A b s t r a c t , the National Library of Medicine (NLM) assembled a large multidisciplinary, multisite team to work on the Unified Medical Language System (UMLS), a collaborative research project aimed at reducing fundamental barriers to the application of computers to medicine. Beyond its tangible products, the UMLS Knowledge Sources, and its influence on the field of informatics, the UMLS project is an interesting case study in collaborative research and development. It illustrates the strengths and challenges of substantive collaboration among widely distributed research groups. Over the past decade, advances in computing and communications have minimized the technical difficulties associated with UMLS collaboration and also facilitated the development, dissemination, and use of the UMLS Knowledge Sources. The spread of the World Wide Web has increased the visibility of the information access problems caused by multiple vocabularies and many information sources which are the focus of UMLS work. The time is propitious for building on UMLS accomplishments and making more progress on the informatics research issues first highlighted by the UMLS project more than 10 years ago.Ⅲ JAMIA. 1998;5:1 -11.Over the past 10 years the Unified Medical Language System (UMLS)* 1 has captured the time, talents, and attention of many informatics investigators from a broad range of disciplines. The project is focused on overcoming two important barriers to the development of information systems that can help health professionals make better decisions. These barriers are the disparity in the terminologies used in different in- formation sources and by different users, and the sheer number and distribution of machine-readable information sources that might be relevant to any user inquiry. The UMLS supports the development of userfriendly systems that can effectively retrieve and integrate relevant information from disparate machinereadable sources. To accomplish this objective, the UMLS project has produced and widely disseminated four multipurpose knowledge sources designed for system developers: the Metathesaurus, the Semantic Network, the Information Sources Map, and the SPE-CIALIST Lexicon and associated lexical programs.

Public concerns about the perils associated with incomplete or delayed reporting of results from clinical trials has heightened interest in trial registries and results databases. Here we review the current status of trial registration efforts and the challenges in developing a comprehensive system of trial registration and reporting of results. ClinicalTrials.gov, the largest trial registry with 36 249 trials from approximately 140 countries, has procedures in place to help ensure that records are valid and informative. Key challenges include the need to minimize inadvertent duplicate registrations, to ensure that interventions have unambiguous names, and to have a search engine that identifies all trials that meet a user's specifications. Recent policy initiatives have called for the development of a database of trial results. Several issues confound the implementation of such a database, including the lack of an accepted format or process for providing summaries of trial results to the public and concerns about disseminating data in the absence of independent scientific review.

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The past 20 years have witnessed computer and communications revolutions, rapid progress in genetics research, increasing public interest in personal health decisions, and corresponding expansions in the services provided by the National Library of Medicine. These concomitant and linked developments have upset the information marketplace and inspired policy debates about telecommunications, intellectual property, and access to the results of governmentfunded research. The Internet and the World Wide Web have transformed the way libraries deliver information services and have created perceived alternatives to libraries. What will happen to medical libraries in the post-Google world?Today, most medical libraries exist within hospitals or academic institutions. Their primary purpose is to provide scholarly information to support health care, education, and the research conducted at these institutions. Given that scholars and researchers continue to rely on information, the work now performed by medical libraries will not disappear. But how, where, and by whom will it be done? Here is one evolutionary scenario for the medical libraries of 2015. Everything we envision exists in some form today.In our 2015, health care professionals, patients, educators, students, researchers, and administrators expect easy access to electronic information from their homes, offices, wards, clinics, and libraries, not to mention while they are en route between these places. People use a constantly changing array of desktop, portable, and wearable computing and telecommunications devices. Most desktop ma-chines and many portable devices support easy teleconferencing and distance education. Everyone craves access to more electronic information, no matter how much is available, but people treasure efficient methods for extracting pertinent information from the fire-hose effect of undifferentiated electronic text (and unwanted commercial offers). Most clinicians, patients, and healthy people use electronic health records. Like basic researchers, clinical researchers depend on electronic data systems. When using such systems, practitioners and researchers expect instant connection to related knowledge, including guidelines, protocols, clinical alerts, and relevant published dicta. Patients and families demand the same information that is available to physicians, nurses, and public health departments.Despite ubiquitous access to electronic information, however, the "library as place" is still highly valued and heavily used (unless the facility is physically decrepit, outmoded, or inconveniently located). Users flock to library buildings and spaces that are attractive, centrally located, technologically current, and arranged to meet the needs of groups as well as of solitary users. 1 In addition to serving coffee, the best facilities support small-group study and larger-group training, provide well-wired space for interdisciplinary collaboration involving complex electronic data sets, and welcome those seeking temporary work space, individual ...