Introduction Antimicrobial resistance is a global problem with serious implications for modern medicine. Education of the public is essential for reducing patient pressure on GPs and subsequent inappropriate prescribing. Evaluation of educational interventions is necessary to assess their impact on public knowledge and attitudes. The aim of this study was to evaluate the effect of a health information website, part of the National electronic Library of Infection, on user knowledge and attitudes. Method Questionnaires testing user knowledge and attitudes before and after using the website. Results There were significant improvements in knowledge about the use of antibiotics and antibiotic resistance. Expectations that antibiotics should be prescribed were significantly reduced after using the website. Health professionals showed a significantly greater knowledge about antibiotics and were less likely to expect antibiotics to be prescribed for acute otitis media than non-health professionals before using the website. There was no significant difference between the knowledge of these groups after using the website, but non-health professionals continued to have higher expectations of antibiotics being prescribed than health professionals. Conclusions Health information websites can play a significant role in influencing public knowledge and attitudes. Further research is needed to investigate how people learn from these interventions and to determine their long-term impact on public attitudes and subsequent behaviour.

The National electronic Library of Infection (NeLI: http://www.neli.org.uk) in the UK is a freely available portal to key evidence and guidelines in the infectious disease field. This paper discusses 5 years of evaluation of the pilot library and how this evaluation informed design of the new library website. The importance of combining qualitative and quantitative evaluation is highlighted and the results of web access logs analysis, free text search query analysis and an online user survey are compared. The paper concludes with a discussion of lessons learned for future development and evaluation of this Internet digital library.

Modern healthcare specialists are overwhelmed with medical information available on the Internet. However, it is difficult to find a particular piece of information when and where they actually need it. The National electronic Library for Health (NeLH) is addressing this issue by providing a single-entry portal to evidence-based medical information on the Internet enhanced with a quality tag assigned by professional experts in the field. In order to fully utilize the potential of an Internet-based library, the NeLH is distributed and consists of a number of Virtual Branch Libraries (VBLs), each dedicated to a particular disease or a medical area. Our team is responsible for the development of the communicable disease branch of the NeLH, called NeLCD (National electronic Library for Communicable Disease). VBLs are dynamically updated and their design reflects the needs of each particular user base. However, users accessing a single VBL may want to search the entire NeLH or should have the option of being able to search the entire NeLH. Therefore, support for a distributed search according to an adopted topology of VBL servers is essential. Intelligent Interface Agents are essential for the development and runtime of the library as they perform autonomously a number of tasks related to the search, assist humans in information publishing, the document review process and data exchange and retrieval. In this paper, we present an agent-based solution to assist in distributed search across the NeLH, and customization and personalization in the NeLCD.

has been funded by the Department of Health to construct a National Electronic Library for Communicable Disease to form part of the National Electronic Library for Health. As a final preparation for its launch, the developers have been conducting a number of experiments to test public understanding of the information housed and if the site is easily accessible and usable. This paper reports on the results of the usability tests, carried out in the Science Museum in February 2003. Data gathering was by questionnaire, observation and interview. Findings suggested a great appreciation of the site by members of the general public.

Medical digital libraries are essentially life-critical applications providing timely access for professionals and the public to current medical knowledge and practice. This paper presents a new methodology for evaluating the impact of the knowledge within a medical digital library on users by testing their knowledge improvements and attitude changes. Using pre and post-use questionnaires we tested the impact of a small medical information website acting as an interface to the National electronic Library for Communicable Disease. The changes in user attitudes and the correlation with knowledge improvements observed indicate the potential for this methodology to be applied as a general evaluation technique of digital libraries and the impact of online information on user learning.