EndLink: EndNote's Link to Online Databases, Niles & Associates, Inc. IBM PC and compatibles. Macintosh version also available. Berkeley, CA, 1994, 52-page spiral manual, $99.00.
Professional success often depends upon the ability to organize, retrieve, and synthesize information from the anesthesia literature. EndNote, a software product specifically designed to manage bibliographic data, stores the complete bibliographic citation (author, title, journal, year, volume, page, etc.). The program can also store the article's abstract and key words as well as personal notes that the user wishes to add. EndNote allows the user to maintain several reference libraries. For example, a cardiac anesthesiologist with an interest in transfusion medicine might have libraries devoted to cardiac anesthesia, pediatric anesthesia, transfusion medicine, and anesthesia in general. A library of 1000 references with abstracts and key words occupies approximately one MEG of hard disk space. The maximum size for any single EndNote library is 32,000 references.
By far the most efficient and accurate approach to creating a personal bibliographic database is by downloading from a MEDLINE source. The companion program, EndLink, is used to download references. Both on-line sources (e.g., BRS, GratefulMed, etc.) and CD-ROM (e.g., CD-Plus, SilverPlatter) are supported. With EndNote and EndLink, one no longer needs to wait in the library while the printer churns out the results of your search (and other users wait impatiently behind you). Instead, one downloads the references and abstracts to a disk. Back in the office, using EndLink you review the search on your own computer screen or print the results. Relevant references are retained in the EndNote library. EndNote can also help the busy clinician stay abreast of current literature. From a MEDLINE source, one selects journals of interest, such as Anesthesia and Analgesia, and limits the search set to the latest update. This yields articles that have appeared within the last 3-6 mo. One browses the list and downloads interesting articles together with their abstracts. These references are added to one's personal EndNote library. One also uses the download to generate copy requests for articles where the entire text is needed. EndLink will import from Current Contents on Diskette, another popular access to the recent literature. Material that is not available on MEDLINE, such as book chapters and abstracts from meetings, can be added to EndNote manually.
EndNote is extremely useful for preparing bibliographies to accompany a manuscript that one hopes to publish. After preparing the manuscript, one adds brief citations, such as [Ellison, 1991], wherever references are needed. EndNote scans the manuscript, places the appropriate numbers in the text, and prepares the reference list formatted according to the journal's style requirements. Occasionally, a manuscript will be rejected, and one then needs to revise the paper and send it to another journal, which may require a totally different reference format. With EndNote, reformatting the references becomes a straightforward process.
EndNote is very helpful for preparing short bibliographies to supplement discussions with colleagues or residents. For example, I was recently discussing with our ENT surgeons the value of local infiltration during tonsillectomy. I searched my EndNote library with the term "tonsil." This yielded two succinct references. I exported the citations and abstracts to the word processor, added a brief title, "Preemptive Analgesia in Tonsillectomy," and gave this to my surgical colleagues before they could finish their first T&A. EndNote does free text searching on the entire library. Therefore, in the example above, the search term "tonsil" also found entries containing tonsillectomy. Without free text searching, the user would need to be extremely careful to use consistent key words in order to relocate references.
EndNote is not a true Windows program; however, it works well from the Windows environment. It is easy to switch between the word processor and EndNote. One can cut and paste to the Windows clipboard. Familiar Windows keystrokes, such as Cntl-C for copy and Cntl-V for paste, work in EndNote. The program has intuitive menus that can be accessed with either the mouse or the keyboard. A true Windows version is under development. The spiral-bound EndNote manual is clear and concise. The program is accompanied by a helpful tutorial. The technical support staff is patient, pleasant, and extremely knowledgeable. Since hard disks can crash, it is important to back up EndNote libraries regularly or a great amount of effort may be lost. An integrated backup function, as found in some financial programs, would be a useful addition.
EndNote should be useful for academic anesthesiologists who prepare grants and manuscripts. This type of program can improve the effectiveness of secretarial support also. For the clinician, EndNote offers a useful approach for maintaining a readily searchable electronic library. In conjunction with EndLink and MEDLINE downloading, EndNote can help the busy clinician-researcher to stay abreast of the current literature.
Richard K. Baumgarten, MD
Department of Anesthesiology, Henry Ford Hospital, Detroit, MI 48202-2689