Teresa L. Knott, director of Tompkins-McCaw Library for the Health Sciences at Virginia Commonwealth University and associate university librarian, is president of the Medical Library Association. The organization, which represents more than 4,000 health sciences information professional members and partners around the world, recently issued a statement affirming its values and expressing concern over “recent government policies that threaten our fundamental beliefs and principles.”

“Our members know from experience that open and public access to information facilitates scientific collaboration, provides researchers with easier access to scientific research and data, strengthens biomedical research, and leads to better patient care,” Knott said in the MLA statement. “Patients who have access to necessary health information are empowered to play an active role in their health care and realize better health outcomes. The free movement of scientists worldwide contributes to a diverse and inclusive research environment in the best interest of all.”

What led to MLA making this statement?

Librarians have a long history of advocating for openness, transparency and access to high-quality research. When the current administration began restricting public communications by imposing rules restricting the use of social media and interactions with the press by the Environmental Protection Agency and departments such as Health and Human Services, and Agriculture, members of the Medical Library Association became concerned.

“We rely on science being rigorous, transparent, and reproducible. We rely on it being readily accessible. ”

The foundation of health care is evidence-based practice, which is built on the framework of peer-reviewed literature. The health care team (practitioners, researchers, students and administrators) seeks the best information to make decisions and advance science. We rely on science being rigorous, transparent, and reproducible. We rely on it being readily accessible. As medical librarians, we organize, evaluate, and facilitate access to authoritative information and educate our user population about assessing, organizing, and using health information.

Health information runs the gamut from peer-reviewed journal articles that are the culmination of research funded by the National Institutes of Health to health sciences literature indexed by the National Library of Medicine, accessible to anyone with an internet connection through databases such as pubmed.gov, to publicly available environmental data from the EPA or influenza data from the Centers for Disease Control and Prevention. Data provided by governmental agencies can be invaluable in tracking down local outbreaks of illnesses, such as the Flint, Michigan, water crisis.

When the administration issued its executive order on immigration on January 27, the MLA Board decided to move forward rapidly with developing and issuing a statement to publicly affirm our values. Science is an international endeavor. MLA has members from around the world who engage with the association in advancing knowledge in library and information sciences. We value these relationships and welcome the opportunity to share information and learn from our colleagues, wherever they may be. 

In addition, health sciences librarians work in complex health care organizations that rely on clinicians and scientists. Nationally, we have an ongoing shortage of health care providers, and we are fortunate that our institutions are able to recruit and train the next generation of providers from among the best and the brightest in the United States as well as from around the world. Biomedical trainees and researchers also join our institutional ranks from around the globe. On the flip side, medical centers, such as VCU Health, attract patients that we are uniquely qualified to treat. One example that comes to my mind was when VCU Health separated conjoined twins, Maria and Teresa Tapia, in 2011. The twins, born in the Dominican Republic, were brought to Richmond and VCU through the efforts of international organizations who wanted to see the twins separated and thriving.

More and more, it is clear that we live in an international community with much to offer each other.

What do you hope this statement achieves?

In just a few weeks, the new administration, through its statements, actions and executive orders, has triggered a flurry of passionate reactions, some supportive and others not. Our values as medical librarians unite all of us, and are the foundation for MLA actions in the future.

What role do you see institutions like medical libraries as having in this era, in which “fake news” is becoming more and more prevalent?

My personal view is that medical librarians have confronted the issue of fake medical information long before “fake news” made the news. The concern here is that the press is being discredited as a reliable source of information. We certainly don't want that to happen to health information providers. Librarians will play an increasing role as unbiased vetters of health information, and the MLA will be engaging with publishers and scholars on this topic

One of my favorite quips is that librarians were the original search engine. As part of our training and ongoing work, we learned to assess the quality of information. This is true whether we are looking at a peer-reviewed journal, consumer health or a possibly “fake news” story. We typically look at the following elements:

• Source: Is it reliable and credible? How long has the publication been in existence? Who publishes it? Is the editor respected as a scientist or researcher? Who is on the editorial board? Is it indexed by the National Library of Medicine or other reputable organization?
• Creator: Does he or she have the credentials to knowledgeably address a topic? Does the author have a financial interest that presents a conflict of interest?
• Bias: Does he or she have a particular bias? Who funded the research?
• References: Does the author cite credible resources? Does the author self-cite frequently? How old are the references?
• Statistics: How large was the sample studied? Are the statistics used appropriate to the study?
• Timeliness: Is the information current?

In the case of fake news, it is especially important to see if the news is reported by a credible news outlet. If a story evokes strong emotions, based on your own biases, please consider looking at one or more mainstream media outlets to verify the story. If the news all seems to slant in one direction on an ideological spectrum, look for verification elsewhere. The International Federation of Library Associations and Institutions created a great infographic for assessing news.

Similar to fake news, another threat in the health sciences is the growth of predatory journals. They appear to be academic or scholarly journals. They often represent themselves as open access journals, but charge high publication fees and do not typically have a rigorous editorial process or publishing services like those offered by a reputable journal publisher. They often mimic the names of more reputable journals.

In a related issue, over the last few months, we have seen groups working feverishly to download and secure data that seems to be at risk of being taken down from official government sites. Scientists, activists, and librarians are scrambling to preserve climate data, environmental data and more through guerilla hackathons. Librarians are working to make sure that the saved data are retrievable and usable in the future.