Paying It Forward

On the importance of honors and awards

We’re approaching conference season and with it, the awards that honor the best in our professions. It’s thrilling to be recognized by one’s peers for notable accomplishments or a stellar career. But I’ve found it can be just as rewarding to nominate someone for such an honor.

It’s both personally and professionally gratifying to me to identify people whose high-caliber work is worthy of public recognition. I enjoy helping colleagues or peers experience the glow that comes with knowing that others value and appreciate their efforts. I take pride in nominating those who give so much to their work, toiling, at times, in relative obscurity. I like to shine a light on their accomplishments and contributions, recognizing their efforts and even more so their impact. Finally, by nominating others, I am paying it forward, acknowledging the debt I owe to those who’ve watched over my career (thank you, Margaret Grier!) and perhaps inspiring those I nominate to nominate others.

Sometimes, those being nominated see it as an expression of gratitude for their professional contributions. And certainly, nominations can be that. But just as often, I nominate others out of a deep sense of awe at what they’ve accomplished in the face of challenges and setbacks. I respect their commitment and their resilience, and I marvel at their tenacity, and yes, even their genius. In nominating them, I not only get to dive deeply into their work—deepening my appreciation for it along the way—but I also learn about its origins and its significance, the service it provides or the problem it solves.

Service also underpins another side effect of awards, particularly those that convey membership in an honorary society. Such honors can be invitations to serve at a higher level—to join fellow members in working together to benefit society.

I’ve often thought of my own memberships in the American Academy of Nursing, the American College of Medical Informatics, and the National Academy of Medicine as both acknowledgements of my work and opportunities to give that work broader impact. It’s like getting a new Rolodex—or for the younger folks, an expanded contacts list—of colleagues with whom I can partner to advance key issues in support of health and health care. And for someone committed to service, I can think of no better gift than to have access to such a Dream Team.

Aside from these individual perks, being nominated or winning an award brings collateral benefits to the awardee’s home institution, to the organization making the award, and to society as a whole.

The home institution gets a boost because an award to one of its staff inevitably highlights the work of the group. Each time I nominate an NLM staffer for an award or fellowship, I get another chance to tell the Library’s story, a fresh opportunity to communicate what we do, how important it is, and how well we do it. And should a staff member win an award? Then the spotlight gets even bigger, shining brightly on what she or he has done as part of the NLM mission.

Professional societies and other organizations also benefit from the awards process. The adage “being known by the company you keep” applies here, as the reputations and contributions of those honored burnishes the public’s perception of the awarding institutions.

And though they might seem removed from the process, the public benefits from professional awards as well. The recognition an award brings can deepen the reach of the work behind it, and that extended reach can, in turn, translate to real lives impacted. The attention an award attracts can also inspire young professionals, pushing them to do more, to develop new skills or take on grander challenges. Their subsequent accomplishments have the potential to profit us all.

It might be too late to nominate a colleague for this year’s round of awards but give some thought to those in your sphere who are deserving and consider nominating them next time. I bet you’ll feel uplifted and encouraged by the process and amazed, as I so often am, by the innovation, brilliance, and grit we are privileged to witness every day. Isn’t it time it got recognized?

Can “Nudging” Help?: Improving Clinical Trial Access Using Artificial Intelligence for Standardization

Guest post by Presidential Innovation Fellows Justin Koufopoulos and Gil Alterovitz, PhD.

Getting into a clinical trial is challenging for patients. Researchers estimate that only 5% of patients eligible to participate in a cancer clinical trial actually take part in one.  Many factors impact this statistic, including how findable and accessible is information about the clinical trials.

Patients often learn about clinical trials from their doctors or through patient advocacy groups like the American Cancer Society. They then typically search for trials on the internet, often ending up on websites like the NIH-run ClinicalTrials.gov or trials.cancer.gov.

Once on these websites, patients still face challenges to access. Prime among them: what search terms to use to find relevant trials.

The terms a patient or doctor uses may not match how researchers running a trial describe the focus of their study, for example “breast cancer” vs. “ductal carcinoma.” While the NIH clinical trials databases track synonyms and work to make the proper matches, users cannot escape this recurring mismatch in language that challenges access.

This challenge becomes even more pronounced with clinical trial eligibility criteria. These criteria describe who can and cannot participate in a study. For example, an eligibility criterion might be “age 18 years or older” or “confirmed breast lesions that can proceed to removal without chemotherapy.” While a computer can easily match a patient to the first criterion, the second involves many more concepts that are harder to separate, understand, and match.

Artificial intelligence can be part of the solution, particularly “machine learning,” which leverages data to teach a program how to make predictions on chosen topics.

Various technology companies have already used machine learning to address language translation problems. As a result, computers can now translate English to Japanese with few errors, and speech-to-text applications can translate human speech to computer inputs and can even reply.

We adopted a similar, albeit scaled back, approach to translate diverse clinical trials eligibility criteria into standardized and structured language. We also drew inspiration from writing tools that help writers improve their text’s readability and grammar.

Instead of highlighting repeated words or sentences in the passive voice, our prototype nudges researchers toward writing eligibility criteria in a way more easily translated by machine. It offers feedback and suggestions, almost like an English language tutor, and proposes alternative ways to write the criteria that would make them more standard and eventually, more translatable.

Sample Word text with track changes

screen shot from within the eligibility criteria normalizer showing alternate phrasings for a sample criterio
We drew inspiration from revision tracking and grammar-type tools to design our standardization tool for researchers.

This shift toward more standardized language can make it easier to match content across databases, such as matching a list of patients with a set of conditions and prior treatments.

The prototype also helps researchers understand the consequences of their word choices. It looks at previous studies with similar eligibility criteria and notes how many participants they recruited. Additionally, input from consensus-based standards may also be presented.  While not a perfect metric for inclusiveness, this feedback shows someone running a study how their word choices compare to others and the potential impact of those choices on their study’s overall success.

Research by academic psychologists has shown that nudging works in a wide variety of settings. To the best of our knowledge, this is the first time a nudge has been used to coach researchers, but these nudges are not requirements. Researchers can still write their eligibility criteria in the way they think makes the most sense. However, by moving researchers toward standardized phrasings, our prototype can help computers match patient characteristics with eligibility criteria and potentially get more eligible patients into clinical trials.

More work is needed before we can fully implement our tool and test at scale, but we are making progress. We recently completed a pilot study with non-federal groups to determine whether the structured data (so, not the nudging agent but the data our tool learns from) could be used to create tools to help with clinical trials access. Our findings were positive, confirming that private industry and academia need more data like ours for building artificial intelligence tools. The work was featured by the White House on AI.gov as an example for “Industries of the Future.”

The Health Sprint piloting effort included physicians and patient advocates as well as data stewards and experts in the relevant domain areas from within government. For example, Rick Bangs, MBA, PMP, a patient advocate, has worked with various organizations including the National Cancer Institute and the ClinicalTrials.gov development team. Regarding clinical trial matching, Bangs noted, “The solution here will require vision, and that vision will cross capabilities that no one supplier will individually have.”

Next up, we need to evaluate whether this tool helps researchers write eligibility criteria in the “real world,” where all innovations must live.

headshot of Justin KoufopoulosJustin Koufopoulos is a Presidential Innovation Fellow and product manager working to making clinical research more patient-centered. He has worked with the White House, CIO Council, National Library of Medicine, General Services Administration, Department of Commerce, and Veterans Administration on issues ranging from internet access to artificial intelligence.

headshot of Gil AlterovitzGil Alterovitz, PhD, FACMI, is a Presidential Innovation Fellow who has worked on bridging data ecosystems and artificial intelligence at the interface of several federal organizations, including the White House, National Cancer Institute, General Services Administration, CIO Council, and Veterans Administration.


The Presidential Innovation Fellowship brings together top innovators and their insights from outside of government, including the private sector, non-profits, and academia. Their insights are brought to bear on some of the most challenging problems within government and its agencies. The goal is to challenge existing paradigms by rethinking problems and leveraging novel, agile approaches. PIF was congressionally mandated under HR 39, the Tested Ability to Leverage Exceptional National Talent (TALENT) Act. The program is administered as a partnership between the White House Office of Science and Technology Policy, the White House Office of Management and Budget, and the General Services Administration.

Didn’t you used to be a nurse?

Didn’t you used to be a nurse?

I get this question more often than you might expect—and frankly, a little more often than I would expect.

I am a nurse who presently serves as the director of the National Library of Medicine. I’m the first nurse to direct the Library but not the first licensed health professional to do so. In fact, all of my predecessors have been licensed health professionals—specifically, physicians. I wonder how many of them were asked, “Didn’t you used to be a physician?”

The answer to the nurse question, by the way, is, “No.”

I am a nurse. I didn’t used to be a nurse.

I have an active license as a registered nurse. I am a member of the American Nurses Association. And though I might wait a beat to raise my hand when that call comes over the airline public address system—“Is there a health professional on board? We have an emergency.”—I sometimes do, doing what I can to help but always deferring to someone with more current clinical knowledge.

I don’t even think it’s possible to leave nursing behind. Nursing is as much a calling as a profession. The calling fuels the desire to be a professional with specialized knowledge, operating under a contract with society (Nursing’s Social Policy Statement: The Essence of the Profession, 2010).  One does not forget the knowledge, nor does one abandon the calling.

A commercial years ago used the slogan, “If caring was enough, anyone could be a nurse.” I care, but that does not make me a nurse. I’m a nurse because I possess specific, advanced knowledge about the diagnosis and treatment of the human response to disease, disability, and developmental challenges, and I apply that knowledge to caring for others.  Today, I demonstrate that caring and fulfill my contract with society as the director of the largest biomedical library in the world.

It takes 1,700 women and men to bring to society all the products and services NLM offers. But being a nurse gives me insights into and an understanding of health that help me channel their efforts in different ways. Being a nurse broadens my perspective on what constitutes relevant health information. Being a nurse drives me to connect the knowledge of how to manage a health problem with the skills needed to do it. It highlights that health is a team sport, not a solo pursuit, and that I must create the environment that lets all team members, including patients, their family, and friends, operate at the top of their skills. And as essential as trusted, quality health information is, being a nurse reminds me that information is only part of the equation. Personal motivation, a sense of self-efficacy, and the ability to act in accord with one’s values and outlook on life contribute mightily to someone’s willingness and ability to move toward health—and even how they define health.

Of course, I’m not the only nurse working outside a traditional clinical setting. Nurses do many things, but all fall under nursing’s contract with society: helping people, sick or well, by understanding their human responses to disease, disability, and development and partnering with them to move toward health informed by mutual respect and shaped by our combined talents and skills.

So, no, I didn’t used to be a nurse. I am a nurse. And my job as a nurse is to lead a library.

Come join me in my practice, add your skills and knowledge to the mix, and work with me toward the future of data-powered health.

Code-Breaking Librarians

Did you know that librarians helped crack enemy codes in support of the US war effort during World War II?

Until I read Liza Mundy’s book Code Girls: The Untold Story of the American Women Code Breakers of World War II, I was unaware, but when I found out, I was certainly not surprised.

Codes and ciphers are the tools of spies and subterfuge. Coded messages systematically replace a word, phrase, or sentence with specific alternates. In ciphers, each letter is replaced according to some formula or algorithm, making ciphers much harder to break.

The US military, caught by surprise at Pearl Harbor, realized they needed to quickly ramp up a code-breaking unit. They turned to thousands of women with classical liberal arts educations and built on those skills to assemble teams of expert code breakers. Like their counterparts working at England’s Bletchley Park, the American women’s collegiate experience reading and interpreting complex texts or wrestling with advanced mathematics prepared them well for untangling the shifting, arcane world of crypotanalysis.

Librarians brought their own skills to the teams. In addition to breaking codes, these professionals, mostly women, set the stage for their teams’ successes. They kept records. They organized vast amounts of disordered and unrelated information into logical categories. And by applying the principles of indexing and cataloging, they connected previously disjointed information and made it discoverable.

Librarians played important wartime roles outside the US as well.

Early in the war, Richard Hayes, director of the National Library of Ireland, was tapped by Irish army intelligence to help decode a cipher found on a German agent captured in Ireland. His success prompted Irish prime minister Éamon de Valera to set up a small office in Dublin for Hayes where Hayes and a small team could decode Axis messages being transmitted out of Ireland—all while Hayes continued to serve as library director. Hayes’ involvement had a significant impact on the war. His ingenuity and tenacity enabled him to unlock a notoriously difficult Nazi code, one that stumped Britain’s MI5 and the intelligence experts at Bletchley Park.

Most librarians today aren’t deciphering secret codes, but the skills behind that work—order, reason, connection, and interpretation—remain essential. We still need skilled professionals to create and maintain enduring systems to organize data, information, and knowledge and make them accessible. Unlocking the secrets of medicine and science depend upon it.

And yet, like the code-breaking librarians of World War II, today’s librarians often go unrecognized and their contributions unacknowledged. What can we do to change that?

Science and Medicine Need Women

The first woman ever to be an institute director at NIH, Dr. Ruth Kirschstein, took the helm at the National Institute of General Medical Sciences in 1974. It took 17 more years for Dr. Bernadine Healy to become the first—and so far only—female director of NIH.

Today, I am one of 10 women serving as directors across the 27 institutes and centers at NIH—the most female directors NIH has ever seen at one time. Clearly, we’ve made some important gains, but as NIH Director Dr. Francis Collins has recently said, “We have not achieved the point where women have their rightful place in leadership.”

It’s not that women aren’t interested in science or in leadership. Instead, studies are finding that far too many women who enter the field abandon their careers, whether due to hiring bias, the wage gap, or sexual or gender harassment. We’re all losing due to that loss of talent and intelligence.

Science needs women, not just as laborers, but as thinkers, innovators, and leaders. It needs our different perspectives and our thoughts on what issues are worthy of research. It needs our different ways of attacking problems, interpreting results, and considering solutions. It needs our diversity to help reduce bias and to yield findings that are more generalizable. The problems science addresses are too large, too multifaceted, and too important to tackle using the talents of only 50% of the population.

It’s a fertile and shifting time. We are becoming increasingly aware of the systemic barriers that keep society and science from benefiting from women’s full contributions, but awareness isn’t enough. We must act. We must change.

NIH is working to do that. New policies and practices are in place to address sexual harassment at NIH, at the institutions we support, and anywhere NIH research activities take place. And NIH has just completed a survey of all staff and contractors to help assess NIH workplace climate and harassment.

It’s a start.

I’m proud to be a part of a group tasked with recommending what comes next. As part of the NIH Director’s Advisory Committee Working Group on Changing the Culture to End Sexual Harassment, I have the opportunity to help redress wrongs and improve engagement. Together my colleagues and I will be looking for ways the institution can promote a safe and inclusive environment.

On a personal level, I work to effect that change by nudging my colleagues gently or, if needed, bluntly, when implicit bias, traditional thinking, or even malignant motives stand in the way of fair judgment or women’s rightful progression in science. And I try to engage all my colleagues, regardless of gender, in working toward ways to dismantle the barriers that hold women back.

Just as with scientific research itself, we need everyone’s full participation in the solution.

What guidance do you have for me about how to take up this important mantle?

Learn More
Women scientists at NLM and throughout history.

Expanding Access, Improving Health

Guest post by Kathryn Funk, program manager for NLM’s PubMed Central.

Last week, National Library Week celebrated how libraries and library workers make our communities stronger. In the spirit of building strong communities, NLM has committed to “democratiz[ing] access to the products and processes of scientific research.”

NLM delivers on that commitment by supporting the NIH Public Access Policy. This policy, passed by Congress in 2008, requires authors funded by NIH to make publicly accessible in PubMed Central (PMC) any peer-reviewed paper accepted for publication. Now, over a decade after the NIH Public Access Policy went in to effect, PMC makes more than 1 million NIH-funded papers available to the research community and the public. This volume of publicly accessible, NIH-funded papers represents a clear return on investment for the public, but numbers alone don’t provide the full story.

A quick dive into NIH Research Matters, a weekly update of NIH research highlights, offers a much richer and more personal picture of how the NIH Public Access Policy and NLM’s support of it can strengthen and empower communities. Making NIH-funded papers publicly accessible in PMC means that the public has free and direct access to research that touches on some of the most critical public health concerns facing our community, including studies that:

  • Suggest a method for detecting breast tumors earlier and more often, creating a higher chance of survival for patients (NIH Research Matters | PMC);
  • Identify treatment options for reducing the risk of death for people who’d previously had a non-fatal opioid overdose (NIH Research Matters | PMC);
  • Explore how maternal nutrition supplements can increase infant birth size and potentially improve children’s life-long health (NIH Research Matters | PMC);
  • Identify young people with suicidal thoughts by using machine learning to analyze brain images (NIH Research Matters | PMC);
  • Gauge exercise’s impact on the growth of new nerve cells in the brains of mice, which could potentially reduce memory problems in people with Alzheimer’s disease (NIH Research Matters | PMC); and
  • Develop blood tests to detect signs of eight common types of cancer (NIH Research Matters | PMC).

These examples illustrate that access, while essential, is not the Library’s end goal. Improved health is.

NLM supports public access to research outputs to accelerate scientific discovery and advance the health of individuals and our communities. It is the best way we can honor the investment made by the American people in scientific research and the surest way to make our communities stronger.

casual photo of Kathryn FunkKathryn Funk is the program manager for PubMed Central. She is responsible for PMC policy as well as PMC’s role in supporting the public access policies of numerous funding agencies, including NIH. Katie received her master’s degree in library and information science from The Catholic University of America.

Building Data Science Expertise at NLM

Guest post by the Data Science @NLM Training Program team.

Regular readers of this blog probably know that NLM staff are expanding their expertise beyond library science and computer science to embrace data science. As a result, NLM—in alignment with strategic plan Goal 3 to “build a workforce for data-driven research and health”—is taking steps to improve the entire staff’s facility and fluency with this field so critical to our future.

The Library is rolling out a new Data Science @NLM Training Program that will provide targeted training to all of NLM’s 1,700 staff members. We are also inviting staff from the National Network of Libraries of Medicine (NNLM) to participate so that everyone in the expanded NLM workforce has the opportunity badge reading "Data Science @NLM Training Kickoff" to become more aware of data science and how it is woven in to so many NLM products and services.

For some of our staff, data science is already a part of their day-to-day activities; for others, data science may be only a concept, a phrase in the strategic plan—and that’s okay. Not everyone needs to be a data scientist, but we can all become more data savvy, learning from one another along the way and preparing to play our part in NLM’s data-driven future. (See NLM in Focus for a glimpse into how seven staff members already see themselves supporting data science.)

Over the course of this year, the data science training program will help strengthen and empower our diverse and data-centric workforce. The program will provide opportunities for all staff to participate in a variety of data science training events targeted to their specific interests and needs. These events range from the all-hands session we had in late January that helped establish a common data science vocabulary among staff to an intensive, 120-hour data science fundamentals course designed to give select NLM staff the skills and tools needed to use data to answer critical research questions. a badge reading "Data Science Readiness Survey Completed" and showing a thumbs up We’re also assessing staff members’ data science skill levels and creating skill development profiles that will guide staff in taking the steps necessary to build their capacity and readiness for working with data.

At the end of this process, we’ll better understand the range of data science expertise across the Library. We’ll also have a much clearer idea of what more we can do to develop staff’s facility and fluency with data science and how to better recruit new employees with the knowledge and skills needed to advance our mission.

In August, the training program will culminate with a data science open house where staff can share their data science journey, highlight group projects from the fundamentals course, and find partners with whom they can collaborate on emerging projects throughout the Library.

But that final phase of the training initiative doesn’t mean NLM’s commitment to data science is over. In fact, it will be just the beginning.

In the coming years, staff will apply their new and evolving skills and knowledge to help NLM achieve its vision of serving as a platform for biomedical discovery and data-powered health.

How you are supporting the data science development of your staff? Let’s share ideas to keep the momentum going!


Co-authored by the Data Science @NLM Training Program team (left to right):

    • Dianne Babski, Deputy Associate Director, Library Operations
    • Peter Cooper, Strategic Communications Team Lead, National Center for Biotechnology Information
    • Lisa Federer, Data Science and Open Science Librarian, Office of Strategic Initiatives
    • Anna Ripple, Information Research Specialist, Lister Hill National Center for Biomedical Communications