTAT, containing 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, population health, health disparities, and Healthy People 2020 objectives. Advanced Information Systems and Research Tools: 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 enhanced tools that support standards-based personal health records;developed open-source programming pipelines that convert CT data to 3-D printable models;enhanced the online, image-based colposcopy Teaching Tool, deployed in over 128 medical residency programs;improved methods for integrated search and discovery across multiple databases;and provided expertise for the trans-NIH Big Data to Knowledge (BD2K) initiative to 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 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 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 150 vocabularies, is a distribution mechanism for standard code sets and vocabularies used in health data systems. NLM 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 FY14, NLM enhanced its Value Set Authority Center to improve access to vocabulary value sets for CMS-required clinical quality measures and support their authors;updated key vocabulary mappings and subsets useful in achieving meaningful use;improved user support and educational resources for SNOMED CT users;and further enhanced its suite of APIs for drug vocabulary.
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