Practically all health professionals now have some familiarity with the MEDLINE database, a tool that has evolved as a "filter" for the journal literature. In the United States, and in many other countries, it has become the primary database for searching the mainstream biomedical research literature, and it would be nearly impossible to locate relevant published journal articles without it. However, when using MEDLINE to locate information on herbal medicine and other CAM areas, three things need to be remembered. First, MEDLINE is intentionally selective in what it includes, indexing less than half of the estimated 10,000 medical journals published each year. Thus, a good deal of information that is published in journals is, for one reason or another, not represented in the MEDLINE database. Second, information related to the safety and efficacy of CAM interventions is difficult to locate and is widely scattered throughout the literature. It often is found in the so-called gray literature, such as trade journals, pamphlets, conference proceedings, and market research reports, and therefore difficult to identify.5 According to a recent study by the National Library of Medicine, CAM information can be found in nearly 700 journals published by many different countries, and in more than 150 electronic databases.6 Finally, a significant number of CAM studies are first initially published in languages other than English.7 For example, some of the most important data on herbal drugs is to be found in the German pharmaceutical literature, the bulk of which needs to be translated and is not indexed by American indexing services. A search for comprehensive information will therefore have to include bibliographic databases other than MEDLINE that have stronger collections in the European pharmaceutical literature. For example, Elsevier Science's EMBASE has more comprehensive international coverage than MEDLINE and is thus stronger in many areas of CAM.
Government-funded centers, such as the National Center for Complementary and Alternative Medicine (NCCAM) and the Office of Dietary Supplements (ODS), have begun to tackle some of the problems mentioned by producing new online information resources specifically designed for retrieving CAM information, such as the IBIDS database and CAM on PubMed. Other organizations, such as the Southwest School of Botanical Medicine, have made available elec tronic versions of their own in-house collection of specialized bibliographic resources. More specialized nonbibliographic factual databases can now also be easily accessed on the Web, making available hard-to-find data such as chemical constituents and medicinal uses of medicinal plants as part of traditional healing systems.
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