Giving Thanks Where Thanks is Due

One of the great joys of being the Director of the National Library of Medicine is the many opportunities for me to express gratitude. In the past, I have given thanks to NLM staff who are veterans (2021), for progress during my tenure (2020), and to our amazing NLM staff members (2019). This year, I am pausing to give thanks for the outstanding products and services developed and stewarded by our NLM staff, made available every day of the year to anyone with an internet connection—and even to some without!

First, I am thankful for our information collections in their many forms. The NLM Board of Regents oversees our Collection and Preservation Policy, which guides NLM as it meets its mission to acquire, organize, preserve, and disseminate biomedical knowledge from around the world. Our collection spans ten centuries from the 11th to the 21st, and ranges from the third oldest Arabic medical manuscript in existence to the “Rosetta Stone” of modern science, Marshall Nirenberg’s genetic chart, from genomic sequences essential for current and future research to information for mothers taking care of sick children.

Organizing the collections and making them findable and accessible builds on the knowledge of library and information science. This foundational knowledge means we can tag objects—real or virtual—with codes and terms that help with organization and retrieval. It also means we use our knowledge of library and information science to guide efforts to annotate and curate molecular data, literature citations, and images so they are accessible to the public. So I am grateful not only for the 66 miles of shelving that hold our precious objects, books, and journals here in Bethesda, but for the ever-powerful computer clouds that preserve our high-value research databases and 34 million bibliographic citations in PubMed. Libraries do more than house books; they use sophisticated knowledge to organize materials and make them readily available.

I am thankful for the ways that staff at NLM’s National Center for Biotechnology Information (NCBI) manages the submission, curation, and dissemination of our enormous genomic and molecular databases. From ClinVar (our collection of genomic sequences linked to clinical annotation) to the Sequence Read Archive (the world’s largest scientific data repository), our staff makes sure that depositors can effectively deposit data, scientific curators can conduct quality checks, and web and interface designers allow access to the data. A few years ago, the NCBI team led a cloud migration process to make available data from the entire 15-petabyte SRA resource on two commercial cloud providers. This bold step democratized sequence-based scientific inquiry and harnessed the computational power of cloud platforms, which contributed to industrial innovations and shortened the pathway for scientific discovery from days and months to minutes and hours. I am thankful for the role NLM plays in accelerating scientific advances and leveraging research resources for public health benefit.

NLM offers more than 1,000 easy-to-read health topic articles through our online consumer health information resource known as MedlinePlus. MedlinePlus is available in both English and Spanish, thereby assuring information access to speakers of two of the world’s most common languages. Through MedlinePlus Connect, our technical team also provides direct, tailored access to MedlinePlus resources automatically through electronic health records, patient portals, and other health information technology systems to deliver information from MedlinePlus to patients and providers at the point of care. I am thankful for the efforts of the MedlinePlus teams that bring timely and trusted information to the lives of everyone, everywhere.

I hinted earlier that there are two main pathways to access NLM products and services. Electronic access, supporting both human- and machine-readable forms, is by far the most common pathway to NLM. We also support the Network of the National Library of Medicine (NNLM) and its more than 8,000 members around the country in public, hospital, and academic medical center libraries to bring the power of NLM and its resources to the public. I am grateful for everyone who works as part of NNLM for their ability to bring NLM’s products and services to communities everywhere as well as how the needs and practices of those communities bring awareness of NLM.

As you pause this year in thanksgiving for the many public services that support you in everyday life, please remember to give thanks for NLM’s products and services. We think they are world class, and we are grateful for our ability to serve you.

The More AMIA Changes, the More It Stays the Same . . .

Right at this very moment, the American Medical Informatics Association (AMIA) 2022 Annual Symposium is underway in Washington, D.C., and we encourage you to visit NLM @ AMIA 2022 for updates on NLM’s products and programs. Now this may sound quite familiar to those of you who have attended AMIA annual symposiums in Washington, D.C., and other major cities over the past 30 years, but this year it is different. And yet, it is the same.

What’s the same? Well, for me and almost 3,000 other attendees, AMIA is our professional home. Through meetings and conversations, journal articles and webinars, and a host of new events and meetings, members build their knowledge about biomedical and health informatics, share that knowledge with colleagues, and advance the health of the public through informatics. We have built friendships, watched babies be born and grow into adults (including my son Conor), and grieved the loss of great leaders in the field. Colleagues have debated the wisdom of electronic health records that may have inadvertently contributed to clinician burnout and expanded the scope of our design and deployment efforts to encompass tools useful to consumers and language reflective of the diversity of society.

AMIA has welcomed young people into informatics and sponsored high school-student participation in national meetings. Special events now include rapid response to public health threats, special interest meetings for women in informatics, and expanded attention to diversity and inclusion. The fall symposium provides an opportunity for formal and informal mentoring, a quick hug with an old friend, and a reunion of those with whom we studied the basics of the field.

And yet, over 30 years, many things have changed! First and foremost, AMIA as an organization has grown, engaged new leadership, and developed new special interest groups. These each change the tenor of the meeting by adding new events to an already rich and attractive suite of offerings and bringing like-minded people together. The ideas shared and the research reported through the annual symposium have morphed throughout the years; now artificial intelligence takes center stage, tempered by thoughts of transparency and equity. A larger number of panels and industry sessions reflect the rapidly changing landscape of informatics. Electronic posters and smartphone apps take the place of what once were paper posters displayed in long corridors of bulletin boards and a three-inch-thick compilation—dare I say phone book size—of all the papers to be presented at the sessions.

And of course, the pandemic changed both everything and nothing. AMIA still hosted an annual symposium and participants still gathered, at least over video chat! Throughout the pandemic, AMIA offered virtual and hybrid conferences—this is the first annual symposium completely in person since 2019 and boy, was I ready for it!

So, rejoice with us—our annual touchstone of gathering for the science of biomedical informatics and the social support of friends and colleagues continued! Please plan to join us in 2023 and see for yourself what it is like!

Traveling a Bridge2AI in a Quest for High-Quality, FAIR Data Sets

This blog was authored by NIH staff who serve on the Bridge to Artificial Intelligence (Bridge2AI) Working Group.

In April 2021, we introduced NIH Common Fund’s Bridge to Artificial Intelligence (Bridge2AI) program to tap the potential of artificial intelligence (AI) for revolutionizing biomedical discovery, increasing our understanding of human health, and improving the practice of medicine. In the past year, Bridge2AI researchers have been creating guidance and standards for the development of ethically sourced, state-of-the-art, AI-ready data sets to help solve some of the most pressing challenges in human health such as uncovering how genetic, behavioral, and environmental factors influence health and wellness. The program will also support the training required to enable the broader biomedical and behavioral research community to leverage AI technologies.

The NIH initiative will support diverse teams and tools to ensure that data sets adhere to FAIR (Findable, Accessible, Interoperable, and Reusable) data principles. Beyond ensuring compliance to FAIR principles, Bridge2AI will develop and disseminate best practices that promote a culture of diversity and continuous ethical inquiry into how data are collected.

The Bridge2AI program will support innovative data-generation projects nationwide to collect complex AI-ready data in four biomedical areas:

Clinical Care Informatics—Intensive care units treat patients with urgent medical conditions such as sepsis and cardiac arrest. This data generation project will collect, integrate, annotate, and share high-resolution physiological data from adult and pediatric critical care patients from 14 health systems that can then be used by AI technologies to identify approaches to improve recovery from acute illness.

Functional GenomicsWithin each cell in the human body lies a wealth of information about health, disease, and the impact of environmental factors. This project will generate richly detailed proteomic, genomic, and cellular imaging data to help predict disease mechanisms and associated gene pathways and networks for a variety of health outcomes.

Precision Public Health—The human voice is as unique as a fingerprint and has been found to contain acoustic signatures of human health and disease. This project will collect large-scale multimodal data sets containing voice, genomic, and clinical data, which AI technologies can use to help improve screening for and the diagnosis and treatment of a variety of developmental, neurological, and mental health conditions.

Return to Health—Much can be learned by uncovering how individuals move from a less healthy to a healthier state, a process called salutogenesis. This project will collect data from a diverse population with varying stages of type 2 diabetes to help improve our understanding of chronic disease progression and recovery. To learn more about Bridge2AI and salutogenesis, please view Bridging Our Way to Health Restoration by Helene M. Langevin, MD, director of the National Center for Complementary and Integrative Health.

To support these data generation projects, the Bridge2AI program includes a BRIDGE Center with a range of expertise to support interdisciplinary team science. The center will facilitate development of cross-cutting products such as standards harmonization, ethical AI best practices, and workforce development opportunities for the research community.

One of the goals of Bridge2AI is to foster a culture that will identify, assess, and address ethical issues as an integral part of creating AI-ready data sets. Ethical considerations include informed consent, data privacy, bias in data, and its impact on fairness and trustworthiness of AI applications, equity, and justice, and inclusion and transparency in design.

Every component of the Bridge2AI program includes a plan for incorporating diverse perspectives at every step. The BRIDGE Center will serve as a hub for supporting ethical and trustworthy AI development across Bridge2AI with the goal of providing tools, best practices, and resources to address cross-cutting biomedical challenges.

Learn more about Bridge2AI in the press release and video. Find the latest news by visiting the Bridge2AI website and following the @NIH_CommonFund on Twitter.

Top Row (left to right):
Patricia Flatley Brennan, RN, PhD, Director, National Library of Medicine
Michael F. Chiang, MD, Director, National Eye Institute
Eric D. Green, MD, PhD, Director, National Human Genome Research Institute

Bottom Row (left to right):
Helene M. Langevin, MD, Director, National Center for Complementary and Integrative Health
Bruce J. Tromberg, PhD, Director, National Institute of Biomedical Imaging and Bioengineering

Engaging with Purpose: Libraries as Healing Spaces

Over the past month, students across the country started their first day of school—it’s a day of excitement, promise, and the hope of new growth. For some students, including those who were at Robb Elementary School in Uvalde, Texas, it’s a challenging time—how to reach for the future without the pain of the past. Importantly, libraries help!

Libraries know the importance of engaging with their communities, and they know how to do this. Over the summer, El Progreso Memorial Library in Uvalde, Texas, became a center of healing for the community—a place to bring people together in times of sorrow, as well as times of joy. I urge you to watch this news segment about how the El Progreso Memorial Library helped support its community in need and to think about the special role that libraries play in strengthening communities.

Through our Network of the National Library of Medicine (NNLM), NLM supports member libraries’ responses within communities around the country to address their health information needs. Our primary goal for engagement through the NNLM is to open a pathway between the community and NLM to make sure our resources are available, accessible, usable, and relevant to them, and to learn from them how they can best access our resources.

We can’t lift up communities without engaging with them, and we can’t be everything to communities. But by our engagement, we co-define the rules of engagement and show how what we do supports what they need.

The story of the El Progreso Memorial Library’s response to the needs of the Uvalde community inspired me in a way that I had not expected. Many times, the “rules of engagement” begin with a clear delineation of who we are and what our business is, essentially letting us step into a community with what we already know how to do. Suppose we started off at a different place—the place that engages with the community by beginning with the question, “What do you need?”

Now, starting with this question does not require us to be all things to all people—this would be foolhardy and frankly not something that would help us be true to our stewardship of the public’s federal investment. But… by starting with the question—“What do you need?”—perhaps we would organize our resources in ways we have yet to envision that make them even more accessible and responsive for those communities. This effort aligns with the second goal of the NLM Strategic Plan to engage with new people in new ways.

And maybe we would learn new things or more effective ways to reach communities. Libraries have a special space in the panoply of communities—we bring a wide range of resources to a wide range of people. Engaging with openness brings us closer to those who need us to bring those resources to them!

Please look around at the communities you are part of and that you serve. Think of how you reach into those communities and of new ways to ask, “What do you need?” to better understand how to serve them!

When You Stand on the Shoulders of a Giant, What Do You See?

This blog contains my remarks from the 2022 Lindberg-King Lecture and Scientific Symposium: Science, Society, and the Legacy of Donald A.B. Lindberg, M.D., which took place on September 1, 2022. Watch a recording of the event here.

I had the great fortune of becoming the director of the National Library of Medicine immediately following the 30-plus-year tenure of Donald A.B. Lindberg, MD. I am sure that each of you here today treasures your own recollection of Don, maybe from a conversation or a laugh you may have had with this great leader, teacher, visionary, and colleague (and husband to Mary, father, grandfather, and friend). I am both proud and humbled to stand on the shoulders of this giant as I lead this incredible organization.

I know more viscerally than most about Don’s legacy as NLM director. I sit in the office he occupied, I walk the halls he walked, I work with the people he hired, and I see and experience the fruits of his judgement, investments, and vision.

I now sit where Don once sat, representing NLM at the leadership table of NIH with the other Institute and Center directors. With Don paving the way, I have a platform to extend NLM’s thought leadership and technical knowledge to guide NIH’s continued efforts to advance data-driven discovery. The good will and collaborative spirit engendered by Don across NIH opened doors for me and helped me continue his legacy to deliver on the promise of science accelerated by broad access to literature and data.

Don and I share a deep commitment to ensuring that the public benefits from NLM’s efforts to assemble, organize, preserve, and disseminate biomedical knowledge for society. It was his early vision that made MedlinePlus a trusted resource for consumer health information and ensured that the PubMed citation database and the PubMed Central full-text literature repository were open and accessible to everyone, everywhere, with an Internet connection, at any time and place.  

Don’s commitment to the public was also evident in his efforts to educate the next generation of biomedical informatics scholars. Frankly, I believe that of all of the aspects of his job, engagement with trainees was his favorite!

When you stand on the shoulders of a giant, you have a great advantage. The foundation Don built and the relationships he established provided me, the 4th appointed director of NLM, with a playbook right out of the gate. It is not enough to solely rely on his vision to guide our future as Don also inspired innovation; in one of our last conversations, he said to me, “This is your game—make sure you play it well!” In order to do that, I cannot simply stand on the shoulders of a giant; I must also keep my head up and my eyes forward to the future to envision new pathways and find new opportunities to bring forward the riches of NLM to the future benefit of science and society.

I close by inviting all of you to stand on the shoulders of this giant and meld your sights with his, for it is not by holding tight to that which he could see, but by using his vision as a stepping-off point for our own that will serve his legacy.

%d bloggers like this: