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    I would like to share with you an experience I just had, searching Pub
Med and NLM Gateway.

    Today, a Physician requested  a literature search to see if there is
any relationship between HUMAN PAPILLOMA VIRUS  and LOOP ELECTRO EXCISION
PROCEDURE (LEEP).

    First, I entered Pub Med, clicked on "Preview/Index", entered the
terms, clicked on "Index", found the terms in the "Index", and clicked on
"Preview".  I didn't Limit the search in any way.  The Results of the
search were "0".

   Then I tried NLM Gateway, entering the terms and clicking on "Find
Terms".  Only HUMAN PAPILLOMA VIRUS was a recognized term, so I decided to
type  the search on the search bar as follows:  HUMAN PAPILLOMA VIRUS AND
LOOP ELECTRO EXCISION PROCEDURE.  "Items Found" were "0".  Then I typed in
HUMAN PAPILLOMA VIRUS AND LOOP ELECTROEXCISION PROCEDURE LEEP.  "Items
Found" were again "0".  Notice that the first search in NLM Gateway, used
ELECTRO EXCISION as two separate words.  The second search in NLM Gateway,
used ELECTROEXCISION as one word.   Plus, I added LEEP after the word
"PROCEDURE".  Both times, "Items Found" were "0".

    Finally,  still in NLM Gateway. I decided to enter the following
search:  HUMAN PAPILLOMA VIRUS AND LEEP.  Notice that this time, I only
used the acronym, LEEP.  And, this time, "Items Found" included one Journal
Citation and one Meeting Abstract!  This time, "Items Found" were not "0"!

   My whole point is that, if it hadn't occurred to me to try searching
HUMAN PAPILLOMA VIRUS AND LEEP, I would have handed the other searches to
the requesting Physician, feeling confident that my searches had
demonstrated that there is no relationship between Human Papilloma Virus
and  Loop Electro Excision Procedure.  The Physician may have felt just as
confident in the results of my search.  Neither one of us would have known
that there was one journal article and one meeting abstract, inter-relating
the two.

    It is just disturbing to me to consider.....What We Miss When We Search.

    Is there a logic that I have overlooked, or is the indexing system
lacking enough cross referencing to avoid oversights?  Or, is it my special
skills as an Information Expert--a Librarian--that made the difference
between finding the inter-relationship and not finding it?

    This is in no way intended as a criticism or an attack on our  NLM
Databases.  I couldn't manage my Medical Library without them.  In
addition,  I love Medline Plus as an excellent and reliable Consumer Health
Information resource in my Consumer Health Information Library.  My real
concern is with the human limitations involved in searching an almost
infinite supply of Information, as well as the human limitations involved
in making that almost infinite supply of Information, fully retrievable.

   Please-- post your comments to this List.

   Elizabeth Killoran
   Director, Medical Library, MLS, AHIP
   Milford-Whitinsville Regional Hospital
   Milford, Massachusetts
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