Information Technology in Conventional & Complementary Veterinary Medicine

(For an update of this paper, see http://homepage.eircom.net/~progers/itupdate.htm]

Phil Rogers MVB, MRCVS <philrogers@eircom.net>
1 Esker Lawns, Lucan, Dublin, Ireland

Updated for:
25^th IVAS Congress, Lexington, Kentucky, September 1999
Irish Veterinary Association Annual Congress, Ennis, October 1999
British Holistic Veterinary Medical Association Meeting, Leeds, UK, March 2000

Summary | Introduction | New Meta Engines on the Web | Vet AP & General Links Pages on the Web
Online Databases [Medline, Acubriefs, VIN, ISI, CAB, DynaMedical, Cornell Consultant]
Developments in AP Pages on the Web | AP Events WebPages | Software for Cookbook AP
Email Discussion Lists [PA-L, AP Mailbase, PVA-L, Other] | Discussion & Conclusions | References

Summary

Communications, information technology (IT) & areas of professional interest (review articles, clinical papers, new research findings, etc) are changing with awesome speed. We need continuing professional development (CPD) to keep up with very these changes in our professional areas.

Ongoing CPD can be formal, informal, or both. Distance learning (computer-aided learning) is readily available now. Intelligent use of modern IT gives the best prospects for rapid communication between professionals interested in all aspects of Veterinary Medicine, acupuncture (AP) & traditional Chinese medicine (TCM). IT also is the best way to influence sceptical & uncommitted scientific & academic professionals to take our clinical & research findings seriously.

The 1999 paper in Taiwan [http://users.med.auth.gr/~karanik/english/articles/tai98it.html] discussed practical uses of modern IT as aids to research, study & clinical practice in TCM & AP in five areas of IT. These were (a) Distance-Learning; (b) Expert Software Databases, CD ROMS & Diskettes; (c) Professional email Discussion Groups; (d) A new concept of peer review, & (e) A new concept to assess clinical therapies: the International Therapeutic Forum. Because many important topics discussed in Taiwan will be omitted here, readers are referred to that paper for background information.

However, the past year has brought many new developments. This year's paper will discuss:

Introduction

The Law of Change is fundamental in traditional Chinese medicine (TCM) & acupuncture (AP). Adaptation to change in the interior & exterior environment is the key to healthy growth; inability to cope with change is a warning sign of extinction.

Communications, information technology (IT) & areas of professional interest (review articles, clinical papers, new research findings, etc) are changing very fast. The list of life-science journals is extensive & growing. Parallel with developments in allopathic medicine, research & clinical publications on holistic medical areas are becoming more numerous. These complementary or alternative medical areas include physiotherapy, homeopathy, biofeedback, meditation techniques, hypnosis, etc. They also include AP, moxibustion & allied methods. The latter include trigger-point therapy, transcutaneous electrical nerve stimulation (TENS), low level laser therapy (LLLT), phytotherapy & TCM.

Medline indexes > 8000 journals. Their abstracts are available online free from the Medline Journal Browser [http://www.ncbi.nlm.nih.gov/PubMed/jbrowser.html].

To remain technically competent, skilled professionals in medical & paramedical areas need to keep up to date with current knowledge in our areas of expertise. We live in an age of Information Overload. No one person could hope to master all these areas. Therefore we must be selective in our reading, & use efficient ways to locate the articles of interest to our expertise.

On July 27th 1999, Medline had indexed 10,120,573 articles. On that date, it had 7031 articles on AP or moxibustion. For such a large database, this is a very low proportion of AP-moxa articles, representing a rate of only 0.695/1000 Medline hits.

Keeping up-to-date, even in narrow areas, is very difficult. If one were to do nothing else but speed-read from morning to night, no one person, no matter how talented, could hope to read a fraction of the annual output in the total medical area. Then, having located & studied the material of interest, the major problem of human memory is accurate recall of the stored information, & making appropriate conceptual linkages between different "packages of memory-stored data". Most people have poor to only partial recall of data; only those with photographic memories can recall (and link) most of what they have read.

In contrast, computer-memories do not "forget", unless there is disk-failure, or power-failure. Digital data on hard disk or media (CD ROMS, floppy disks, zip disks, etc) usually are retrievable. Modern technology offers fast, easy & total retrieval of stored data. In contrast to human memory, if the data are coded correctly, & if correct search terms are used, every reference to a particular data-string can be recalled.

In the age of "information overload", we need a quick & easy way to filter out the data of most value to us. For example, the monumental work "A Practical Dictionary of Chinese Medicine" (Wiseman & Ye, 1998, Paradigm Publications, Brookline, Mass) has 945 pages of dense text on all aspects of TCM terminology, classical TCM Syndromes, AP points, herbal formulas etc. Assuming a rapid reading rate of 25 pages/h, & a study time of 2h/d, it would take >18 days to "skim" the book once. To absorb its contents would take dozens of readings. Having absorbed them, what would our recall of specific details be 12 or 18 months later? On the other hand, suppose that a CD-ROM, with a proper index/thesaurus, contained the total detail of this work. If one had access to that via a fast computer, one could query any term at any time & locate every bit of detail about that term in minutes.

The GIGO Law: Note that, in computer jargon, GIGO means "garbage in, garbage out!" Keyboards do not refuse keystrokes. If incorrect, misleading or false data are accepted for publication, the reader is exposed to (and may be misled by) those incorrect data.

1. New Meta Engines on the Web

One must use a Web Search Engine to do a general Web Search, say to locate the Internet Address for the Homepage of Acupuncture Supply Houses. Many people know some of the standard Web Search Engines, such as AltaVista [http://www.altavista.com], or Excite [http://www.excite.com]. There are advanced versions of these - AltaVista Advanced Search [http://www.altavista.com/cgi-bin/query?pg=aq&what=web] & Excite Power Search [http://www.excite.com/search/options.html]. These allow the user to impose restrictions on the search; this can return more specific hits.

However, there are new, more powerful engines that search multiple basic engines simultaneously. These are called Meta Search Engines. Good examples are:

SavvySearch is one of the best. It can be customised to search dozens of other engines & newsgroups etc simultaneously.

The main trouble with Web Surfing, even with a powerful Meta Search Engine, is that one must wade through mounds of hits to find the one Page, or few Pages, of direct interest. Also, most Web Pages have vested commercial interest, & can not be regarded with the same degree of trust as the expert scientific databases

2. Vet AP & General Links Pages on the Web

The IVAS Homepage & the AAVA Homepage are now online [http://www.ivas.org/main.cfm & http://www.aava.org/].

2a. International Acupuncture Links Page [http://homepage.eircom.net/~progers/vaplinks.htm] has useful Links, for example to IVAS, IVAD (Intnl Vet AP Directory), & National Vet AP Socs in many countries. See http://www.komvet.at/ivadkom/vapsocs.htm (b, below).

The International Acupuncture Links Page links also to the Vet AP Page, Online Study Materials, Vet AP Events, Databases (Medline, Acubriefs), AP Supplies etc, PA-L & PVA-L. It also has extensive links to most aspects of veterinary medicine. See veturls.htm (2c, below).

2b. IVAD (Intnl Vet AP Directory): Index of Societies & Practitioners (below) [http://www.komvet.at/ivadkom/vapsocs.htm] allows users to locate the National Executive & some members in many countries. Online Registration Forms allow easy updates of details of a Society, or of individual members who want an IVAD Listing.

All IVAD Listees must show either IVAS-Certification, or acceptance by their peers in their National Vet AP Soc. This will ensure that each National Vet AP Soc will police its own members.

2c. The Veterinary Links Page [veturls.htm] has many Links to sites on Agriculture, Veterinary Medicine, Medicine, & Science, Universities, Institutes, Organisations & Libraries. It is very extensive & worth a visit, if not a Bookmark. It is structured as follows:

GENERAL VETERINARY LINKS MENU

3. Online Databases
[Medline, Acubriefs, VIN, ISI, CAB, DynaMedical, Cornell Consultant]

a. MEDLINE is the most powerful database of medicine on the WWW. Until last year, it was also the best online source for free abstracts on AP & TCM. [Since then, Acubriefs, with many more abstracts than Medline, is online].

Medline is a free service, courtesy of the US Government, via the National Library of Medicine. In the last ten years, it has indexed >400,000 titles/year. Of those, papers on AP or moxibustion averaged only 274/year, or only 0.683 AP-Moxa hits/1000 Medline hits:

Assuming a mean of 3-5 pages/article, these articles would contain 1.2 to >2.0 million pages of text/year!

MEDLINE is invaluable for clinicians & researchers who want to access the abstracts of medical & veterinary papers. The next table shows the number of "hits" (titles or abstracts) that contained key words commonly used in alternative- or complementary- medicine.

For those of us who seek to integrate complementary methods into mainstream medicine, the data above make grim reading. They show clearly that publications in complementary methods are a very small part of total medical literature. If we are to make any significant impact on the medical sciences, we must publish much more extensively, & we must have a standard of publication that will reach the journals indexed by Medline.

b. Acubriefs: This is a great resource; 11000+ abstracts / titles on AP. See 3a, above.

c. Veterinary Information Network (VIN) [http://www.vin.com/] is a US-based Online Vet service, but with a growing international membership. It costs circa 400 US$/year, but is a powerful resource. It has extensive Speciality Boards, Bulletin Boards on every conceivable aspects of Vet Med (including Complementary Med & AP), access to abstracts of most Veterinary Journals & a powerful Search Engine to search its entire Site, including its Archived Message Boards.

d. ISI (Inst of Scientific Information) [http://www.isinet.com/index/index.html] & CAB Abstracts (Commonwealth Agricultural Bureau Intnl [http://www.cabi.org/]) are commercial (expensive) Online Databases. They cover the biological sciences, including Agric & Vet Sciences & are essential resources for researchers. However, Vet practitioners can get most abstracts of interest to them free from MEDLINE, or from the Medline Journal Browser.

e. DynaMedical [http://www.dynamicmedical.com/] is an online resource for medical doctors, but Vets may register also. Registered users receive a User ID & Password. Then, they may use the database without restriction. DynaMedical has intensively edited (distilled) practical information on >2000 human diseases, including presenting signs, differential diagnosis, therapy, prognosis & access to key review articles on the main diseases. This is a must for small-animal practitioners, but all Vets with medical queries can get a wealth of technical information here.

 f. Cornell Consultant [http://www.vet.cornell.edu/consultant/consult.asp] is a free Online Diagnostic Package for Vets. It is a powerful resource, & an eye-opener to users not familiar with it. It will remove any illusions that casual Vets may have about their diagnostic ability - the ability to recall all the diseases which may present with a given set of clinical signs.

4. Developments in AP Pages on the Web: Since the Taiwan Congress, there have been great advances in the quality & quantity of information AP-related WebPages. These include:

Also see 2a & 2b, above. 

5. AP Events WebPages

a. The Vet AP Events Page [http://users.med.auth.gr/~karanik/english/articles/sinedrv.htm] allows Vets anywhere to post notices of upcoming Vet AP Events to the Web. Notification is very easy. Go to the Site & fill in the details on the Online Form at the bottom of the Page.

b. KomVet has KomVet Calendar [http://www.komvet.at/english/calendar.htm]. E-mail the details of the event to <redaktion@komvet.at>.

c. IVAS has a Calendar of Events [http://www.ivas.org/calendar/calendar.cfm]. E-mail the details of the event to <IvasOffice@aol.com>.

d. The AP Events Page [http://users.med.auth.gr/~karanik/english/articles/sinedr.htm] also has a similar Events Page for human AP.

6. Software for Cookbook AP: Great developments have occurred in Software for AP & TCM. The BMAS (British Med AP Soc) Page [http://www.medical-acupuncture.co.uk/] has a review of the software. Some of it is expensive.

My homepage has a comprehensive and free "Online Acupoint Cookbook", the Top Ten Points for Common Conditions [http://homepage.eircom.net/~progers/adtop.htm ] This database has a Fast Find function for experienced users [http://homepage.eircom.net/~progers/adtop.htm ].

A new company ATRAR [http://www.dscs.demon.co.uk/] has very good software (graphics, TCM data, client accounts, history files etc), but has no points database to enable users to input a variety of signs & extract the points which bert match that syndrome. I am negotiating with ATRAR to see if they can incorporate my database, ADA (Acupuncture Data Assistant), into their software.

7. Email Discussion Lists

a. Professional Acupuncture List (PA-L) [http://users.med.auth.gr/~karanik/english/pal.html] is a useful discussion list, restricted to OMDs, MDs, Osteopaths, DVMs, & other professionals who use AP routinely. See details at 2a, above.

b. Acupuncture Mailbase: This is a UK-based open list for physiotherapists, OMDs, MDs, Osteopaths, DVMs, & other professionals who use AP routinely. To join, email the server <Mailbase@mailbase.ac.uk> with the message "Join Acupuncture Firstname Lastname" in the Message Field.

c. Professional Vet Acupuncture List (PVA-L): This is a useful discussion list, restricted to qualified veterinary acupuncturists. See details at 2a, above.

d. Other E-mail Lists of interest to Vets: There are many other lists of interest to Vets. NetVet [http://netvet.wustl.edu/vetmed.htm & http://netvet.wustl.edu/vmla.htm] & Clark Consulting Intnl Inc. [http://www.agpr.com/consulting/maillist.html] summarise most of the useful Vet / Agric Lists.

These Lists (reorganised at Veturle1.htm) cover topics as diverse as:

| agriculture | alpacas | anaesthesia | animal ethology, behaviour | animal rights | animal-related | aquaculture, fish, marine & shellfish | avian (birds, emus, fowl) | bees, insects, spiders | bioscience | biotechnology | bovine, cattle | canines, dogs | cash crops, gardens, herbs, horticulture & vegetables | cats | complementary med & vet med | deer | ecology & environment | education | epidemiology | equine, horses, donkeys | ferrets | food & food safety | forage | general topics | genetics & genomes | goats | immunology | lab diagnosis, lab safety & lab animals | meat specialists | microbiology | ovine, sheep | pathology | pests & pesticides | swine (pigs, hogs) | toxicology | vegetarianism | vet nuclear medicine | vet informatics, library & web design | veterinary |

Discussion & Conclusions

There are several thousand WWW Sites for AP, TCM, Vet & biological / pharmaceutical areas. Many are commercial sites, advertising books, equipment, software, or training etc. Others are Homepages for private clinics, which offer diagnostic or therapeutic services. Commercial sites & other homepages that advertise for business may have little to offer the serious researcher or clinician in AP & TCM. In contrast to strictly commercial sites, there are several hundred good sites with vast amounts of useful data. The Links Pages, discussed above, are useful, fast ways to access the best of these.

IT & multimedia can provide rapid answers to specific technical queries, & solve more problems that depend on expert information. Given access to a phone & a modern computer, a practitioner in a rural outpost can cheaply communicate by email with colleagues around the globe. Direct access to medical & TCM databases, whether online or on CD ROMs, etc, allows instant access to the most up-to-date information. Self-study by distance learning will become a powerful educational medium in the near future. Modern IT also offers a marvellous opportunity to integrate eastern & western medical knowledge in a way never possible before.

Vets who fail to keep up with rapidly changing information will be left behind with the "also rans".

References

Felt B (no date) Paradigm's Computers & Oriental Medicine Forum [http://www.paradigm-pubs.com/html/forum.html]

Lin JH, Rogers PAM & Yamada H (1998) Integration of ancient & modern medicine towards a sustainable system of animal production & medical care. Proceedings of 24^th IVAS (International Veterinary Acupuncture Society) Annual Congress, Taiwan, August 1998. [http://users.med.auth.gr/~karanik/english/articles/integr1.html]

Rogers PAM (1998) Information Technology in AP & TCM. Proc 24^th IVAS (International Veterinary Acupuncture Society) Annual Congress, Taiwan, Aug 1998 [http://users.med.auth.gr/~karanik/english/articles/tai98it.html].

Rogers PAM (1999) Acupuncture Links Pages [http://homepage.eircom.net/~progers/vaplinks.htm] & Lectures on Acupuncture & Holistic Medicine [http://homepage.eircom.net/~progers/rogpubco.htm].

Wiseman N & Ye F (1998) A Practical Dictionary of Chinese Medicine. Paradigm Publications, Brookline, Mass, USA, 945 pp.