Workshop - Searching the Orthopaedic Internet
Overview
This workshop will examine strategies for finding material posted on the Internet (as opposed to journal articles in Medline). To give us focus we will consider Pilon Fractures as a subject.
We will use all categories of Internet searching devices - Google as a representative General Search Engine, OrthoSearch, OrthoGuide and OWL.
Just to show that there is valuable information about the subject on the Internet we will start by accessing Wheeless' Textbook. Go to the Main Menu http://www.medmedia.com/med.htm and click on Fractures to bring up the Fracture Index http://www.medmedia.com/orthoo/41.htm Scroll down the list of fractures to find Pilon Fractures and click on that to open the page entitled Tibial Pilon Fracture http://www.medmedia.com/ooa1/52.htm. This page has a comprehensive description of the injury, classification and management strategies with 25 illustrations and 18 references. Reference to Wheeless' Textbook should always be the first step in a review of an orthopaedic subject on the Internet IMHO.
From the very specific we will now turn to the most general search engine and use Google and compare it with Yahoo and Excite
Click on the link to Google and enter the words pilon fracture in the search box. (Note the illustrations on this page do not work)
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You will retrieve approx 900 pages with a high degree of relevance. The first 20-30 pages are focused on Pilon Fractures as the main subject. Thereafter the subject may be more incidental to the main subject of the page. Nevertheless the extensive treatment of ankle fractures from the Emergency Room point of view found on the eMedicine Site came up in the second hundred links of this collection. Towards the end of the collection you find pages which have the words Pilon and Fracture on them but which may have nothing to do with the subject.
Using Excite
over 14,000 pages were found but only the first 4 were relevant. Clearly the database, the searching algorithm and the relevance algorithm are different between the two search engines. One might suspect that Excite searches for Pilon OR Fracture and Google for Pilon AND Fracture.
Yahoo has an index site which can be browsed but if the subject does not appear in the index the search is automatically switched to Google, so with this subject you get the same list of sites that you got from Google.
Fast is another powerful search engine. It appears to have a very sophisticated relevance algorithm because it selected 163 pages (only) but they were all highly relevant. I noted that the search engine automatically rewrote the search string as "pilon fracture" making it a two word phrase.
AltaVista is another well established search engine. Searching for pilon fracture yielded over 290,000 pages but only the first 50 or so were relevant. It appears that Altavista's default in this situation would be pilon OR fracture. A search for "pilon fracture" (in quotes) yielded 66 highly relevant pages.
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OrthoGuide ( http://www.orthoguide.com ) is a subject specific search engine that searches a diverse collection of links for the target search string. Unlike the major search engines and Orthosearch it only looks for the target in the title of the page. Enter pilon fracture in the search box and make sure that you check the radio button for match entire phrase; otherwise it will provide the addresses of 93 pages about other fractures! There are no pages specifically about pilon fractures in this search engine's database.
The Orthosearch search engine is based on a database and will not work except on its own page; however the interface will be similar to the above. Go to the website, type Pilon fracture in the box and accept the default "in Teaching Resources". You will then see the page headed as above. The search is partitioned into several categories as noted. The Teaching category is the most successful, finding the Wheeless' Textbook pages and pages on World Ortho. Another category which is frequently useful is Journals as the database includes a number of journal tables of contents and you can find titles and abstracts of articles. In this particular case searching in the journals category is not very rewarding.
The two main problems with Orthosearch are the difficulty of keeping it up to date and the difficulty of reviewing orthopaedic topics. The OWL collection of orthopaedic links is part of the Orthosearch database but not the Orthopaedic Topics categories. This means that many interesting orthopaedic sites are not in the Orthosearch database as yet.
OWL (Orthopaedic Web Links) is a browsable collection of links with special interest to orthopaedic surgeons. Click on the link to the front page then select Orthopaedic Topics ( http://owl.orthogate.org/topics.html ) Click on Trauma and the Ankle to see the Internet pages on this topic in the OWL collection. There is only one of note, the AO protocol for management of Pilon Fractures from University of Alabama http://www.ortho.uab.edu/sub_spclty/trauma/trauma.html#PilonFrac Note that despite the respect and strong connections between OWL and Wheeless' Textbook the pages on this subject were not specifically linked. Like many other Internet resources OWL needs to be regularly updated and checked for dead links. For further details about this site see the OWL Workshop
Summary
This workshop serves to emphasize two things. The first is that there is a good deal of high quality information on orthopaedic subjects on the Internet. The second is that searching needs to be multifaceted if you are to be successful finding everything of value. If you wish only to find an authoritative accounts it would be best to see what Wheeless has to offer. You can then widen the net by using the Orthosearch engine or the browsable OWL collection.These collections are the most comprehensive subject specific aids to searching the Orthopaedic Internet. However, they do not cover the ground completely. If there is still a feeling that more information should be sought then a search through a number of the major search engines should be undertaken.
Very often the amount of information one gets from the first attempt at a search is inappropriate, either too much or too little. For most of the search engines the only way to improve this situation is to alter the search string using Boolean Logic to broaden or narrow your search.