Podiatric Medical Resources on the Internet. A Fourth Update

Internet access to medical information has increased significantly over the past several years. This report is intended to update information about World Wide Web resources in podiatric medicine for students and health professionals that was presented and reviewed in previous articles [1,2,3,4]. New Web sites have been added, and some previously mentioned sites have been either updated or omitted. Among the new Web sites added are consumer-oriented health Web resources that physicians can share with their patients. All Uniform Resource Locators (URLs) are current at the time of this writing. The authors welcome any comments or suggestions from readers who have discovered other podiatric medical Web sites not featured in this report and will consider presenting them in future updates.

Evaluating Web Sites for Accuracy

In the May 2001 issue of the Journal of the American Medical Association, results of a study to evaluate health information on the Internet revealed that more than 60 million US residents searched the Web for information on health-related issues. Although there is an abundance of health information on the World Wide Web, little is known about the accuracy and quality of these Web sites [5]. It is important to carefully examine Web sites for accuracy and whether they are kept up to date. The first areas to examine are the author and the organization sponsoring the page. Readers wishing to send correspondence should look for a mailing address, phone number, or e-mail address of the author and the organization, such as American Medical Association or American Academy of Pediatrics. The other area to examine is the date the Web page was last modified, which usually appears at the bottom of the page. It is important to make sure the information is updated on a regular basis [6].

Web Search Tools

Listed in Table 1 are a few of the many free search and metasearch engines available on the Internet. Metasearch engines, which have the ability to search a topic from multiple engines, are increasingly popular; they save time and have many helpful components. Some very useful features include organizing the search results into specific categories or folders. The Vivisimo metasearch engine (Vivisimo, Inc, Pittsburgh, Pennsylvania) has this nice feature. For example, a search for “tinea pedis” yields the top 161 documents and gives the reader the choice of searching all of the results or those from one of the folders of specific topics, such as “Dermatophyte Infections” or “Tinea Corporis.” A useful feature of the Vivisimo search engine is the ability to find Web pages within a specified domain (Web address). For example, performing an advanced search for “tinea pedis” and choosing only Web addresses that end with “.edu” will yield only educational Web pages on the subject.

Many metasearch engines have the ability to search in various languages, which is a useful feature of the Ixquick, Vivisimo, and qbSearch metasearch engines. Ixquick (Surfboard Holding BV, Haarlem, The Netherlands) also gives the reader the choice of searching a topic through specific venues, such as news, music, and picture Web sites, and it displays the “top 10” search results from various search engines. A unique feature of the qbSearch engine (Quickbrowse.com, Inc, Miami Beach, Florida) is the ability to display up to 20 results pages all joined together on one page, instead of requiring the user to constantly click to the next page. On the search results page, the reader can activate the time-saving “Quickbrowse This” feature to choose the desired Web pages and view them all on one page, instead of clicking on links one at a time.

The MSN search engine (Microsoft Corp, Redmond, Washington) is an excellent tool when looking for any kind of information on the Internet. A particularly useful feature of this search engine is the spell correction feature. If you accidentally misspell a word, the search engine will automatically correct it and find the best results for your search. The MSN search engine does not list Web sites with objectionable content in its search results. It yields only relevant and up-to-date information on any topic you might be looking for.

Go.com (formerly Infoseek) (Walt Disney Internet Group, Seattle, Washington) is one of the top-rated search engines on the Internet. This site offers its own directory and search engine databases along with many supplemental reference databases. This specific engine sorts its searches by site and date. Go.com offers excellent Boolean search techniques such as “+” (and), “or,” and “–” (not) or words between the terms to find the best possible results for your search. Proximity searching is also available by using double quotation marks around a phrase or by entering consecutive capitalized words such as proper names. Go.com also has a translation service for English, French, German, Italian, Spanish, and Portuguese. This translation service uses the SYSTRAN Machine Translation software system (SYSTRAN Software, Inc, San Diego, California), allowing it to translate larger documents than most other Web pages. The Go.com search engine is a great tool for any user of the Internet.

Table 2 lists general Internet reference resources that may be useful to anyone seeking information. Refdesk is a new addition to this list. Maintained by Refdesk.com, located in Salisbury, Maryland, this unique reference site is an amazing resource center and deserves to be bookmarked for continuing reference use.

General Medical Web Sites

Table 3 is a listing of general medical information resources available on the Internet. Many of these Web resources have information for both the health professional and the consumer. One such Web site is the Health on the Net Foundation (HON), a not-for-profit international organization located in Geneva, Switzerland. HON was created in 1995 to provide high-quality health information to consumers and health-care professionals. The site can be searched in English and French. Health professionals can search health topics in the HONselect search tool, which incorporates five information types: Medical Subject Heading (MeSH) searches, health-care news, Web sites, multimedia, and authoritative scientific articles that can be accessed through MEDLINE, the online medical literature database of the National Library of Medicine (NLM) in Bethesda, Maryland.

Consumers can search by keyword within HON by using the MedHunt search tool. Each search result gives a description of the Web page, URL, type of page (eg, commercial, government, educational, etc), and geographic location. The search results can be displayed by continent, country, and state (United States only). Also provided are the date the Web page was last reviewed by HON, a list of keywords related to the topic, the language used in the Web page, and a description of the search request in MeSH terms (this will automatically go to the HONselect site). As an ethical guide for other medical and consumer-directed health Web sites, HON created a Code of Conduct (HONcode) consisting of eight ethical principles: honesty in advertising and editorial policy, transparency of sponsorship, transparency of authorship, justifiability, confidentiality, attribution, complementarity, and authority. This can be viewed in 19 different languages. There are many health-related Web sites that subscribe to the HONcode principles. This would be indicated on the Web site’s home page. Two user-friendly consumer health Web sites that do are MDAdvice.com and HealthAtoZ.com.

MDAdvice.com, produced by Online Medical Network, Inc, located in Rochelle Park, New Jersey, features many useful resources such as links to health organizations, information on clinical trials, online health journals, local listings of poison control centers, and a medical dictionary, among others. Users can search for a physician via a link to the American Medical Association Physician Select Web site and can search MEDLINE for medical journal articles. There are two choices to search for health topics: clicking the “Health Topics” button and selecting from a menu of topics or typing a health topic in the “Quick Search” window. Users can also select from special health topic areas such as men’s, women’s, children’s, and seniors’ health or drug information. For answers to health questions, there is an “Ask an Expert” forum. MDAdvice.com also includes a large video library of medical news. Real Player G2 or higher (RealNetworks, Inc, Seattle, Washington), which can be plugged in at no cost, is required to view the articles.

HealthAtoZ.com, maintained by Medical Network, Inc, located in Cranbury, New Jersey, has similar features and is very informative and user friendly. This Web site covers a great majority of health topics and makes searching for information easy with its interactive tools, such as healthy weight tools, healthy lifestyle tools, glossaries and dictionaries, and drug information, to name a few. HealthAtoZ.com has a sister site for health professionals called MedConnect. With free registration, users can access the free continuing medical education center, online journals, and other health-management tools. It is important to note that just because a Web site does not subscribe to the HONcode principles does not mean that it does not follow a code of ethics or provide good, high-quality, and up-to-date health information.

Of the millions of consumers who surf the Internet for information, young children and teenagers are an expanding group of information seekers. This group tends to be ignored when it comes to health information presented in simple, understandable terms. KidsHealth is an excellent health Web site created by the Nemours Foundation, a not-for-profit organization devoted to children’s health located in Jacksonville, Florida. This site provides up-to-date information about child health issues such as immunization, illnesses, and exercise and fitness, to name a few. What is unique about this site is its approach to its audiences. On the home page, there are areas for kids, teens, and parents. The section for kids is bright and colorful and uses language that informs, but does not frighten, the young reader. The teen section is appropriately more mature, and uses language that is readily understood and does not intimidate. The parents’ section includes advice and additional resources that users can seek out on their own.

HSTAT (Health Services/Technology Assessment Text) is a wonderful resource provided by the NLM. Access to full-text documents provides much useful medical information for both health-care providers and consumers. A wide variety of publications, such as clinical practice guidelines, quick-reference guides for clinicians, consumer health brochures, and evidence reports and technology assessments from the Agency for Healthcare Research and Quality, are available here.

The Emergency Medicine and Primary Care (EMBBS) Web site, maintained by MDchoice.com, Inc, in Somerville, New Jersey, addresses a wide variety of emergency topics in many fields of medicine. In the “Radiology Library” the user can look up a plethora of images of various parts of the human body. One can browse through the computed tomographic scan images and pediatric emergency topics. A very interesting feature of this site is the Megacode Simulator. The Megacode Simulator tests the user’s skills in different emergency situations and determines whether one can successfully save a patient. A similar feature is the Pediatric Advanced Life Support Megacode Simulator, which also tests the user’s skills in saving a patient. This Web site provides reviews of clinical topics for the emergency and primary-care physician as well as toxicology cases and has up-to-date information on the latest medical software. Moreover, the EMBBS site contains numerous links to other useful medical Web sites. Any resident, student, or physician would find this Web site an invaluable source of accurate medical information.

Bioethics.net is maintained by the American Journal of Bioethics, located at the University of Pennsylvania in Philadelphia and published by the MIT Press in Cambridge, Massachusetts. This site has much useful information on medical ethics topics and includes tutorials on ethics for people new to the field. Extensive links to information on palliative care, cloning, genetics, and much more are presented.

MedicineNet.com is a well-recognized Web site. Established in 1996 by MedicineNet, Inc, located in San Clemente, California, this site is very popular for its wide range of medical information and up-to-date resources for many professions in the medical field. This Web site has an entire database from A to Z on diseases and conditions. A few search engines offer easy navigation through the site. “Current Health News,” “Doctor’s Views,” “Updates,” and “Health Facts” are always available on the home page of Medicine-Net.com. A particularly useful feature is the online dictionary, which can be used at any time to look up a specific medical term. The site offers information in practically all fields of medicine. Many links lead to other large medical Web sites that are also important sources of current information. MedicineNet.com is the ultimate research tool for any physician, resident, student, patient, or anyone else interested in medicine.

DermIS–Dermatology Information System is an exceptional site that presents dermatologic information in addition to thousands of illustrations of common and rare skin disorders. The site is run by Dermis.net, a cooperative venture of the University of Heidelberg Department of Clinical Social Medicine and the University of Erlangen Department of Dermatology, both in Germany. The illustrations may be used as part of lectures in academic institutions as long as appropriate credit is given, as explained at the site.

The Johns Hopkins Antibiotic Guide is a resource of the Division of Infectious Diseases at the Johns Hopkins University, in Baltimore, Maryland. Access is free, but registration is required in order to use all of the site’s features. This highly authoritative guide for professionals provides “concise, clinically useful, and up-to-date information about the evaluation and treatment of infectious diseases in adults.” Unfortunately, pediatric information is not yet available at this site.

Drug InfoNet is another drug information resource that may prove beneficial to both the podiatric practitioner and the consumer. It is maintained by Drug InfoNet, Inc, located in Jamesville, New York. Official package inserts are available for many commonly prescribed drugs, along with patient package inserts. The user can search by brand name, generic name, or manufacturer. The package insert links take the user directly to the manufacturer’s Web site and seem to provide the most current insert available.

RxList is another site presenting current drug information. It is run by RxList.com, located in San Benicia, California. It is updated very frequently and maintained by a professional pharmacist. Besides professional and patient information on a number of drugs, information concerning alternative medicine is presented as well.

FreeMedicalJournals.com is run by the Amedeo-Group in Wuppertal, Germany. For those who relish having instant access to the full text of a journal article, this amazing site lists a large number of medical journals that provide this feature at no cost. Some of the journals listed allow immediate access to full text upon print publication, while others delay online access for up to 2 years after print publication. This page is well worth bookmarking.

Doctors’ Guide–Global Edition is run by Doctors’ Guide Publishing Limited, which is owned by P\S\L Group Inc, located in Montreal, Quebec, Canada. This resource is filled with general medical information including medical news updates and disease-specific information.

Medscape is a superlative collection of drug and medical resources. Medscape Portals, Inc, a subsidiary of WebMD Medscape Health Network, located in New York City, maintains the site. One can participate in continuing medical education activities as well as search for drug information. Access to WebMD Scientific American Medicine will be available at this site on a paid subscription basis. At this point, free registration is required to use the professional areas of the site.

MEDLINE Searching

Since it became free to the public in 1997, MEDLINE, produced by the NLM, has undergone some changes. As of September 28, 2001, the Internet Grateful Med version of MEDLINE has been retired. It has been replaced by the NLM Gateway, a Web-based system that allows users to search through multiple systems that are available at the NLM. It allows the user to perform one search with the results divided into various categories, including journal citations, books/serials/audiovisual, consumer health, meeting abstracts, and other collections. The Gateway connects with various NLM online resources including MEDLINE/PubMed for journal citations from 1966 to the present; OLDMEDLINE for journal citations from 1957 to 1965; MEDLINEplus for consumer health resources; DIRLINE (Directory of Information Resources Online), an online directory of health organizations; and LOCATORplus, the NLM’s online catalog and other special databases.

MEDLINE is available via PubMed, which provides easy MeSH and keyword searching. PubMed has links to special molecular biology and genetics databases, including the TOXNET database for information on toxicology, hazardous chemicals, and environmental health. In addition, it has links to the NLM Gateway, ClinicalTrials.gov, MEDLINEplus, and PubMed Central, a digital archive of free and unrestricted life-science journal articles maintained by the NLM. PubMed provides links to full-text articles and has a new “LinkOut” feature, which provides access to various Web resources, including research materials, related consumer health resources, and more.

Podiatric Medical Web Sites

Table 4 is a listing of various Web resources in podiatric medicine. Two new podiatric consumer-oriented health Web pages on the list are PodiatryNetwork.com and NOAH: Foot and Ankle. PodiatryNetwork.com is a comprehensive Web site providing information about the foot, ankle, and lower extremity. Consumers can click on “Foot Health Resources” to access a listing of common foot conditions, common disorders of the lower extremities, and featured articles that include information on how to find the right doctor, selecting the right shoes for adults and children, and other related topics in podiatry. Users can key in their ZIP code and find a podiatric physician in their specific area. Health professionals can click on “Physician Resources” to retrieve links to various resources, including podiatric medical schools, research and reference guides, podiatry organizations, publications, and news articles. Physicians can purchase medical supplies and podiatry books, advertise their products and services, and develop their own Web pages. PodiatryNetwork.com is maintained by Podiatry Management Services, Inc, located in Seabrook, Texas.

NOAH (New York Online Access to Health): Foot and Ankle is a not-for-profit bilingual consumer health Web site edited by health-science librarians and information professionals to provide access to high-quality health information on the Internet. This page covers anatomy of the foot and ankle, foot and ankle care, and the basics of the adult, child, and female foot, and contains links to information on various foot and ankle disorders, injuries, and treatments. The NOAH page also provides foot and ankle resources that include podiatry and orthopedic organizations, journals, magazines, and New York–area resources. It identifies new information added to the page, and indicates links that are specifically for children and teenagers. NOAH is a bilingual consumer health Web page with resources in both English and Spanish. The NOAH Web site was developed through the partnership of several New York library organizations, including the New York Public Library, the Metropolitan New York Library Council (METRO), the City University of New York, the New York Academy of Medicine, the Brooklyn Public Library, and the Queens Public Library. The site is maintained by the New York Academy of Medicine, located in New York City.

Foot.com–The Foot Health Network is maintained by Foot.com, Inc, located in Teaneck, New Jersey. Dedicated to educating the public about foot health, this site provides information and illustrations concerning common podiatric problems in language that the layperson can understand.

The American Board of Podiatric Orthopedics and Primary Podiatric Medicine has a Web site that presents much useful information concerning the certification process, including a 28-page “Examination Study Guide” document that may be downloaded. The site is for health consumers, podiatric physicians, and credentials-verification organizations. It is maintained by Primal Image Web Design, Inc, located in Manhattan Beach, California.

The American Podiatric Medical Students’ Association has a home page that presents basic facts about the organization, a list of the representatives at all of the US podiatric medical colleges, and more. The site is produced by MEC Design, Inc, located in North Potomac, Maryland.

The American Professional Wound Care Association home page is administered in Richboro, Pennsylvania. Its mission is to “help decrease the rate of complications from chronic wounds, accelerate wound healing and preserve and/or enhance the quality of life for these patients.” Professionals interested in wound care and healing can find a listing of seminars at this site.

David G. Armstrong, DPM, of Tucson, Arizona, runs the DiabeticFootOnline.com site. This resource is a collaborative effort of the Department of Surgery, Podiatry Section, Southern Arizona Veterans Affairs Health Care System, Tucson, and the Diabetes Lower Extremity Research Group of the University Department of Medicine, Manchester Royal Infirmary, Manchester, England. This joint-effort Web site has dedicated areas for health-care professionals and for health consumers. One of the purposes of the site is to “advance current knowledge regarding assessment and treatment of the diabetic foot,” and much information is presented to that end.

The Podiatry Encyclopedia is maintained by the Department of Podiatry, Curtin University of Technology, Perth, Australia. Free access is allowed to all sections of this document, which includes appropriate illustrations.

The Federation of Podiatric Medical Boards, located in Boca Raton, Florida, has a Web site with a state-by-state compendium of board requirements and a listing of the number of registered podiatric physicians in each state. Several state podiatric medical associations or societies also have Web sites, such as the New York State Podiatric Medical Association in New York City. Loaded with both professional and consumer podiatric health information, this site also has links to related foot-health sites.

The Podiatry Exchange is a site that allows podiatric medical students, residents, practicing physicians, and podiatric residency programs to create Web pages. There is also a section for career opportunities. Services are free, but registration is required for access to the professional features of this site. A listing of podiatric residency programs by state is another useful feature of this Web page. The site is run by Physician’s Management Company of Delaware, Inc, located in Wilmington, Delaware.

The Foot Talk Web page is among many medical sites that offer an excellent collection of links dealing with podiatry and foot disorders. This fairly simple site addresses important questions about foot disorders. The “Foot Orthotics” section provides vital information on orthotic anatomy and orthotic types. It also includes an interesting slide show of heel pain and answers a plethora of frequently asked questions. The links page contains podiatry, diabetes, and shoe-related links. Foot Talk makes a nice addition to an already large database of podiatry Web sites. The site is maintained by the Calgary Foot and Wellness Clinic, located in Calgary, Alberta, Canada.

Podiatry Management Online is the online edition of Podiatry Management magazine. Kane Communications, Inc, located in Upper Darby, Pennsylvania, runs this site. Articles are available in full-text format, and one may search the archives for older articles. Access to Podiatry Management’s continuing education program is also provided.

Table 5 is a listing of US schools of podiatric medicine. These Web sites have more information on podiatry as a profession and resources for consumers.

Table 1. Web Search Tools

Table 1. Web Search Tools

Table 2. General Reference Resources on the Web

Table 2. General Reference Resources on the Web

Table 3. General Medical Web Sites

Table 3. General Medical Web Sites

Table 4. Podiatric Medical Web Sites

Table 4. Podiatric Medical Web Sites

Table 5. Web Sites of US Colleges of Podiatric Medicine

Table 5. Web Sites of US Colleges of Podiatric Medicine