The Internet is an accepted place to turn for research, and nowhere has this become more apparent than in the fields of medicine and health care. A veritable explosion of available medical information seeks to meet the needs of both professionals and the public. In fact, many professionally-oriented health care sites have evolved to meet consumer needs, and consumer-oriented sites often include professional literature. Although sites for consumers and support groups make up an important and extremely useful segment of health care web sites, I will concentrate on the needs of the professional researcher. For example, legal researchers, who often have to consult medical sources, usually do not have a medical library at hand. We can appreciate that the Internet provides free access to a great deal of the medical literature, either in full text or citation/abstract format, and that it offers relatively good search capabilities.
Medical journals, dictionaries, textbooks, indexes, rankings, images – all can be found on the Net, and much of it is free. The sources include publishers, government agencies, professional organizations, health libraries, and commercial entities. The following is not intended to be an exhaustive list, but rather notes on databases that I have found to be reliable and useful.
National Library of Medicine (NLM) Medical Literature Databases
With so many medical web sites available, how does a researcher know which to search? It depends on what you are looking for. Journal articles make up an extremely important category of the medical literature because they contain the latest research. MEDLINE, one of the jewels of medical research, is the National Library of Medicine’s electronic database that gives citation and/or abstracts for journal articles in the life sciences with a concentration on biomedicine. Over 5200 journals are currently indexed by Medline. Most records are from English-language sources or have English abstracts. The database contains over 16 million citations and dates back to 1950. As such, it is a mainstay of medical research, especially for current information. It can be searched from 2 NLM web sites, PubMed and NLM Gateway.
Links to Medline can also be found on other sites, such as those of medical libraries. But remember: not all Medline links are the same. Some do not provide a link to the NLM site and all its search features; instead they may offer less powerful searching. Or, they may not search the entire Medline database. Read the web site’s description, if there is one, to determine exactly how much Medline is offered.
Medline is a sophisticated database that can be somewhat confusing, even to an experienced researcher. Throw in medical terminology and searching can be that much harder. Help screens and FAQ pages abound on the NLM web sites, and I recommend that you use them.
For example, articles in Medline are indexed by assigned medical terms, so it is critical to use these terms when searching. Because not everyone who uses Medline is familiar with medical vocabulary, the system is designed to help you find precise terminology by leading you to these subject headings. The National Library of Medicine has developed an extensive controlled vocabulary called MeSH, or Medical Subject Headings. Using MeSH terms in a search will lead to greater accuracy and relevancy in search results. Medline was originally designed for medical professionals - medical terminology can seem like another language to the layman. But NLM knows this and continues to find ways to make searching easier.
As an example of how Medline directs users to correct terms, go to the MeSH web page. I entered “norplant” into the MeSH search box and got back the correct MeSH heading “levornorgestrel” along with a short definition. Clicking on levornorgestrel led me to a hierarchy of the term and its subheadings. I cannot stress enough how important it is to use the MeSH feature. How many of us, for example, know that “mad cow disease” is represented in Medline as “encephalopathy, bovine spongiform”? But note that very recent articles may not yet have been assigned MeSH headings.
(note: PubMed is referred to on its web site as Entrez PubMed. “Entrez” refers to the date that a citation is added to the database, as opposed to the actual publication date of the article.)
Medline makes up the largest part of the PubMed database. PubMed also contains in-process citations of articles not yet indexed or assigned subject headings and citations for some articles or journals not selected for regular Medline indexing. A link to a good overview of PubMed can be found on the home page.
PubMed offers powerful searching. You can search or limit by author, title, journal, date, MeSH heading, language, gender, age, publication type, full text availability, and more. PubMed allows for Boolean searching or the use of a command language to designate search fields. For detailed explanations, I urge you to read the help page, FAQ screen or take the search tutorials; links are on the home page. There is also a QuickStart page if you are in a hurry.
Search results can be displayed in different formats that you select from a pull-down menu. Most citations also have links to related articles. The citation format will include MeSH terms that were assigned to that article. The abstract format does not include the MeSH terms. Very old and very new citations will probably not have abstracts.
A Send To pull-down menu on the results screen allows you to save or send search results. You can also send them to a Loansome Doc order screen; Loansome Doc is the fee-based online ordering system of NLM. The user has only to point and click to order the full text of desired articles. Results can also be used to create RSS feeds; just select RSS Feed from the Send To pull-down menu.
A wonderful trend in medical literature is the amount of full-text information that is available on the Internet. NLM has been in the forefront of this trend. Via a Links icon next to the citation/abstract, PubMed will take you to free or fee sources of the full text of participating journals if they are available. It is clear when an article must be paid for.
PubMed has other useful features; links are on the homepage sidebar:
- The Journals Database lets you look up journal names, Medline abbreviations, or ISSN numbers
- Single Citation Matcher allows you to verify a single citation
- The Batch Citation Matcher allows you to verify multiple citations
- My NCBI is a stored search feature that allows users to store and automatically update searches and create alerts.
Along with access to full text articles, PubMed also offers access to a growing collection of biomedical textbooks.
Another link on the left sidebar is to NLM Mobile, a page that gives access to a directory of PubMed tools that are appropriate for mobile devices.
NLM Gateway is the user-friendly way to search Medline plus additional NLM databases. It is broader in scope than PubMed because it covers not only journals, but the books, serials and non-print media of the collection of the National Library of Medicine, as well as the contents of the databases listed below. Its “one-stop shopping” interface searches all the databases simultaneously. It is aimed at “the Internet user who is new to NLM’s online resources and does not know what information is available there or how best to search for it.”
Gateway searches these databases:
- NLM Catalog
- MedlinePlus, NLM’s web site for consumer health information
- Toxline, a bibliographic database on toxicology
- Bookshelf, full text biomedical books
- DART, a database covering teratology
- Meeting Abstracts, NLM’s online collection of abstracts from HIV/AIDS, Health Sciences Research, and Space Life Sciences meetings
- ClinicalTrials.gov, information about clinical research studies
- DIRLINE, the Directory of Information Resources Online
- Genetics Home Reference, a consumer web site about genetic conditions
- Household Products Database, a consumer’s guide to health effects of chemicals in household products
- HSRProj, information about ongoing grants and contracts
- OMIM, updated catalog of human genes and genetic disorders
- HSDB, a toxicology data file on the toxicology of potentially hazardous chemicals
- IRIS, a toxicology data file with data in support of human health risk assessment
- ITER, a toxicology data file with human health risk assessments
- GENE-TOX, on genetic toxicology test data
- CCRIS, Chemical Carcinogenesis Research Information System
- Profiles in Science, access to archival collections of leaders in biomedical research and public health.
NLM Updating Services
To stay current on the many improvements and changes made to the NLM databases, turn to the NLM Technical Bulletins for regular updates. You can get these via email or RSS feed.
NLM Mobile is a web page that has information about tools for handhelds being developed at NLM. For example, it links to a web site about using handhelds to search PubMed.
Before we leave NLM, let me mention MedlinePlus, NLM’s effort to provide consumer-oriented medical information. It is easy to use and understand. Sources include medical dictionaries, a medical encyclopedia, provider directories, health news, and access to health-related government and non-government databases, including a link to PubMed for Medline searching. It is updated daily and is a good place to get basic information on a disease, medical condition or treatment, or a drug; you can then turn to the medical literature for more sophisticated information. A site map organizes the many sources of information.
Additional U.S. Department of Health and Human Services Web Sites
The National Library of Medicine is just one of the agencies under the umbrella of the U.S. Department of Health and Human Services (HHS). Their web sites link to an enormous amount of information for both the researcher and the consumer. They also do an excellent job of providing information and news in a variety of formats. However, it can be hard to find specific pieces of information when searching by keyword. Results can number in the hundreds – one reason that commercial services with superior search capabilities have evolved.
The National Institutes of Health is made up of 27 separate institutes and centers, including the National Library of Medicine. For descriptions and links, click on “Institutes” on the top of the home page. NIH takes a multimedia approach to information: it comes in radio, video, podcasts, newsletters, and RSS feeds.
The Centers for Disease Control and Prevention is another major component of NIH. Its web site offers email updates, podcasts, and RSS feeds.
Part of the CDC, the National Center for Health Statistics compiles statistical information that aids in policy formulations. Its web site has links to various statistical reports.
The Centers for Medicaid and Medicaid Services (CMS) is the federal agency responsible for administering the Medicare, Medicaid, SCHIP (State Children’s Health Insurance), HIPAA (Health Insurance Portability and Accountability Act), CLIA (Clinical Laboratory Improvement Amendments), and several other health-related programs. Like the other HHS agencies, CMS puts an enormous amount of information – regulations, research, statistics, and more – on its web site.
Web sites that have links to many medical web sites or that provide many kinds of medical information – such as medical literature, expert commentary, drug information, CME programs, and news – are useful because they strive to be comprehensive. Some are commercial ventures, some are produced by professional associations, and others are products of medical schools and their librarians. Many have links to Medline/PubMed.
Medscape is a part of the WebMD Health Professional Network. It aims to make it easier for physicians and healthcare professionals to access clinical reference sources, to stay abreast of the latest clinical information, to learn about new treatments, to earn continuing education credits, and to communicate with peers. It has articles, drug information, news, and other information of interest to clinicians. Information can also be read on mobile devices.
eMedicine, another WebMD database, is an open access database of original content written by nearly 10,000 physician authors and editors for eMedicine. There are articles on 7000 diseases and disorders. It also offers the latest practice guidelines in 59 specialties. Content undergoes 4 levels of physician peer review and is updated regularly. There is also a search box for medical images.
Medscape and eMedicine are being merged and one free registration will allow access to both sites; users can also search both collections simultaneously along with Medline and drug information via a simple search box on both home pages. Or you can browse by medical specialty. These web sites, especially Medscape, have enormous amounts of information but are a bit confusing and sometimes lacking in clear explanation. In particular, the Medline that is searched is called “Physician Optimized Medline”. If there is an description of this, I could not find it. Site maps would be appreciated. Nevertheless, WebMD is to be applauded for its comprehensive approach to medical information and for the fact that its information is free.
Also part of the WebMD network, MedicineNet.com is an online, healthcare media publishing company aimed at consumers. I include it because it is a good place to go for understandable yet in-depth medical information. Produced by a network of over 70 U.S. board-certified physicians, it has hundreds of articles on diseases, treatments, procedures, symptoms, tests, medications as well as news. And it has a site map.
MyHeart is an online guide dedicated to understanding and promoting heart health. Each article is authored by a cardiologist. Some of the topics covered include heart valve disease, POTS syndrome, NSTEMI and STEMI heart attacks, coronary artery disease, and explaining the difference between Doctors of Osteopathy (DO) and Medical Doctors (MD).
Simon Williamson Clinic provides extensive information about obstetrics and gynecology, as well the debate of midwifery. The clinic is curretly the only provider of midwives Birmingham, AL .
Aetna InteliHealth, a subsidiary of Aetna, is another site that provides a range of medical information, from news updates to in-depth coverage to drug information and medical reference tools. It seeks to provide “credible information from the most trusted sources, including Harvard Medical School and Columbia University College of Dental Medicine.” Content is reviewed and approved by medical experts. Over 150 health care organizations, including the National Institutes of Health, are contributors. A Help button that is buried on the button of the home page leads to searching tips. Also on the home page are two search boxes, one for Drug Names and one for Search Terms. Entering a drug name links you to information found on SafeMedication.com, a site produced by the American Society of Health-System Pharmacists. This site has pronunciation guides for drug names, which I think is very useful.
MedWeb Community (MWC)
MedWeb Community is a catalog of biomedical and health related web sites maintained by the staff of the Robert W. Woodruff Health Sciences Center Library at Emory University. MWC focuses on globally available, quality biomedical resources. The web sites are not ranked in any way but to be included in MedWeb, they must meet relevancy, credibility, currency, design, and content guidelines.
When I entered “Medline” in the search box, I got 46 links to sites that offer Medline searching as well as to some that were about Medline searching. When I entered “Chicago”, I got links to both Chicago-area web sites and sites related in some way to health care in Chicago. It is a quick way to find web sites on a specific topic or in a specific location.
Medical Libraries and Librarians
The web sites of medical school libraries are good places to look for links to medical literature and research guides. For example, the librarians of the Denison Memorial Library of the University of Colorado at Denver Health and Sciences Center have put together an excellent guide called Medical Reference for Non-Medical Librarians. Divided by category such as dictionaries, diagnostic tests, drugs and search engines, it has tips and annotated links and as such, functions as a research guide and metasite.
Another example is the web site of the Health Library at Stanford University, which brings together information, via links, from a variety of free sources, such as government agencies, the Mayo Clinic and other medical centers, and professional associations.
Resources for Health Consumers
This is part of the Medical Library Association’s website. It is valuable for the medical researcher as well as the consumer. Topics include a tutorial on finding medical information on the Internet, how to get information on hospital quality, how to evaluate medical web sites, deciphering “medspeak”, and more.
Medical/Health Sciences Libraries on the Web is produced by the University of Iowa Hardin Library for the Health Sciences. It is a one-screen, no-frills set of links to academic, hospital, and military medical libraries in the U.S. and around the world. It also links to selected free PubMed articles on 15 subjects.
The free information on prescription and over-the-counter drugs that is found on Drugs.com is supplied by four independent medical information suppliers, WoltersKluwer Health, Physicians’ Desk Reference, Cerner Multum and Thomson Micromedex. It is not affiliated with any pharmaceutical companies. This is a great site with lots of information. By selecting a drug from the alphabetical list or by entering a name in a search box, you will get information labeled by category, such as consumer information or professional monograph, plus a picture of the drug.
You can also search by medical condition, drug interactions, and visual images of drugs. The Pill Identifier lets you use pull-down menus to enter a description of a drug. It responds with the names and pictures of pills that fit the description. You can also click on Drug Image Search to search for images of drugs and pills.
Drug Information Portal
This NLM web site gives users a gateway to selected drug information from the National Library of Medicine and other key government agencies. At the top of the page are links to individual resources with potential drug information, including summaries tailored to various audiences.
The layman’s version of the Physicians’ Desk Reference can be found on this site, which is produced by Thomson Healthcare. The drug information here is written in plain English and is not as detailed, but it does display images. It covers prescription drugs, over-the-counter drugs, nutritional supplements, and herbal medicines. There is also an interaction checker. The physician’s version of the PDR is found at PDR.net and requires a purchase by anyone who is not a health care professional.
Another member of the WebMD family of web sites, RxList.com offers an A to Z drug list, a pill identifier, an interaction checker, and explanations of diseases, conditions and treatments.
SafeMedication.com is produced by the American Society of Health-System Pharmacists.
Prescription Drug State Legislation, a report by the National Conference of State Legislatures, provides information about enacted and pending state drug legislation. The latest report is 2007, with 2008 legislation being added.
Journals and Textbooks
Just as electronic information and the Internet have changed the nature of legal publishing, they are also having a profound effect on medical and scientific publishing. More and more free scholarly medical information is becoming available on the Internet.
PubMed Central is the National Library of Medicine’s database of free, full-text medical articles made available by contributing publishers. The web site includes a list of participating journals.
Directory of Open Access Journals
This directory of free, full-text, quality-controlled scientific and scholarly journals aims to cover all subjects and languages and therefore is a valuable guide to foreign-language medical journals. It represents a truly international effort to bring free content to the Web. It covers 3312 journals, with 1103 titles searchable at the article level. In other words, you cannot find citations to articles for every journal listed, nor can you find the full text for every article that is cited.
FindArticles.com is a search engine for periodical articles from journals in many subjects. Click on “Health” on the home page to search health-related titles. Although some of the content is available only for a fee (marked by a $ sign), much of it is free. Explanations of what is covered are sparse, but the site is easy to use.
ScienceDirect is a part of Elsevier, a publisher of scientific, technical and medical information provider. It is an online collection of published scientific research, including over 2500 journals and 6000 books (the latter includes 4000 ebooks). You can search ScienceDirect for free, but the full text of only about 35 journals is free. Most of the content requires a subscription or the purchase of articles on a pay-as-you-go basis.
Public Library of Science (PLoS)
The Public Library of Science is a non-profit organization of scientists and physicians committed to free and timely online access to the world’s scientific and medical literature. They have created seven online journals that cover different medical topics and that are intended to make research accessible to everyone. The full contents of every issue are placed in PubMedCentral.
This site gives free access to the full text of 430 medical journals, sorted by specialty and title and covering English and foreign-language publications.
A sister site to FreeMedicalJournals, this site links to the full text of 650 medical texts in different languages.
Researching medicine often includes a hunt for visual information in the form of illustrations or images. The fact that the Internet is not restricted to textual information makes it an extremely valuable research tool. However, an image on a web site might not be free. For example, a thumbnail image of a disease or a medical condition might be available at no cost, but a larger image may require payment. Or you might have to pay to download the image.
Medical Images on the Web, produced by the McGoogan Library of Medicine of the University of Nebraska Medical Center, has annotated links to 32 web sites of visual medical information.
Hardin MD – Medical Pictures/Diseases Pictures gathers links to a huge number of medical images; the arrangement is by subject.
Medical Matrix: a pull-down menu next to the search box allows you to search for Pathological/clinical image resources or X-ray image resources.
MedPix is a free online medical image database, provided by the Departments of Radiology and Biomedical Informatics, Uniformed Services University, Bethesda, MD. All public content is peer-reviewed.Its primary commitment is supporting medical students, graduates, and post-graduate residents for their CME education but it is also available to the public. Use the pull-down menu “What do you want to do?” to search.
WebPath is an electronic collection of 1900 images of pathology specimens along with text, tutorials, and laboratory exercises.
Findlaw’s Medical Demonstrative Evidence web page offers medical exhibits and animations, anatomical models and videos and dvds for sale for use as evidence or illustration in medical litigation.
Science.gov is a search engine for U.S. government science information and research results. You can search over 47 million pages with one query or have access to over 1800 science web sites. A simple search on the home page will search the entire database. To limit your search to health-related sites, go to the advanced search page and select “Health and Medicine”. You can also create email alerts from your search.
Scirus, an Elsevier product, is another science-specific search engine that searches over 450 million web pages while it filters out non-scientific web sites. It covers scientific, scholarly, technical, and medical data from reports, peer-reviewed articles, and journals, including pages often invisible to other search engines. Like Science.gov, you have to go the advanced search page to narrow your searching to Medicine and Life Sciences. Scirus retrieves both free and fee information.
OmniMedicalSearch does several things. It is a meta search engine with tabs for searching for medicine, news, images, and “Medpro” – a search tab for medical professionals who need peer level information. It is also a directory, with pages of lists and/or links to medical associations, journals, searchable medical databases, and almost 20 medical image web sites. It is produced by an individual who is named but whose qualifications are not given. Nevertheless, it is well designed and easy to use.
MedBot is a product of Stanford University. It brings together several types of resources: general search engines, medical indices, news sites, medical education, and medical imaging and multimedia sites. The user can select up to 4 databases to be searched at one time, or you can click on each category and search the listed sites one at a time. MedBot is easy to use, but some of the search engines listed no longer exist or have broken links.
SearchMedica is a U.K.-based search engine that gathers information from both U.K and non-U.K. sites. It is directed toward medical practitioners. Some of the content that it links to requires a fee by the publisher.
Health Care Providers and Facilities
Researchers may need to investigate medical providers and medical institutions. This information can be hard to track down, but a growing number of web sites are making it more available. You may want to identify a doctor, verify her credentials, or determine if she has been the subject of disciplinary action.
DoctorFinder is produced by the American Medical Association. It provides basic information on individual physicians and includes more than 690,000 AMA member and non-member doctors of medicine (MD) and doctors of osteopathy or osteopathic medicine (DO). It does not include other licensed health care professionals such as dentists, optometrists, chiropractors, nurses, or allied health personnel.
To find out if a doctor is board-certified, go to the web site of the American Board of Medical Specialties. Once you register for free use, you can log in and search by name and location or specialty and location.
Licensing data and educational background for medical professionals are usually available from the provider’s state medical board or licensing agency. The State Board Directory web site is a directory of state medical boards with links to most of the boards’ web sites.
While it is not that difficult to determine if a physician is licensed, the lack of information about whether he or she has ever been disciplined is a growing concern. Part of the problem is that the availability of this information varies from state to state. Some state medical boards provide this information, some do not. Information that is provided by state medical boards should be free.
The Federation of State Medical Boards (FSMB] is made up of 70 medical licensing authorities in the United States and its territories. Its web site has a directory with links to these authorities. It also houses the Federation Physician Data Center, which is a central repository for formal actions taken against physicians by state licensing and disciplinary boards, Canadian licensing authorities, the U.S. armed forces, the U.S. Department of Health and Human Services, and other national and international regulatory bodies. The Federation Physician Data Center offers two services used in performing credentialing functions or pre-employment background checks: the Board Action Data Search and the Disciplinary Alert Service. However, according to the web page, “Access to this site is limited to credentialing entities under contract with FSMB. Public inquires should be directed to http://www.docinfo.org.”
DocInfo is the part of the FSMB that is available to the public. Through this web site, users can request disciplinary reports on U.S. licensed medical physicians, osteopathic physicians, and some physician assistants. Reports cost $9.95 per physician.
In addition, each year the Federation of State Medical Boards publishes the Summary of Board Actions, a compilation of disciplinary actions initiated by its 70 member medical boards. The latest issue is dated 2007.
BoardCertifiedDocs.com is published by Elsevier in cooperation with the American Board of Medical Specialties (ABMS). It is a commercial tool that provides certification status and complete biographical and professional information about board-certified physicians. Price information can be found here.
Researchers may need information on organizations as well as on individuals. The Joint Commission on Accreditation of Healthcare Organizations evaluates and accredits over 15,000 healthcare organizations and programs in the United States, including hospitals, nursing homes, and laboratory services. If you want to see what entities have been accredited in a particular geographic location or to see if a particular organization is accredited, go to its Quality Check page for instructions. This is a very easy-to-use site that rewards the searcher with useful, current information.
Another source for hospital information is the American Hospital Directory, which covers over 6000 hospitals with information from private and public sources. Basic information (address, web link, number of beds, etc.) is available for free. Subscribers get more detailed information, including costs and charges, financial reports, specialties, and outpatient and inpatient information. A single user pays $395 for unlimited access; there are discounts for multiple users.
HealthGrades is a nonprofit organization that issues reports that rate hospitals, physicians, health plans and nursing homes, and most recently, prescription drugs. It is not clear to me who is doing the rating, but its ratings are widely used and quoted and seem to be an industry standard. Consumers have the option to communicate their own experiences. Some of the information is basic and free; more comprehensive reports must be purchased. Physician reports cost $29.95 with an additional $7.95 required for malpractice information. A full hospital report costs $17.95, and a complete nursing home report costs $9.95. A “watchdog citizen” notification service at $4.95 per month will alert you to changes in the information. Sample reports can be viewed for free.
Hospital Compare is a government consumer-oriented website that provides information on how well hospitals provide recommended care to their patients. It is a product of the Centers for Medicaid and Medicare Services and the Hospital Quality Alliance. On this site, the consumer can see the recommended care that an adult should get if being treated for a NSTEMI heart attack, heart failure, or pneumonia or having surgery and the quality of care given by hospitals for treatment of these conditions.Nursing Home Compare is another federal government web site whose primary purpose is to provide detailed information about the past performance of every Medicare and Medicaid certified nursing home in the country.
As of this writing, Consumers Union has announced that it plans to launch a hospital-rating service. It already reviews health-insurance plans, drugs and some medical treatments. It will cover about 3,000 hospitals.
There are many web sites that allow consumers to report on their health care providers and facilities and the number is growing. It is beyond the scope of this article to report on them.
Podcasts, Blogs, and Mixed Media
Many “establishment” web sites, such as PubMed, use blogs, RSS feeds, podcasts and other audio/video media to deliver medical information, especially news of new research. Many of the sites already mentioned have these options. Check the web site to see what’s offered. Following are just a few examples of medical information that can be found on the Web in different media.
Johns Hopkins Medicine Podcasts is an example of an institution offering information in podcasts.
The web sites of many medical journals have links to mixed media reports and/or summaries of issues as well. See the Annals of Internal Medicine’s Audio/Video page for an example.
Public Health Grand Rounds “is a series of satellite broadcasts and webcasts presenting real-world case studies on public health issues ranging from obesity to bioterrorism, from SARS to food safety.
It is a collaborative effort between the Centers for Disease Control and Prevention and the School of Public Health at the University of North Carolina at Chapel Hill. “
Medical blogs, sometimes called medlogs, have invaded the Internet. Medical News Feeds is a medlog aggregator. A long list with links to other medlogs appears on the left sidebar; take a look. MedWorm is a tool for searching or browsing medical blogs and RSS feeds.
Doctors are also blogging. One example out of many is California Medicine Man’s blog.
Think Tanks and Other Organizations
Many agencies and organizations issue reports and analyses on different aspects of health care and health care policy. Some of them are:
Congressional Research Service (CRS): selected reports can be found on various web sites. See Guide to CRS Reports on the Web, by Stephen Young, on LLRX.com web, for links.
The General Accountability Office (GAO) issues reports on many subjects, including health care.
The Congressional Budget Office (CBO) will issue cost analyses of health care policies and legislation.
Health Policy Picks “is a monthly selection of recent publications, such as technical reports, conference proceedings, and other material produced by organizations and government agencies that conduct health care policy analysis and research. Health Policy Picks is a partnership between KaiserEDU.org and the New York Academy of Medicine Library's Grey Literature Collection.” You can sign up to receive email updates.
The Internet has become an important, if not essential, tool for those looking for information in medicine and the health sciences. Medical information professionals are at the forefront of the effort to organize this vast, ever-increasing store of knowledge. The sites that I have mentioned reflect this effort and are meant to be a sampling of the marvelous resources that are now available to the medical researcher. Take some time to explore medicine on the Web; no doubt you will discover many more.