An important issue related to a few of the last exchanges on this topic might be that of knowledge integration. Discussion seems to have centered on librarians or health professionals searching for individual items one at a time, either by hand or through primary archival resources (like MEDLARS, GOOGLE, etc.). There is, of course, the strategy of starting such searches by looking for review articles as a way of then locating the most promising individual publications cited. However, there are the secondary archives which provide overviews of pertinent literature assembled by experts in the subject area of that archive, and tertiary archives which provide formal meta-analysis. I maintain one of those secondary archives in my subject area (hospital epidemiology & infection control): some of its subscribers have commented that the electronic search usually answers their question without having to dig deeper, but my work of maintaining that product involves both electronic search and hand search work. As Julie Glanville commented, sometimes valuable bits of information are hidden within the body of an article rather than made obvious in its abstract or indexing terms. So, perhaps an answer suggested in a previous posting holds the key - hand searching still is useful for those who produce electronic resource knowledge integration products, but electronic searching within specialized knowledge integration products is more efficient for clinicians and other health professionals to locate answers. The latter group may be better advised to start their searches in tertiary or secondary archival products, which they can do themselves, then bring their finds to librarians only when searching deeper in primary archives for "more like this but more specific to..." becomes necessary.
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David Birnbaum, PhD, MPH
Visiting Associate Professor
School of Nursing
University of British Columbia
Principal, Applied Epidemiology
British Columbia, Canada
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