National Library of Medicine and Drug Information. Part 1: Present Resources*, The
The National Library of Medicine began in 1836 as a small collection of books in the office of the Army Surgeon General. Today, the National Library of Medicine is the world's largest medical library, providing access to its vast collection of seven million items onsite and through the World Wide Web. Historical interest in drug information dates to 1967, when Congress provided funds for a Drug Literature Program at the National Library of Medicine. Drug information is now dispersed among a number of National Library of Medicine bibliographic and factual databases that offer an array of clinical, research, and toxicological drug data. Target audiences for drug information include consumers, patients, healthcare practitioners, clinical researchers, and scientists. Drug development and medical publishing have both accelerated to such an extent that it is virtually impossible for healthcare practitioners and researchers to keep apprised of current information. Due to wide utilization for posting medically-related data, the internet is discussed in terms of its impact on medical library responsibilities, the need to preserve clinical and scientific information in the public domain, and how such imperatives indicate a need to create new drug-related databases, including an Internet portal to drug information.
Drug information; National Library of Medicine; Internet
The National Library of Medicine (NLM), the world's largest medical library, is a leader in the selection, acquisition, organization, and provision of medically-related literature and data. The NLM is perhaps best known for its bibliographic database MEDLINE. In addition, it offers a vast collection of bibliographic and factual databases, an array of historical, audiovisual, and print materials and, organizationally, includes two biomedical/biotechnology information research centers. Its collections are freely available to users onsite (eg, print and audiovisual materials), or accessible on a global scale through the Internet. Users do not need to register Lo access the NLM's electronic databases.
The NLM has evolved somewhat unevenly over the past 40 years in terms of its focus on drug information. In the mid-1960s a Drug Literature Program was created at the NLM, but it was disbanded within a few years. Since that time, drug information has appeared in various venues and is presently dispersed among several bibliographic and factual databases. Those databases provide drug data that are useful Lo different audiences, including consumers, patients, students of the medical sciences, healthcare professionals, medical researchers and scientists, and persons with an interest in data relating to environmental and occupational toxicology.
The purposes of this paper are to:
1. Present an historical overview of the NLM,
2. Delineate NLM resources that have drug-related content,
3. Describe the transition of medical library roles in a digital era and the impact on provision of medical information,
4. Discuss the need to preserve clinical and scientific data in the public domain, and
5. Present new drug information initiatives at the NLM that could have future importance in meeting systemic needs.
Selected Web links to NLM resources are provided in Table 1.
Since its inception, the NLM has moved through several transformational phases from traditional collection, retrieval, and distribution systems, to embracing the World Wide Web (WWW) as an effective mechanism for providing online information about the library, and disseminating cataloged, bibliographic, full-text journal and factual data. What follows is a synopsis of significant events relating to the NLM's historical progression to the present, with a subsequent focus on drug information. Readers will find a comprehensive and fascinating history of the NLM in W.D. Miles' A History of the National Library of Medicine: the Nation's Treasury of Medical Knowledge, the principal source from which this account is derived (1).
The library's origins began in 1818 with a few books stored in the office of the Army Surgeon General. However, the NLM dates its beginning to 1936, when the first budget request for medical books was prepared by the Surgeon General's office. Until the early 1860s, the small collection of medical books and journals was called the "Library." During the Civil War, the Army Surgeon General procured numerous books and journals for distribution to military hospitals, and published the first library catalog in 1864. In 1862, a building adjacent to Riggs Bank in Washington, D.C. served as the Army Surgeon General's office and the library repository, which moved to Ford's Theatre in 1867.
An assistant surgeon, John Shaw Billings, transferred to the Surgeon General's office in 1865 and within a few years was given sole responsibility for developing the library. Billings set out on a relentless effort to create a "national" medical library while serving as its librarian until 1895. During his tenure, Billings greatly expanded the Army Surgeon General's library into a truly national library for use by both military and civilian physicians, founded the Index-Catalogue and Index Medicus, and gained Congressional support for a new building in Washington, D.C., the Library-Museum Building, to which the library relocated in 1887.
The library continued to grow through several decades and in 1952 was changed from the Army Medical Library to the Armed Forces Medical Library. In 1956, Senators Lister Hill and John F. Kennedy sponsored a bill in Congress "... to promote the progress of medicine and to advance the national health and welfare by creating a National Library of Medicine." Legislation was passed transforming the Armed Forces Medical Library into the NLM and placing it organizationally within the Public Health Service. By 1961, a new building for the NLM was built on the campus of the National Institutes of Health (NIH) in Bethesda, Maryland, and a high-rise building adjacent to the main library named the Lister Hill National Center for Biomedical Communications was finished in 1980.
In 1960, the NLM published Medical Subject Headings (MeSH), a hierarchical controlled vocabulary thesaurus, and initiated development of the Medical Literature Analysis and Retrieval System, or MEDLARS. MEDLARS is a computerized system initially built to produce Index Medicus. The system's capabilities were broadened to publish recurring bibliographic lists on defined medical topics, and to retrieve subjectspecific journal citations by a "demand search." To avoid being overwhelmed by requests for computer searches and build a partnership to provide national access, MEDLARS was formally decentralized as a result of the Medical Library Assistance Act of 1965, which established 11 Regional Medical Libraries throughout the United States. The Regional Medical Libraries had substantial, requisite resources to serve medical, hospital, and community libraries within their jurisdictional areas, and librarians were trained at the NLM to learn how to formulate online searches. By 1973, MEDLINE, an acronym derived from MEDLARS onLINE, was made available for online search and retrieval of catalog and bibliographic data, essentially replacing the batch search service of MEDLARS.
By 1991, the Regional Medical Library program was renamed the National Network of Libraries of Medicine. The National Network of Libraries of Medicine is comprised of eight Regional Medical Libraries, more than 140 resource libraries that are primarily at health sciences schools, and about 4,700 primary access libraries such as hospital libraries. Together, the National Network of Libraries of Medicine form partnerships with a range of organizations to provide access to current health information for healthcare professionals, with an emphasis on those who serve minority groups and/or work in rural areas and inner cities. This was a fundamental shift in the NLM mission, namely, to promote its information services directly to endusers, with medical librarians providing the training and technical assistance needed by health professionals to search its databases (2). In 1997, MEDLINE was made accessible at no cost on the Web, and the Web interface PubMed and its Entre/, system replaced ELHILL as the basic MEDLINE retrieval system.
The NLM continues to expand its information services to healthcare professionals and the public, and to make significant progress in meeting the challenges of a new millennium. For current information about NLM, the National Library of Medicine Programs & Services 2001 is an excellent resource (3).
THE DRUG LITERATURE PROGRAM