Simon Kung, MD

Why pay for diagnostic, treatment, and research information when the Internet offers scores of free resources? Which free references are best, and when are they more clinically beneficial than paid information?

This article reviews select free online references and—where applicable—compares them with fee-based resources.

Diagnostic resources

We often don’t look past DSM-IV-TR guidelines when forming a diagnosis. In such cases, BehaveNet’s simple yet comprehensive list of DSM-IV-TR criteria is handy (www.behavenet.com, click on “Diagnoses and criteria by category”).

For in-depth diagnostic guidelines, American Psychiatric Publishing (www.appi.org) offers its DSM-IV-TR Quick Reference for $29, and Skyscape (www.skyscape.com) offers the full DSM-IV-TR at $77. Both personal digital assistant (PDA)-based programs come in Palm OS and Pocket PC versions.

Treatment decision aids

Free drug information references such as PDR.net (www.pdr.net) and Epocrates (www.epocrates.com) can help with medication choices. Both services let you check interactions on several drugs at once, which is important when treating patients who are taking multiple medications.

PDR.net is free for U.S.-based physicians and prescribers and requires registration. Epocrates can be used without registering, but going through the free registration process will provide additional features such as medication cost estimates. For a fee, Epocrates will throw in premium features such as pill identification, clinical tables and guidelines, and medical calculators.

Both PDR.net and Epocrates offer free PDA versions (Epocrates started as a PDA-based service). Other PDA-based drug references charge for access, but in some cases the information is more comprehensive and accurate.

For cytochrome P-450 metabolism information, you could reference the metabolism sections of each drug information sheet. Alternatively:

• Indiana University offers a good free drug interaction table showing substrates, inhibitors, and inducers of CYP-450 isoenzymes (http://medicine.iupui.edu/flockhart).
• http://mhc.com/Cytochromes offers similar information and links to more CYP-450 resources.

Clinical trials. Numerous Web sites offer free access to evidence-based findings and randomized clinical trials. The National Institute of Mental Health, for example, offers free online information on:

• Sequenced Treatment Alternatives to Relieve Depression (STAR*D, www.nimh.nih.gov/healthinformation/stard.cfm)
• Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE, www.nimh.nih.gov/healthinformation/catie.cfm).

The sites describe these medication trials in a lucid question-and-answer format. Clinicians can use the study results to guide medication choices. The STAR*D site also lists percentages of treatment success and describes duration-of-treatment trials.

Online algorithms. Free drug treatment algorithms and guidelines based on literature reviews and expert consensus are available online:

• The Texas Medication Algorithm Project (www.dshs.state.tx.us/mhprograms/TMAPtoc.shtm) addresses depression, bipolar disorder, and schizophrenia treatment.
• The Harvard Psychopharmacology Algorithm Project (http://mhc.com/Algorithms) covers depression, schizophrenia, and anxiety in patients with substance abuse.
• The International Psychopharmacology Algorithm Project (www.ipap.org) covers schizophrenia, posttraumatic stress disorder, and generalized anxiety disorder.

Free psychiatric rating scales—such as the Patient Health Questionnaire-9 (PHQ-9, www.depression-primarycare.org/clinicians/toolkits/materials/forms/phq9)—can help you efficiently monitor the progress of patients who complete the self-report forms.

The Psychiatric Rating Scales Index (www.neurotransmitter.net/ratingscales.html) lists links to other rating scales and descriptions, and notes which scales are free and which must be purchased.

Access to clinical articles

Online abstracts. By subscribing to Medline services, academic institutions provide students and faculty access to journal articles.

If you don’t have Medline access, use the free National Institutes of Health PubMed database (www.pubmed.gov) to search for abstracts on a given topic. You can view abstracts to all types of articles or click on the “review” tab on the search results page to view only reviews.

Although abstracts are free, full-text access usually is not unless your institution has a site license for that journal or you have purchased online access to that publication. By reading the abstract, you often can tell whether the full article contains information relevant to your practice.

Evidence-based medicine. The Centre for Evidence Based Mental Health (www.cebmh.com, click on “Research”) lists links to reviews, clinical trial information, and resources for learning about evidence-based medicine. CEBMH posts references to articles but does not offer full-text access.

The Cochrane Collaboration (www.cochrane.org/reviews/en/topics/index.html) offers free online abstracts of systematic reviews of psychiatric treatments, but you need a paid subscription to access full articles.

News sites such as Psychiatric News (http://pn.psychiatryonline.org), Psychiatric Times (www.psychiatrictimes.com), Clinical Psychiatry News (www.clinicalpsychiatrynews.com), and Medscape Psychiatry (www.medscape.com/psychiatry) offer free full-text access to news updates and summaries of recent major papers and presentations. These summaries help you stay abreast of the literature, but they are not as detailed as the original sources.

You don’t need a subscription to request free electronic tables of contents (e-TOCs) from selected journals. Some e-TOCs list links to abstracts of all articles in the current issue.

Online clinical textbooks and journals. American Psychiatric Publishing’s online DSM Premium package (www.psychiatryonline.com) includes access to the Textbook of Clinical Psychiatry, 5 psychiatry journals, American Psychiatric Association (APA) practice guidelines, and the DSM Library. DSM Premium Plus also includes access to 3 PDA-based eBooks (DSM-IV-TR Quick Reference, DSM-IV-TR Differential Diagnosis, and APA Practice Guidelines Quick Reference). Packages cost $229 to $399 annually, depending on which package you choose and whether you are an APA member.

Open-source book technology allows users to contribute to and edit an online volume. Wikipedia (http://en.wikipedia.org), the prototypical open-source site, hosts a free online encyclopedia.

Giles¹ in 2005 found the accuracy of science entries in Wikipedia comparable to similar entries in Encyclopaedia Britannica. Among 42 entries from both encyclopedias, researchers found on average 4 errors per entry with Wikipedia and 3 with Encyclopaedia Britannica.

One sister Wiki project, Wikibooks (http://en.wikibooks.org), is designed to encourage production of open-source textbooks. This has led to one fledgling psychiatry textbook (http://en.wikibooks.org/wiki/Psychiatry) and others soon could follow. The clinical accuracy of this Wiki-based psychiatry textbook is variable, though this could improve if more psychiatrists become involved with Wikibook peer review.

Why pay for diagnostic, treatment, and research information when the Internet offers scores of free resources? Which free references are best, and when are they more clinically beneficial than paid information?

This article reviews select free online references and—where applicable—compares them with fee-based resources.

Diagnostic resources

We often don’t look past DSM-IV-TR guidelines when forming a diagnosis. In such cases, BehaveNet’s simple yet comprehensive list of DSM-IV-TR criteria is handy (www.behavenet.com, click on “Diagnoses and criteria by category”).

For in-depth diagnostic guidelines, American Psychiatric Publishing (www.appi.org) offers its DSM-IV-TR Quick Reference for $29, and Skyscape (www.skyscape.com) offers the full DSM-IV-TR at $77. Both personal digital assistant (PDA)-based programs come in Palm OS and Pocket PC versions.

Treatment decision aids

Free drug information references such as PDR.net (www.pdr.net) and Epocrates (www.epocrates.com) can help with medication choices. Both services let you check interactions on several drugs at once, which is important when treating patients who are taking multiple medications.

PDR.net is free for U.S.-based physicians and prescribers and requires registration. Epocrates can be used without registering, but going through the free registration process will provide additional features such as medication cost estimates. For a fee, Epocrates will throw in premium features such as pill identification, clinical tables and guidelines, and medical calculators.

Both PDR.net and Epocrates offer free PDA versions (Epocrates started as a PDA-based service). Other PDA-based drug references charge for access, but in some cases the information is more comprehensive and accurate.

For cytochrome P-450 metabolism information, you could reference the metabolism sections of each drug information sheet. Alternatively:

• Indiana University offers a good free drug interaction table showing substrates, inhibitors, and inducers of CYP-450 isoenzymes (http://medicine.iupui.edu/flockhart).
• http://mhc.com/Cytochromes offers similar information and links to more CYP-450 resources.

Clinical trials. Numerous Web sites offer free access to evidence-based findings and randomized clinical trials. The National Institute of Mental Health, for example, offers free online information on:

• Sequenced Treatment Alternatives to Relieve Depression (STAR*D, www.nimh.nih.gov/healthinformation/stard.cfm)
• Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE, www.nimh.nih.gov/healthinformation/catie.cfm).

The sites describe these medication trials in a lucid question-and-answer format. Clinicians can use the study results to guide medication choices. The STAR*D site also lists percentages of treatment success and describes duration-of-treatment trials.

Online algorithms. Free drug treatment algorithms and guidelines based on literature reviews and expert consensus are available online:

• The Texas Medication Algorithm Project (www.dshs.state.tx.us/mhprograms/TMAPtoc.shtm) addresses depression, bipolar disorder, and schizophrenia treatment.
• The Harvard Psychopharmacology Algorithm Project (http://mhc.com/Algorithms) covers depression, schizophrenia, and anxiety in patients with substance abuse.
• The International Psychopharmacology Algorithm Project (www.ipap.org) covers schizophrenia, posttraumatic stress disorder, and generalized anxiety disorder.

Free psychiatric rating scales—such as the Patient Health Questionnaire-9 (PHQ-9, www.depression-primarycare.org/clinicians/toolkits/materials/forms/phq9)—can help you efficiently monitor the progress of patients who complete the self-report forms.

The Psychiatric Rating Scales Index (www.neurotransmitter.net/ratingscales.html) lists links to other rating scales and descriptions, and notes which scales are free and which must be purchased.

Access to clinical articles

Online abstracts. By subscribing to Medline services, academic institutions provide students and faculty access to journal articles.

If you don’t have Medline access, use the free National Institutes of Health PubMed database (www.pubmed.gov) to search for abstracts on a given topic. You can view abstracts to all types of articles or click on the “review” tab on the search results page to view only reviews.

Although abstracts are free, full-text access usually is not unless your institution has a site license for that journal or you have purchased online access to that publication. By reading the abstract, you often can tell whether the full article contains information relevant to your practice.

Evidence-based medicine. The Centre for Evidence Based Mental Health (www.cebmh.com, click on “Research”) lists links to reviews, clinical trial information, and resources for learning about evidence-based medicine. CEBMH posts references to articles but does not offer full-text access.

The Cochrane Collaboration (www.cochrane.org/reviews/en/topics/index.html) offers free online abstracts of systematic reviews of psychiatric treatments, but you need a paid subscription to access full articles.

News sites such as Psychiatric News (http://pn.psychiatryonline.org), Psychiatric Times (www.psychiatrictimes.com), Clinical Psychiatry News (www.clinicalpsychiatrynews.com), and Medscape Psychiatry (www.medscape.com/psychiatry) offer free full-text access to news updates and summaries of recent major papers and presentations. These summaries help you stay abreast of the literature, but they are not as detailed as the original sources.

You don’t need a subscription to request free electronic tables of contents (e-TOCs) from selected journals. Some e-TOCs list links to abstracts of all articles in the current issue.

Online clinical textbooks and journals. American Psychiatric Publishing’s online DSM Premium package (www.psychiatryonline.com) includes access to the Textbook of Clinical Psychiatry, 5 psychiatry journals, American Psychiatric Association (APA) practice guidelines, and the DSM Library. DSM Premium Plus also includes access to 3 PDA-based eBooks (DSM-IV-TR Quick Reference, DSM-IV-TR Differential Diagnosis, and APA Practice Guidelines Quick Reference). Packages cost $229 to $399 annually, depending on which package you choose and whether you are an APA member.

Open-source book technology allows users to contribute to and edit an online volume. Wikipedia (http://en.wikipedia.org), the prototypical open-source site, hosts a free online encyclopedia.

Giles¹ in 2005 found the accuracy of science entries in Wikipedia comparable to similar entries in Encyclopaedia Britannica. Among 42 entries from both encyclopedias, researchers found on average 4 errors per entry with Wikipedia and 3 with Encyclopaedia Britannica.

One sister Wiki project, Wikibooks (http://en.wikibooks.org), is designed to encourage production of open-source textbooks. This has led to one fledgling psychiatry textbook (http://en.wikibooks.org/wiki/Psychiatry) and others soon could follow. The clinical accuracy of this Wiki-based psychiatry textbook is variable, though this could improve if more psychiatrists become involved with Wikibook peer review.

Why pay for diagnostic, treatment, and research information when the Internet offers scores of free resources? Which free references are best, and when are they more clinically beneficial than paid information?

This article reviews select free online references and—where applicable—compares them with fee-based resources.

Diagnostic resources

We often don’t look past DSM-IV-TR guidelines when forming a diagnosis. In such cases, BehaveNet’s simple yet comprehensive list of DSM-IV-TR criteria is handy (www.behavenet.com, click on “Diagnoses and criteria by category”).

For in-depth diagnostic guidelines, American Psychiatric Publishing (www.appi.org) offers its DSM-IV-TR Quick Reference for $29, and Skyscape (www.skyscape.com) offers the full DSM-IV-TR at $77. Both personal digital assistant (PDA)-based programs come in Palm OS and Pocket PC versions.

Treatment decision aids

Free drug information references such as PDR.net (www.pdr.net) and Epocrates (www.epocrates.com) can help with medication choices. Both services let you check interactions on several drugs at once, which is important when treating patients who are taking multiple medications.

PDR.net is free for U.S.-based physicians and prescribers and requires registration. Epocrates can be used without registering, but going through the free registration process will provide additional features such as medication cost estimates. For a fee, Epocrates will throw in premium features such as pill identification, clinical tables and guidelines, and medical calculators.

Both PDR.net and Epocrates offer free PDA versions (Epocrates started as a PDA-based service). Other PDA-based drug references charge for access, but in some cases the information is more comprehensive and accurate.

For cytochrome P-450 metabolism information, you could reference the metabolism sections of each drug information sheet. Alternatively:

• Indiana University offers a good free drug interaction table showing substrates, inhibitors, and inducers of CYP-450 isoenzymes (http://medicine.iupui.edu/flockhart).
• http://mhc.com/Cytochromes offers similar information and links to more CYP-450 resources.

Clinical trials. Numerous Web sites offer free access to evidence-based findings and randomized clinical trials. The National Institute of Mental Health, for example, offers free online information on:

• Sequenced Treatment Alternatives to Relieve Depression (STAR*D, www.nimh.nih.gov/healthinformation/stard.cfm)
• Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE, www.nimh.nih.gov/healthinformation/catie.cfm).

The sites describe these medication trials in a lucid question-and-answer format. Clinicians can use the study results to guide medication choices. The STAR*D site also lists percentages of treatment success and describes duration-of-treatment trials.

Online algorithms. Free drug treatment algorithms and guidelines based on literature reviews and expert consensus are available online:

• The Texas Medication Algorithm Project (www.dshs.state.tx.us/mhprograms/TMAPtoc.shtm) addresses depression, bipolar disorder, and schizophrenia treatment.
• The Harvard Psychopharmacology Algorithm Project (http://mhc.com/Algorithms) covers depression, schizophrenia, and anxiety in patients with substance abuse.
• The International Psychopharmacology Algorithm Project (www.ipap.org) covers schizophrenia, posttraumatic stress disorder, and generalized anxiety disorder.

Free psychiatric rating scales—such as the Patient Health Questionnaire-9 (PHQ-9, www.depression-primarycare.org/clinicians/toolkits/materials/forms/phq9)—can help you efficiently monitor the progress of patients who complete the self-report forms.

The Psychiatric Rating Scales Index (www.neurotransmitter.net/ratingscales.html) lists links to other rating scales and descriptions, and notes which scales are free and which must be purchased.

Access to clinical articles

Online abstracts. By subscribing to Medline services, academic institutions provide students and faculty access to journal articles.

If you don’t have Medline access, use the free National Institutes of Health PubMed database (www.pubmed.gov) to search for abstracts on a given topic. You can view abstracts to all types of articles or click on the “review” tab on the search results page to view only reviews.

Although abstracts are free, full-text access usually is not unless your institution has a site license for that journal or you have purchased online access to that publication. By reading the abstract, you often can tell whether the full article contains information relevant to your practice.

Evidence-based medicine. The Centre for Evidence Based Mental Health (www.cebmh.com, click on “Research”) lists links to reviews, clinical trial information, and resources for learning about evidence-based medicine. CEBMH posts references to articles but does not offer full-text access.

The Cochrane Collaboration (www.cochrane.org/reviews/en/topics/index.html) offers free online abstracts of systematic reviews of psychiatric treatments, but you need a paid subscription to access full articles.

News sites such as Psychiatric News (http://pn.psychiatryonline.org), Psychiatric Times (www.psychiatrictimes.com), Clinical Psychiatry News (www.clinicalpsychiatrynews.com), and Medscape Psychiatry (www.medscape.com/psychiatry) offer free full-text access to news updates and summaries of recent major papers and presentations. These summaries help you stay abreast of the literature, but they are not as detailed as the original sources.

You don’t need a subscription to request free electronic tables of contents (e-TOCs) from selected journals. Some e-TOCs list links to abstracts of all articles in the current issue.

Online clinical textbooks and journals. American Psychiatric Publishing’s online DSM Premium package (www.psychiatryonline.com) includes access to the Textbook of Clinical Psychiatry, 5 psychiatry journals, American Psychiatric Association (APA) practice guidelines, and the DSM Library. DSM Premium Plus also includes access to 3 PDA-based eBooks (DSM-IV-TR Quick Reference, DSM-IV-TR Differential Diagnosis, and APA Practice Guidelines Quick Reference). Packages cost $229 to $399 annually, depending on which package you choose and whether you are an APA member.

Open-source book technology allows users to contribute to and edit an online volume. Wikipedia (http://en.wikipedia.org), the prototypical open-source site, hosts a free online encyclopedia.

Giles¹ in 2005 found the accuracy of science entries in Wikipedia comparable to similar entries in Encyclopaedia Britannica. Among 42 entries from both encyclopedias, researchers found on average 4 errors per entry with Wikipedia and 3 with Encyclopaedia Britannica.

One sister Wiki project, Wikibooks (http://en.wikibooks.org), is designed to encourage production of open-source textbooks. This has led to one fledgling psychiatry textbook (http://en.wikibooks.org/wiki/Psychiatry) and others soon could follow. The clinical accuracy of this Wiki-based psychiatry textbook is variable, though this could improve if more psychiatrists become involved with Wikibook peer review.

Are e-alerts cluttering your in box?

These indispensable e-mails offer immediate access to current clinical articles. But with so many e-alerts and search services available, useless alerts and irrelevant search results can clog your client—in the bargain slowing access to the data you need.

This article explains how to customize your subscriptions and choose e-alerts that most closely meet your needs.

Which e-alert is best for you?

When new issues appear online, journals typically send out:

• Publication alerts, which provide a link to the journal’s home page or current table of contents.
• Tables of contents—or eTOCs. Whereas publication alerts contain a few links, eTOCs list the current issue’s full TOC with links to abstracts and full-text versions of each article.
• Content alerts, which consolidate links to new articles on a specific topic. Content alerts are sent each time a keyword on your interest list is included within a new article’s title, keywords, or abstract.
• Citation alerts when an article on your list is cited. This helps you track how often authors are citing an article and alerts you to other articles in your field of interest.
• Author alerts when an article by a selected author is published, helping you consolidate links to current data from thought leaders on a given topic. Author alerts also help you track articles you’ve published.
• Saved search alerts, which retrieve a prior search each time the publisher’s database is updated. This can help you avoid having to restart searches.

E-alerts usually are free, but a paid subscription to the journal often is required to access full-text articles.

Psychiatric journals offer many types of e-alerts:

• Archives of General Psychiatry offers free eTOCs, content, author, and saved search alerts, as well as links to “early release” articles that are published online before they appear in print.
• The American Journal of Psychiatry offers these alerts through HighWire Press as well as PDA services, which each month download TOCs, citations, and abstracts to your personal digital assistant. You need a (free) HighWire account to subscribe to these services.

Publisher alerts. Some journal publishers—including American Psychiatric Publishing, Elsevier, Karger, and Springer—offer free publisher alerts that announce online updates to all journals in their groups. Elsevier offers a range of e-alert services, including free issue, citation, and saved search alerts, and a quarterly alert listing the “25 hottest articles.”

Publisher alerts contain links to several journals in one message. You don’t need to subscribe to any one journal to receive a publisher alert, but the information is limited to that publisher’s journals. American Psychiatric Publishing’s alert, for example, offers links to The American Journal of Psychiatry and the publisher’s other journals, but you need a separate alert for Journal of Clinical Psychiatry.

Choosing an e-alert service

Independent e-alert services, which scan the medical literature for links to pertinent articles, offer substantially more links than do publication or group e-alerts

HighWire Press, a division of Stanford University Libraries, hosts a searchable repository of full-text online articles from more than 900 journals—many of which can be accessed at no charge. HighWire also offers:

• eTOCs
• CiteTrack, an alert on new journal content based on search criteria (topics/keywords, authors, or articles being referenced or cited)
• PDA Channels, which delivers alerts to Palm OS and Pocket PC handhelds
• RSS (really simple syndication) feeds—compilations of alerts and headlines from various publications that must be viewed using RSS Reader software
• Subscription alerts, which warn users a few weeks before that their subscription will expire.

PubMed Central. Users can open MyNCBI accounts to save searches and receive alerts for new content, authors, journals, and saved searches.

AMEDEO offers weekly updates of journals by topic and alerts providing information on various medical fields. AMEDEO’s “psychiatric disorders” link, however, lists articles only on depression and schizophrenia.

MDLinx offers daily updates of journal and medical news by specialty and subspecialty. “PsychLinx” provides links to psychiatry articles, by subspecialty or topic, and direct links to journals.

IngentaConnect sends users free monthly eTOCs from five journals. Institutions that purchase an institutional alerting license from IngentaConnect can receive unlimited new-issue alerts and free search alerts.

We find that using HighWire with PubMed Central offers an optimal yield of psychiatric articles. Paid alert services, such as Ovid or Web of Science, require an institutional or personal subscription and offer no significant advantage over free services.

You can customize your e-alert based on specialty and specific search criteria. By scrolling to “Alert Sources” on the HighWire site, for example, you can choose to scan all PubMed content (abstracts), all HighWire-hosted content (abstracts and full text), or psychiatry journals only by clicking on “View list by topic” and checking the “Psychiatry” box.

Remember that e-alerts—no matter how effective they are or how many you receive—cannot link you to every article you need. Web searches will be necessary at times.

Avoiding spam, viruses, other problems

Before you subscribe to an e-alert, ask these questions to prevent unwanted e-mails:

Is the e-alert secure? As with any online service, giving your e-mail address when subscribing to an e-alert could open your client to spam or—worse—a virus transmitted via an unwanted message.

To reduce the risk, update your subscription form as needed to confirm your identity, and change your password yearly to guard your privacy. Most publishers/services enforce privacy policies that ensure safe transmission.

Is the journal site easy to navigate? The site should offer advanced search capabilities that allow you to customize searches. Instructions or answers to frequently asked questions about alert frequency, managing and refining alerts, and other issues should be clear and accessible.

Will my search terms work? Use specific terms to filter information. Whereas a broad search term such as “bipolar disorder” would yield a long list of irrelevant articles, a more specific term such as “bipolar maintenance therapy” would substantially narrow the search. Adjust and refine your search terms and update your interest list as needed to ensure an optimal flow of information.

Is the journal’s Webmaster accessible? Contact the Webmaster if an e-alert is not meeting your needs or if you have suggestions for improvement. A link to the Webmaster should be listed on the “contact us” page.

Related resources

Cuddy C. HighWire Press and its journey to become the world’s largest full-text STM online journal collection. Journal of Electronic Resources in Medical Libraries 2005;2:1-13.

Drs. Lapid and Kung report no financial relationship with any company whose products are mentioned in this article, or with manufacturers of competing products.

To comment on this article or share your experience with e-alerts, click here.

Are e-alerts cluttering your in box?

These indispensable e-mails offer immediate access to current clinical articles. But with so many e-alerts and search services available, useless alerts and irrelevant search results can clog your client—in the bargain slowing access to the data you need.

This article explains how to customize your subscriptions and choose e-alerts that most closely meet your needs.

Which e-alert is best for you?

When new issues appear online, journals typically send out:

• Publication alerts, which provide a link to the journal’s home page or current table of contents.
• Tables of contents—or eTOCs. Whereas publication alerts contain a few links, eTOCs list the current issue’s full TOC with links to abstracts and full-text versions of each article.
• Content alerts, which consolidate links to new articles on a specific topic. Content alerts are sent each time a keyword on your interest list is included within a new article’s title, keywords, or abstract.
• Citation alerts when an article on your list is cited. This helps you track how often authors are citing an article and alerts you to other articles in your field of interest.
• Author alerts when an article by a selected author is published, helping you consolidate links to current data from thought leaders on a given topic. Author alerts also help you track articles you’ve published.
• Saved search alerts, which retrieve a prior search each time the publisher’s database is updated. This can help you avoid having to restart searches.

E-alerts usually are free, but a paid subscription to the journal often is required to access full-text articles.

Psychiatric journals offer many types of e-alerts:

• Archives of General Psychiatry offers free eTOCs, content, author, and saved search alerts, as well as links to “early release” articles that are published online before they appear in print.
• The American Journal of Psychiatry offers these alerts through HighWire Press as well as PDA services, which each month download TOCs, citations, and abstracts to your personal digital assistant. You need a (free) HighWire account to subscribe to these services.

Publisher alerts. Some journal publishers—including American Psychiatric Publishing, Elsevier, Karger, and Springer—offer free publisher alerts that announce online updates to all journals in their groups. Elsevier offers a range of e-alert services, including free issue, citation, and saved search alerts, and a quarterly alert listing the “25 hottest articles.”

Publisher alerts contain links to several journals in one message. You don’t need to subscribe to any one journal to receive a publisher alert, but the information is limited to that publisher’s journals. American Psychiatric Publishing’s alert, for example, offers links to The American Journal of Psychiatry and the publisher’s other journals, but you need a separate alert for Journal of Clinical Psychiatry.

Choosing an e-alert service

Independent e-alert services, which scan the medical literature for links to pertinent articles, offer substantially more links than do publication or group e-alerts

HighWire Press, a division of Stanford University Libraries, hosts a searchable repository of full-text online articles from more than 900 journals—many of which can be accessed at no charge. HighWire also offers:

• eTOCs
• CiteTrack, an alert on new journal content based on search criteria (topics/keywords, authors, or articles being referenced or cited)
• PDA Channels, which delivers alerts to Palm OS and Pocket PC handhelds
• RSS (really simple syndication) feeds—compilations of alerts and headlines from various publications that must be viewed using RSS Reader software
• Subscription alerts, which warn users a few weeks before that their subscription will expire.

PubMed Central. Users can open MyNCBI accounts to save searches and receive alerts for new content, authors, journals, and saved searches.

AMEDEO offers weekly updates of journals by topic and alerts providing information on various medical fields. AMEDEO’s “psychiatric disorders” link, however, lists articles only on depression and schizophrenia.

MDLinx offers daily updates of journal and medical news by specialty and subspecialty. “PsychLinx” provides links to psychiatry articles, by subspecialty or topic, and direct links to journals.

IngentaConnect sends users free monthly eTOCs from five journals. Institutions that purchase an institutional alerting license from IngentaConnect can receive unlimited new-issue alerts and free search alerts.

We find that using HighWire with PubMed Central offers an optimal yield of psychiatric articles. Paid alert services, such as Ovid or Web of Science, require an institutional or personal subscription and offer no significant advantage over free services.

You can customize your e-alert based on specialty and specific search criteria. By scrolling to “Alert Sources” on the HighWire site, for example, you can choose to scan all PubMed content (abstracts), all HighWire-hosted content (abstracts and full text), or psychiatry journals only by clicking on “View list by topic” and checking the “Psychiatry” box.

Remember that e-alerts—no matter how effective they are or how many you receive—cannot link you to every article you need. Web searches will be necessary at times.

Avoiding spam, viruses, other problems

Before you subscribe to an e-alert, ask these questions to prevent unwanted e-mails:

Is the e-alert secure? As with any online service, giving your e-mail address when subscribing to an e-alert could open your client to spam or—worse—a virus transmitted via an unwanted message.

To reduce the risk, update your subscription form as needed to confirm your identity, and change your password yearly to guard your privacy. Most publishers/services enforce privacy policies that ensure safe transmission.

Is the journal site easy to navigate? The site should offer advanced search capabilities that allow you to customize searches. Instructions or answers to frequently asked questions about alert frequency, managing and refining alerts, and other issues should be clear and accessible.

Will my search terms work? Use specific terms to filter information. Whereas a broad search term such as “bipolar disorder” would yield a long list of irrelevant articles, a more specific term such as “bipolar maintenance therapy” would substantially narrow the search. Adjust and refine your search terms and update your interest list as needed to ensure an optimal flow of information.

Is the journal’s Webmaster accessible? Contact the Webmaster if an e-alert is not meeting your needs or if you have suggestions for improvement. A link to the Webmaster should be listed on the “contact us” page.

Related resources

Cuddy C. HighWire Press and its journey to become the world’s largest full-text STM online journal collection. Journal of Electronic Resources in Medical Libraries 2005;2:1-13.

Drs. Lapid and Kung report no financial relationship with any company whose products are mentioned in this article, or with manufacturers of competing products.

To comment on this article or share your experience with e-alerts, click here.

Are e-alerts cluttering your in box?

These indispensable e-mails offer immediate access to current clinical articles. But with so many e-alerts and search services available, useless alerts and irrelevant search results can clog your client—in the bargain slowing access to the data you need.

This article explains how to customize your subscriptions and choose e-alerts that most closely meet your needs.

Which e-alert is best for you?

When new issues appear online, journals typically send out:

• Publication alerts, which provide a link to the journal’s home page or current table of contents.
• Tables of contents—or eTOCs. Whereas publication alerts contain a few links, eTOCs list the current issue’s full TOC with links to abstracts and full-text versions of each article.
• Content alerts, which consolidate links to new articles on a specific topic. Content alerts are sent each time a keyword on your interest list is included within a new article’s title, keywords, or abstract.
• Citation alerts when an article on your list is cited. This helps you track how often authors are citing an article and alerts you to other articles in your field of interest.
• Author alerts when an article by a selected author is published, helping you consolidate links to current data from thought leaders on a given topic. Author alerts also help you track articles you’ve published.
• Saved search alerts, which retrieve a prior search each time the publisher’s database is updated. This can help you avoid having to restart searches.

E-alerts usually are free, but a paid subscription to the journal often is required to access full-text articles.

Psychiatric journals offer many types of e-alerts:

• Archives of General Psychiatry offers free eTOCs, content, author, and saved search alerts, as well as links to “early release” articles that are published online before they appear in print.
• The American Journal of Psychiatry offers these alerts through HighWire Press as well as PDA services, which each month download TOCs, citations, and abstracts to your personal digital assistant. You need a (free) HighWire account to subscribe to these services.

Publisher alerts. Some journal publishers—including American Psychiatric Publishing, Elsevier, Karger, and Springer—offer free publisher alerts that announce online updates to all journals in their groups. Elsevier offers a range of e-alert services, including free issue, citation, and saved search alerts, and a quarterly alert listing the “25 hottest articles.”

Publisher alerts contain links to several journals in one message. You don’t need to subscribe to any one journal to receive a publisher alert, but the information is limited to that publisher’s journals. American Psychiatric Publishing’s alert, for example, offers links to The American Journal of Psychiatry and the publisher’s other journals, but you need a separate alert for Journal of Clinical Psychiatry.

Choosing an e-alert service

Independent e-alert services, which scan the medical literature for links to pertinent articles, offer substantially more links than do publication or group e-alerts

HighWire Press, a division of Stanford University Libraries, hosts a searchable repository of full-text online articles from more than 900 journals—many of which can be accessed at no charge. HighWire also offers:

• eTOCs
• CiteTrack, an alert on new journal content based on search criteria (topics/keywords, authors, or articles being referenced or cited)
• PDA Channels, which delivers alerts to Palm OS and Pocket PC handhelds
• RSS (really simple syndication) feeds—compilations of alerts and headlines from various publications that must be viewed using RSS Reader software
• Subscription alerts, which warn users a few weeks before that their subscription will expire.

PubMed Central. Users can open MyNCBI accounts to save searches and receive alerts for new content, authors, journals, and saved searches.

AMEDEO offers weekly updates of journals by topic and alerts providing information on various medical fields. AMEDEO’s “psychiatric disorders” link, however, lists articles only on depression and schizophrenia.

MDLinx offers daily updates of journal and medical news by specialty and subspecialty. “PsychLinx” provides links to psychiatry articles, by subspecialty or topic, and direct links to journals.

IngentaConnect sends users free monthly eTOCs from five journals. Institutions that purchase an institutional alerting license from IngentaConnect can receive unlimited new-issue alerts and free search alerts.

We find that using HighWire with PubMed Central offers an optimal yield of psychiatric articles. Paid alert services, such as Ovid or Web of Science, require an institutional or personal subscription and offer no significant advantage over free services.

You can customize your e-alert based on specialty and specific search criteria. By scrolling to “Alert Sources” on the HighWire site, for example, you can choose to scan all PubMed content (abstracts), all HighWire-hosted content (abstracts and full text), or psychiatry journals only by clicking on “View list by topic” and checking the “Psychiatry” box.

Remember that e-alerts—no matter how effective they are or how many you receive—cannot link you to every article you need. Web searches will be necessary at times.

Avoiding spam, viruses, other problems

Before you subscribe to an e-alert, ask these questions to prevent unwanted e-mails:

Is the e-alert secure? As with any online service, giving your e-mail address when subscribing to an e-alert could open your client to spam or—worse—a virus transmitted via an unwanted message.

To reduce the risk, update your subscription form as needed to confirm your identity, and change your password yearly to guard your privacy. Most publishers/services enforce privacy policies that ensure safe transmission.

Is the journal site easy to navigate? The site should offer advanced search capabilities that allow you to customize searches. Instructions or answers to frequently asked questions about alert frequency, managing and refining alerts, and other issues should be clear and accessible.

Will my search terms work? Use specific terms to filter information. Whereas a broad search term such as “bipolar disorder” would yield a long list of irrelevant articles, a more specific term such as “bipolar maintenance therapy” would substantially narrow the search. Adjust and refine your search terms and update your interest list as needed to ensure an optimal flow of information.

Is the journal’s Webmaster accessible? Contact the Webmaster if an e-alert is not meeting your needs or if you have suggestions for improvement. A link to the Webmaster should be listed on the “contact us” page.

Related resources

Cuddy C. HighWire Press and its journey to become the world’s largest full-text STM online journal collection. Journal of Electronic Resources in Medical Libraries 2005;2:1-13.

Drs. Lapid and Kung report no financial relationship with any company whose products are mentioned in this article, or with manufacturers of competing products.

To comment on this article or share your experience with e-alerts, click here.

Online algorithms and guidelines offer fast access to evidence-based, clinically applicable information on treating a range of psychiatric disorders (Current Psychiatry 2004;3(2):22-40.

Disclosure

Drs. Kung and Lapid report no financial relationship with any company whose products are mentioned in this article, or with manufacturers of competing products.

To comment on this article or share an algorithm that works in your practice, click here.

Online algorithms and guidelines offer fast access to evidence-based, clinically applicable information on treating a range of psychiatric disorders (Current Psychiatry 2004;3(2):22-40.

Disclosure

Drs. Kung and Lapid report no financial relationship with any company whose products are mentioned in this article, or with manufacturers of competing products.

To comment on this article or share an algorithm that works in your practice, click here.

Online algorithms and guidelines offer fast access to evidence-based, clinically applicable information on treating a range of psychiatric disorders (Current Psychiatry 2004;3(2):22-40.

Disclosure

Drs. Kung and Lapid report no financial relationship with any company whose products are mentioned in this article, or with manufacturers of competing products.

To comment on this article or share an algorithm that works in your practice, click here.