MEDLINE: From Committee to Consultants

As I shared on June 16, I've been concerned about the PubMed database of biomedical and life sciences literature this year. I didn't explicitly say MEDLINE, the primary indexed biomedical sciences component of PubMed, but perhaps I should have. 

There was a Technical Bulletin on September 8 about MEDLINE selection that I followed to learn more, and saw that the Literature Selection Technical Review Committee (LSTRC, a National Library of Medicine advisory committee since 1987) was terminated this year.  

Here's what was there on July 25 for the Journal Selection for MEDLINE.

I underlined below who made the final decision about MEDLINE journal indexing: 

 ... as well as the recommendations of an NIH Federal Advisory Committee, the Literature Selection Technical Review Committee (LSTRC).

The LSTRC consists of fifteen members, including scientists (i.e., Ph.D.- or M.D.-level researchers and physicians) and medical librarians. The LSTRC generally reviews articles from the last two years of journal content and evaluates them primarily based on scientific and editorial quality.

MEDLINE’s Scientific Quality Review is a rigorous, multi-step process in which many factors are assessed. NLM views each journal comprehensively, rather than basing a decision on a defined list of criteria. Each title is reviewed by multiple individuals both within the NLM and the LSTRC, and final decisions are based on input from all these sources. The final decision of whether to index a journal for MEDLINE is made by the Director of the NLM.  

Here's what's the Journal Selection for MEDLINE description is now (September 21). I underlined some observed differences where LSTRC-related information used to be in the July 25 version. 

It is now not stated exactly who makes the final decision about MEDLINE journal indexing, and the consultants' recommendations line is new:

...as well as the recommendations of external, expert consultants

At least two consultants, usually one scientist (i.e., doctoral-level researchers or physicians) and one medical librarian review each journal. The consultants generally review articles from the last two years of journal content and evaluate them primarily based on scientific and editorial quality. Their recommendations are taken into consideration by NLM in reaching a final decision on selecting a title for inclusion in MEDLINE.

MEDLINE’s Scientific Quality Review is a rigorous, multi-step process in which many factors are assessed. NLM views each journal comprehensively, rather than basing a decision on a defined list of criteria. Each title is reviewed by multiple individuals both internal and external to NLM, and final decisions are based on input from all these sources.

Some additional concerns about publishing the past few days include news headlines of

• September 18: DOJ Deletes Study Alleging Rise in Far-Right Terrorism in US.*
• September 20: EPA tells scientists to stop publishing studies, employees say. 

There are still spaces available to register for the English update on September 25 at 9:00 am Pacific time of the European OLSPub project, an alternative to PubMed that I'd encourage medical librarians to check out. 

*Chermak, S., Demichele, M., Gruenewald, J., Jensen, M., Lewis, R., & Lopez, B. E. (2024). What NIJ research tells us about domestic terrorism. National Institute of Justice. 
https://nij.ojp.gov/topics/articles/what-nij-research-tells-us-about-domestic-terrorism [with Internet Archive link to content]

Public health: "It’s truly a matter of life and death"

 

Faculty lead & program manager a lifetime ago (January 2020)

I often describe November 2019 - January 2024 as 'I worked for the School of Public Health for 5 years then came back to the Health Sciences Library as their librarian,' but that summary can never do justice to that time & certainly not to my phenomenal colleagues. 

We did amazing work. I can't remember what was so funny on this day when we launched it. We certainly had no idea what was about to happen to everyday life as we knew it. We kept the program going throughout 2020 & 2021 in a virtual pivot, then in hybrid yearly cohorts supportive of where our scholars were at & improving to the best of our ability and resources based on evaluation feedback. 

Our faculty lead back then is now our State Health Officer (previously Chief Science Officer) who signed a standing order for all of Washington, in break with FDA rules, acts to assure wide access to COVID-19 vaccines last week. He notes, "COVID-19 vaccines are well-researched, well-tested, and have saved millions of lives around the world." 

That resulted in his national time with Rachel Maddow Tuesday! We are so lucky to have him & the rest of our solidly scientific evidence-based team at the helm of our state's department of health, and on Thursday our insurance announced their COVID-19 vaccine coverage at no cost too.

Last week also had the Surgeons general warning: CDC saves lives. It's up to us to save public health that included this blog post title. 

They caution "As former surgeons general, we took an oath to protect the health of the American people. This includes speaking out when the public’s health is in danger ‒ even when doing so is uncomfortable or politically charged. We see that danger now in the current turmoil at the CDC. We call on the American people to recognize the stakes. The CDC’s work is foundational to our health security, and without a stable, expert-led agency, we are vulnerable.

We urge all Americans to contact their elected representatives and demand that they prioritize the stability and competence of the CDC."

Even the World Health Organization says US CDC needs to be protected. 

I'm still thinking about what the best strategy is to protect public health as I revisit all the federal .gov health information sources links we have. Some are fine, some are gone, some are looking rather questionable. 

Protect Public Health

I keep meaning to blog over the weekends but can't keep up with the magnitude of things spiraling since the August 8 assault was an attack on CDC and on violence prevention, so here's yesterday alone since the article headlines say it all and present a range of perspectives within them.

As a medical librarian, I'm revisiting our Code of Ethics that hasn't been updated for 15 years (seriously?) and thinking we need to have some conversations about that. Can we in good faith still promote US government-produced health resources as the "best available information"? 

Potential action item: Read then Sign the Letter - Save HHS

Yesterday (August 28)- 

• CDC Director Susan Monarez fired weeks after being sworn in (AllSides)
• CDC's leadership is in chaos - Experts warn of public health risks (Scientific American)
• Kennedy's attack on public health must be stopped (American Public Health Association)

 

Bias by exclusion: MedlinePlus & more

 

Last week Matthew Noe shared an update (alt text available on clickthrough) - 

Sharing this update provided to me directly about the state of NLM and the future of NNLM, traveling exhibits, and, somehow, MedlinePlus. I am so worried for friends and colleagues, and I'm stuck on that, but it is hard to not want to scream WTF about a MedlinePlus with no new material. #medlibs

[image or embed]

— Matthew Noe 🔜 #ALAAC25 (@noethematt.bsky.social) June 18, 2025 at 5:36 AM

There is much concern about these potential directions of the National Library of Medicine (NLM) and the Network of the National Library of Medicine (NNLM). Following up from last week's post, there's still no sign of FY25 funding for NNLM (source) which should have begun on May 1 (6/30 edit to add: I published this blog entry at 6 am Pacific time June 23; I note FY25 NNLM NOA (Notice of Award) dated June 23 have been posted for many but not all NNLM). It's heartening to see Outside groups organize to form unbiased, independent vaccine panel. 

Speaking of bias, I had been both using & recommending MedlinePlus.gov as a source of 'trusted health information for you' in plain language since I was an NNLM intern in 2007.

I don't anymore as MedlinePlus and other federal health information resources contain bias by exclusion for American Indians and Alaska Natives, Asian Americans, Black and African Americans, Latino and Hispanic Americans, LGBTQIA+, and Native Hawaiian and Pacific Islanders with the 2025 administration change. 

This is my federal health information resources teaching strategy that I've been using with students, researchers & faculty for when a website no longer works or now seems to have less inclusive information since Federal DEI websites go dark after Trump order and threat of 'consequences' 

1. Look at the current information (a MedlinePlus example, Population Groups).  
2. Look at the previous information using archive.org (Population Groups on January 14, 2025).
3. Who/what is included there now? 
4. Who/what was included there but is now excluded? 
5. Why is that? 

American Indians and Alaska Natives have been here since time immemorial - 

• American Indian and Alaska Native Health no longer exists as a MedlinePlus population group or health topic.
• American Indian and Alaska Native Health did exist as a MedlinePlus population group and health topic.

Why is that? There is no apparent reason, and -

• American Indian/Alaska Native Health still exists at the Office of Minority Health (OMH) under the U.S. Department of Health and Human Services (HHS).
• American Indian/Alaska Native Health at OMH was more inclusive and informative before the 2025 administration change. 

Why is that when at a glance they may look the same?

Look deeper; the first section is unchanged, strikethroughs were January 18, 2025 wording, + are current changes:

This profile offers an overview of the social, economic, and environmental factors that shape the health of the American Indian and Alaska Native (AI/AN) population in the United States. Considering the unique environments, cultures, histories, and circumstances of AI/AN populations is fundamental to improving their health outcomes and reducing longstanding disparities. These factors, known as social determinants of health (SDOH), affect various health, functioning, and quality-of-life outcomes and risks. Non-medical factors like poverty, limited access to healthcare, and lack of education are all examples of individual SDOH that contribute to health disparities. + Factors such as education, income, and health insurance coverage, which are examples of non-medical drivers to health, can affect various health, function, and quality-of-life outcomes and contribute to disparities in health outcomes.

Visit Healthy People 2030 to learn more about SDOH 

Why is that when social determinants of health (SDOH) at Healthy People 2030 from the Office of Disease Prevention and Health Promotion (ODPHP) under HHS still exists? Shouldn't SDOH be more prominent for American Indian and Alaska Native health given last week's study showing Official US records underestimate Native American deaths and life expectancy?

There is no apparent reason, but look deeper; racism has been removed as a current SDOH example and discrimination has been excluded from current SDOH literature summaries.  

Be intentional with your health information seeking. Question any lack of inclusivity within it. Racism and discrimination exist and have real impacts on health. Excluding diverse population groups and certain words from federal health information resources does not mean health equity has been achieved.   

I'm not stopping my efforts towards working for the health for all people and I encourage you to do the same. 

Resist: 5 months back after 5 years away

*gently blows 9+ years of digital dust off blogging*

Today marks 5 months since my return to the health information field as a public health librarian after a bit over 5 years away as a continuing education coordinator for public health workforce development and training. 

You know things are bad since I'm blogging again, although they were & are not bad with either of my jobs since 2019. It's very clear to me I've been called to help in both for the past 6 years of unprecedented times. Now it's also time to move from shock to storytelling to start documenting them.

On November 15 last year I had a horrible and quite visceral gut feeling about the direction we were headed in. Sure enough it's manifested into reality, just a few examples from last week include RFK Jr. sent Congress 'medical disinformation' to defend COVID change and having to honestly ask Can you still trust the US government’s vaccine recommendations?  

I stand in solidarity with National Institutes of Health (NIH) staff and last week's Bethesda Declaration and may have accidentally signed it twice. Please take the time to read the gut-wrenching Shattered Science: The Research Lost as Trump Targets NIH Funding. 

As of today the entire NIH-grant funded Network of the National Library of Medicine (NNLM) hasn't received FY25 funding (source), which should have begun on May 1. I'm thankful for the Alt NNLM YouTube channel and will watch for more alt resources - especially equity resources like the Diversity, Equity and Inclusion guide.  

The health information field is fortunate to have Hilda Bastian asking hard questions like What if We Can't Rely on PubMed? early (February 14). It was thanks to her thoughtful coverage last month of Germany's Plan for an Open and Independent PubMed Safety Net that I went to their English webinar last week, and encourage checking out ZB MED's Open Life Science Publication (OLSPub) database project information.   

I still have hope for both NNLM and my previous job's Public Health Training Center Network, which is Health Resources & Services Administration (HRSA)-grant funded, as their FY25 begins July 1. I have to hope. The consequences of losing these colleagues and the vast amount of work they've done for decades creating resources to support continuing education in their respective fields is unfathomable to me.