: The National Library
Brings Quality Information
Naomi Miller, Rebecca J. Tyler, and Joyce E. B. Backus
The National Library of Medicine’s (NLM®) MedlinePlus® is a high-quality
gateway to consumer health information from NLM, the National Insti-
tutes of Health (NIH), and other authoritative organizations. For decades,
NLM has been a leader in indexing, organizing, and distributing health
information to health professionals. In creating MedlinePlus, NLM uses
years of accumulated expertise and technical knowledge to produce an
authoritative, reliable consumer health Web site. This article describes the
development of MedlinePlus—its quality control processes, the integration
of NLM and NIH information, NLM’s relationship to other institutions,
the technical and stafﬁng infrastructures, the use of feedback for quality
improvement, and future plans.
The National Library of Medicine Begins Direct
Service to Consumers
The legislation establishing the National Library of Medicine (NLM)
(42 U.S.C. § 286) as a component of the National Institutes of Health
(NIH) in 1956 describes the mission of the library as collecting, preserv-
ing, and disseminating medical literature as well as making “available its
bibliographic, reference, or other services, to public and private entities
and individuals.” NLM fulﬁlled this mission for many years by primarily
serving health professionals, especially through the MEDLINE® database
of references to millions of biomedical research publications. In recent
Naomi Miller, Senior Systems Librarian, Public Services Division, National Library of Medicine,
8600 Rockville Pike, Bethesda, MD 20894; Rebecca J. Tyler, Systems Librarian, Public Services
Division, National Library of Medicine, 8600 Rockville Pike, Bethesda, MD 20894; and Joyce
E. B. Backus, Head, Reference and Customer Services Section, National Library of Medicine,
8600 Rockville Pike, Bethesda, MD 20894.
LIBRARY TRENDS, Vol. 53, No. 2, Fall 2004 (“Consumer Health Issues, Trends, and Research:
Part 1. Strategic Strides toward a Better Future,” edited by Tammy L. Mays), pp. 375–388
This article provided courtesy of NIH/NLM.
library trends/fall 2004
years, NLM’s governing Board of Regents encouraged NLM to expand its
services to the general public of health consumers (NLM, 2000).
When the MEDLINE database became free to the Internet public in
public. Early studies showed that many MEDLINE users were not profes-
sionals and researchers but rather were members of the general public
seeking health information for themselves, family members, and friends
(Free MEDLINE, 1997). MEDLINE began indexing a few consumer-level
publications in early 1998 (MEDLINE to index, 1998), but it was clear that
NLM could do more to provide quality health information for the public.
In 1998 NLM began a project with the National Network of Libraries of
Medicine (NN/LM) to work with public libraries to better serve health
consumers (Wood et al., 2000). This project found that public librarians
needed training to become more comfortable providing health informa-
tion and a trusted place to turn for health content.
With the advice of public libraries and customer feedback from users of
creating MedlinePlus, NLM drew upon the skills of medical librarians and
information technology professionals to make consumer-level authoritative
medical information available to anyone with access to the World Wide Web.
Combining this expertise with the strength and authority of NIH and other
government and nongovernment organizations, MedlinePlus has become
a source of health information to millions of health consumers as well as
their health care providers.
Health Topics: Quality at the Core of MedlinePlus
Initially, MedlinePlus provided consumers with authoritative health
information from the federal government and other organizations. These
lists of links, or Health Topic pages, remain the core of MedlinePlus. Health
Topic pages are highly selective collections of links to Web documents, not
comprehensive lists of everything on the Web. They point consumers to the
best Web resources and minimize redundant listings. The experienced bio-
medical librarians who create and maintain the Health Topic pages organize
them into categories such as overviews, diagnosis, treatment, and preven-
tion. They also identify the publishing organization, easy to read materials,
and other special features such as pictures, diagrams, and ﬂowcharts. The
Health Topic pages function like a table of contents to a virtual Internet
book broken down into chapters. This organization helps consumers eas-
ily scan the page and provides them with a refuge from the overwhelming
amounts or varying quality of Internet health information.
Addressing the Need for Quality
The number and popularity of sites providing health information to
consumers constantly increases. This growth heightens concern in the medi-
miller et al./medlineplus
cal profession about the importance of reliable, quality information (Fox &
Fallows, 2003; Licciardone, Smith-Barbaro, & Coleridge, 2001). One study
shows that only a quarter of health information seekers check the quality
of the Web resources they use (Lewis & Behana, 2001). Many consumers
consider a professional-looking Web design with scientiﬁc-looking touches
to be sufﬁcient assurance of the high quality of the information on the Web
site (Eysenbach & Köhler, 2002). Rather than appearance, health informa-
tion experts know that consumers should look for key characteristics when
evaluating a health information Web site. These criteria include author and
author afﬁliation; attribution of sources and references used; information
about funding, ownership, and sponsorship of the Web site (Gagliardi &
Jadad, 2002); and clear labeling of advertising (Karp & Monroe, 2002).
For MedlinePlus, NLM uses written guidelines to identify and select
organizations, and nongovernmental health information providers. The
librarians building MedlinePlus Health Topic pages follow the same model
that collection development librarians have used for years to create print
reference collections, but the Web format creates additional challenges to
collection evaluation and selection. MedlinePlus publishes these guide-
lines so that organizations can evaluate themselves against the selection
standards. These guidelines assure users that the information they ﬁnd
on Health Topic pages is reliable and up to date. They cover four main
of their advisory board members or be published by a government agen-
cy. MedlinePlus staff check board members’ names in MEDLINE and
other databases to ascertain whether they have published on the sub-
jects covered by the Web site. If the medical authority of the site is not
evident, the MedlinePlus team contacts the site’s Webmaster requesting
information or clariﬁcation.
2. Purpose of site: The site’s primary purpose must be to provide health
information, not to sell a product or service. Intrusive or content-linked
advertisements disqualify pages from inclusion. Most of the content
must be free and not require registration.
3. Maintenance: The site must be consistently available, without broken
links, and provide a Webmaster address. Pages must display dates.
4. Quality, nonredundant content: Because MedlinePlus is selective, not
comprehensive, links on Health Topic should have minimal redundancy.
Each linked document provides unique information to the consumer
using that Health Topic page. Some links bring users a clear summary
of an entire disease or condition, while others bring unique features,
such as different reading levels, clear diagrams, illustrations, or interac-
As a government Web site, MedlinePlus offers consumers an Internet
experience free from advertisements. The site also uses no cookies and
does not request any personal information.
Studies of NLM Web site search logs from the mid-1990s revealed that
over 70 percent of the searches were for medical information (Miller, 1997).
The logs of user terms provided a valuable window into consumers’ interests
and the vocabulary they used to express their information needs. The Lister
Hill National Center for Biomedical Communications used Uniﬁed Medical
Language System (UMLS) tools to further analyze search logs and created
a ranked list of search terms organized by NLM’s Medical Subject Heading
(MeSH) vocabulary (McCray, Loane, Browne, & Bangalore, 1999). These
studies of the language of users’ searches gave direction for developing the
vocabulary terms MedlinePlus uses to direct users to Health Topic pages.
To best serve consumers, MedlinePlus terminology reﬂects users’ expec-
perience in medical terminology is a key factor in making the MedlinePlus
vocabulary work well for consumers. MedlinePlus developers examine a
number of vocabularies to create Health Topic names and “see references.”
NLM’s own MeSH vocabulary, developed for health professional literature,
provides background for the structure of medical knowledge, but it is often
too scientiﬁc for consumers. Other medical thesauri that provide inspiration
include the Planetree Classiﬁcation (Planetree Health Resource Center,
1991), the CINAHL Thesaurus (CINAHL Information Systems, 2004), and
the terms used on other consumer health Web sites. The ﬁnal Health Topic
page names are based on considering all these sources.
For Health Topic pages, MeSH terms are preferred when they coincide
sources. For example, MedlinePlus has Health Topic pages that use MeSH
terms for cataract, ﬁbromyalgia, and multiple sclerosis. In contrast, there
are Health Topic pages for heart attack rather than myocardial infarction,
breast cancer rather than breast neoplasms, and high blood pressure rather
than hypertension. In other cases, MeSH does not have certain consumer
concepts, such as club drugs or men’s health. In these cases, MedlinePlus
uses the consumer term. MedlinePlus includes liberal “See references,” so
more technical versions or synonyms become links in alphabetic topic lists.
This process of using customer suggestions and search behavior to improve
MedlinePlus keeps the quality, usability, and customer satisfaction at the
highest level possible.
Although MedlinePlus displays a unique consumer vocabulary, the
links from MedlinePlus to other NLM resources depend on MeSH. Behind
the scenes, software allows MedlinePlus staff to link MeSH vocabulary with
Health Topic pages. The MedlinePlus management system generates the
ﬁles that allow MedlinePlus to link to MeSH-based NLM resources. For
example, one ﬁle creates the links between ClinicalTrials.gov and Med-
linePlus. These links allow users of ClinicalTrials.gov to learn more about
medical conditions in research trials and MedlinePlus users to ﬁnd clinical
trials on a particular condition. Another ﬁle enables PubMed/MEDLINE
to link from biomedical article references to MedlinePlus Health Topics.
These PubMed/MedlinePlus mappings allow users to select the “Consumer
Health” LinkOut text from PubMed/MEDLINE and immediately explore
that Health Topic page on MedlinePlus. Librarians maintaining MeSH in
MedlinePlus keep it up to date with annual changes and improvements to
MeSH and the systems themselves.
Relationships with NIH Institutes and Other
As a part of the NIH, NLM is an important partner in bringing the
knowledge of the United States’ premier biomedical research organiza-
tion to the public. NLM staff work with the staff of other NIH Institutes
who write and publish unbiased, well-reviewed information for consumers.
NLM provides feedback from MedlinePlus users to the institutes that they
consider as they determine priorities and policy direction.
Leveraging NLM’s Strengths as an NIH Institute
NIH Content and Collaboration NIH consumer health documents are an
integral part of MedlinePlus. Each MedlinePlus Health Topic page features
a link to the institute with primary research responsibility for that disease,
condition, or health issue. These institute links connect users to a premier
research organization for additional resources as they seek information.
The NIH MedlinePlus Advisory Group is key to ensuring the quality
group consists of public information ofﬁce managers who are responsible
for information dissemination to the public from the NIH Institutes, such
as the National Cancer Institute and the National Institute of Diabetes and
Digestive and Kidney Diseases. The advisory group meets three times a year
to learn about new MedlinePlus developments, advise on future directions,
and inform each other about new projects and resources. This group en-
sures good coordination and communication between NIH organizations
providing health information to consumers and contributes to the quality
of all the NIH consumer Web information. Staff from these ofﬁces interact
with NLM staff throughout the year to improve NIH content linked from
Non-NIH Organizations The MedlinePlus Health Topic Pages link to
documents from hundreds of organizations. These organizations include
well-known professional organizations (American Academy of Family Phy-
sicians, American Academy of Orthopaedic Surgeons), large voluntary as-
sociations (American Heart Association, American Diabetes Association),
groups dealing with a speciﬁc problem (Lupus Foundation of America,
Macular Degeneration Partnership), and well-known health care organiza-
tions (Mayo Clinic, National Jewish Research and Medical Center.) While
selecting and maintaining these links, MedlinePlus staff often contact these
organizations and encourage them to follow the MedlinePlus selection
guidelines on their health Web sites. Requests range from dating pages, to
updating older documents, to removing registration requirements from
sites. By working directly with these health information producers, Med-
linePlus serves the public by encouraging as many as possible to adhere to
the selection guidelines. Many of these contacts have evolved into ongoing
cooperative relationships and link exchanges.
Enhancing MedlinePlus with Licensed Content
One goal of a collection development librarian is to cover a subject as
completely as needed by the patron. Biomedical librarians construct Med-
linePlus Health Topic pages to provide as complete a consumer resource
as possible on a disease or condition. However, topic coverage depends
on organizations to publish documents that meet the selection criteria.
Examinations of “zero hit” terms from MedlinePlus search logs show that
Health Topic page links do not cover all medical issues of interest to con-
sumers. Licensed content supplements the Health Topic pages in areas
where authoritative Web content is not available. MedlinePlus licenses drug
information, a medical encyclopedia, health news, a medical dictionary, and
low-literacy interactive health tutorials and makes them freely available to
the public for personal use. These materials supplement the information
provided on the Health Topic pages. They are kept up to date by the licensed
content providers and make up an important component of the Web site.
All MedlinePlus licensed content is available at no charge. Users may read
and print all these materials; in addition, they may email single copies of
many materials to share with family and friends for personal use.
Leveraging NLM’s strengths
The MeSH vocabulary is the key to linking MedlinePlus users to other
NLM products. Staff make these links behind the scenes in the systems
that manage the vocabulary. These systems create the links that provide
options for consumers to navigate between MedlinePlus, PubMed/MED-
LINE, ClinicalTrials.gov, and Genetics Home Reference.
PubMed/MEDLINE Customer feedback and other research have
taught NLM that patients and families need information at a variety of lev-
els. For users who want to read research literature, MedlinePlus integrates
PubMed/MEDLINE searches of peer-reviewed biomedical journal citations
into the Health Topic pages. Expert searchers from the Library’s Reference
and Customer Service Section create “prepackaged” searches tailored for
consumers and review them twice a year to maintain quality. These searches
retrieve citations to English-language review articles, evidence-based medi-
cine, and consensus practice guidelines, and run on demand when the user
selects one. Patients and families coping with a serious or chronic illness
use this feature to learn more advanced information or to keep up with the
latest developments on a disease or condition. Health practitioners report
using the searches as a quick start in areas outside their expertise.
ClinicalTrials.gov In February 2000 NIH launched the ClinicalTrials.
gov database (National Institutes of Health Launches, 2000), providing con-
sumers with access to medical research studies that seek to evaluate the
safety and effectiveness of new drugs, medical procedures, or other means
of treating, diagnosing, or preventing diseases. The database is built by
the NLM’s Lister Hill National Center for Biomedical Communications.
To deliver the most recent information to consumers, the MedlinePlus
ClinicalTrials.gov link performs a new search each time a consumer uses
it. These searches retrieve clinical trials currently recruiting patients on the
subject of the MedlinePlus Health Topic pages. Once again, biomedical
librarians use their well-honed search and retrieval skills to review links
every six months and after the annual MeSH vocabulary changes.
Genetics Home Reference The Genetics Home Reference (GHR) is a
recent addition to NLM’s consumer health information Web sites (Genet-
Biomedical Communications at NLM, the site provides in-depth informa-
tion on dozens of genetic conditions, such as Marfan’s syndrome, as well as
other conditions with a genetic component, such as breast cancer. Again,
the GHR records link to MedlinePlus pages and vice versa using MeSH and
a mapping ﬁle maintained by MedlinePlus librarians.
NLM is the world’s largest medical library, but it depends on collabora-
tion with other libraries to provide consumer health information wherever
consumers need it. Sometimes that “location” is the Internet. Other times,
it is a local library. The public library pilot project showed that consum-
ers prefer that health sites provide full-text information they can print on
demand. They also expect local access to libraries where staff can help
them ﬁnd information when they need it. These consumer expectations
are why MedlinePlus Health Topic pages link, wherever possible, to pages
of full-text information, not to other portals or lists of links. Today, public
libraries throughout the United States use MedlinePlus as a primary health
resource for their patrons and continue to provide valuable feedback.
From its inception, MedlinePlus provided consumers with a single
page of links to biomedical libraries willing to serve consumers. This list
was incomplete because it depended on libraries contacting MedlinePlus
staff to request a listing. In the spring of 2003 MedlinePlus began to build
the library directory pages from a database of “Institutions” in NLM’s in-
terlibrary loan system, DOCLINE. NLM added the ability for DOCLINE
libraries to choose to be listed in the MedlinePlus directory of biomedical
libraries willing to serve consumers. Each library listing includes its address,
phone number, and Web site URL. MedlinePlus library pages include over
600 libraries from the United States, Canada, U.S. territories, and foreign
countries. Forty-nine states list at least one library (the smallest states, Rhode
Island and Delaware, each list three), and many states list dozens (Colorado
lists forty-one, and Michigan lists thirty-two). Through DOCLINE and Med-
linePlus, every biomedical library can offer their expert services to health
Public librarians in the pilot project as well as many others requested
that MedlinePlus expand and provide Health Topic pages entirely in Span-
ish to assist them in providing information to Spanish-speaking patrons.
In response to these requests and to better serve the Spanish-speaking
populations, MedlinePlus en español (http://medlineplus.gov/esp) made
its debut in September of 2002 (Medlineplus goes Spanish, 2002).
MedlinePlus en español contains over 600 Health Topic pages with
as those on the main site. The Spanish-language site also includes drug
information, an encyclopedia, news, and Spanish-language interactive tu-
torials. For non-Spanish speakers, a single click on the español link leads
from the English content to its corresponding Spanish content.
The processes for developing Spanish Health Topic pages are designed
Health Topic pages in English. These parallel procedures manage Span-
ish-language Health Topics and associated vocabulary. Bilingual medical
librarians select and review Web site records, build new topics, and update
existing topics every six months. MedlinePlus en español uses the same
selection guidelines as the MedlinePlus site. However, the Spanish-lan-
guage site links to more information from local governments, university
departments, and international sources than the English version because
there are not as many Web documents available in Spanish from national
U.S. organizations. By using the same procedures and guidelines that have
proven vital to the success of MedlinePlus, MedlinePlus en español provides
authoritative, quality information.
MedlinePlus Stafﬁng, Roles, and Workﬂow
Staff positions for MedlinePlus include librarians, computer specialists,
managers, and others. MedlinePlus is a collaborative effort among several
NLM departments. Medical librarians at medical schools and hospitals
contribute their expertise to MedlinePlus through several contracts. Fig-
ure 1 provides an overview of staff functions for policy, content, technical
demands, and feedback, all important aspects of maintaining a quality site.
MedlinePlus draws upon staff strengths throughout NLM. MedlinePlus
beneﬁts from name authority and selection expertise from the Technical
Services Division, promotion and evaluation expertise from its Ofﬁce of
the Director, health information expertise from the Reference and Cus-
tomer Services Section, and programming and technical skills from the
information technology department. The strength and quality of Medline-
Plus comes from each NLM organization contributing its best expertise to
beneﬁt the health consumer.
Keeping the content of the MedlinePlus Health Topics pages main-
selectors and reviewers. Selectors search the Web for appropriate materials,
apply the selection guidelines, enter records into the database, and review
Health Topic pages every six months. Records include information such as
the name of the page, URL, type of site (NIH, other government agency,
or nongovernmental organization), MedlinePlus Health Topic, and the
organization responsible for the page. These selectors can work anywhere
they have a computer with a browser and an Internet connection.
Selectors enter information for pages they choose to add to a Health
tion guidelines. The MedlinePlus staff records these decisions for several
reasons: to record the decision for other selectors who ﬁnd that Web page
later, to hold the information while staff contact the organization and ask
them to correct a problem, and to review the Web site later during Health
Topic Page review. Selectors and reviewers make notes that become a record
of the decisions made regarding a Web page so that the corporate memory
retains this information even as the people change.
Reviewers, the second category of users, release selectors’ work to the
check before information appears to the public. These senior librarians
also perform overall management tasks that include creating new Health
Topics, subcategories, and “see references”; releasing records and Health
Topics to the public; and performing system management functions like
adding new users and removing obsolete records. These persistent review
processes and daily link ﬁxes keep MedlinePlus as up-to-date and accurate
as possible in the world of constantly changing medical information and
Web sites (Figure 2).
A small team of NLM staff oversees the overall process of content quality
approves requests for new topics and resolves conﬂicts of opinion as they
arise. MedlinePlus en español has a corresponding content manager who
serves this role for that site. An acquisitions librarian from the Selection
and Acquisitions Section evaluates organization information at least annu-
ally. A Topic Manager from the Reference and Customer Services Section
maintains the schedule of topic reviews and identiﬁes high-proﬁle topics
for quick review on an as-needed basis. The MedlinePlus content team
meets with all selectors and reviewers monthly via teleconference and posts
meeting summaries on an internal listserv. Once again, each of these staff
members contributing their speciﬁc information skills adds to the quality
and accuracy of MedlinePlus.
NLM staff created a few basic HTML pages for the MedlinePlus pro-
totype in the summer of 1998. While creating this prototype, staff quickly
realized there were many problems of consistency, reliability, and scalability
if this simple approach were used for an entire health information Web
site. With manually developed HTML pages, two staff members might ﬁnd
the same Web page and describe it in two different ways. Staff indexing a
page called “Stroke Risks: High Blood Pressure Can Lead to Stroke” might
use both a title and subtitle on the high blood pressure page but use only
Figure 2. MedlinePlus input system diagram.
its title on the stroke page. For consistency and maintenance, Web docu-
ment links need the same description every place they appear on the site.
A database was the answer for developing a large Web site and maintaining
it in good working order.
The MedlinePlus development team turned to NLM’s Ofﬁce of Com-
review, and maintain MedlinePlus. OCCS recommended using a database
to ensure consistency of vocabulary and descriptions. The database also
allows staff to create and maintain records centrally for display on multiple
MedlinePlus pages. They also recommended that the public Web site not
use the database directly but rather an HTML version of the site. This
structure allows NLM to deliver pages quickly and securely to the public
and to use existing Web management tools including a search engine, link
checker, and Web statistics software. The MedlinePlus system combines an
Oracle database, which stores all data, with a Cold Fusion Web forms-based
system to control the data and workﬂow (Figure 2). Today, this Web-based
system design ably serves the MedlinePlus public and allows medical librar-
ians at geographically dispersed sites to perform any MedlinePlus update
or maintenance task.
Feedback Drives Future Plans
Customer feedback of many types drives improvements to MedlinePlus.
NLM staff gather this feedback through both passive and active collec-
tion. Passive collections of user behavior such as examining search engine
and Web activity logs guide MedlinePlus toward better serving user needs.
The medical terms users type into the search box are a valuable source of
consumer feedback. These search terms suggest new MedlinePlus topics
and “see references,” requests to NIH Institutes to develop new materials,
and new variations for the list of misspelled words for the search engine to
map to correct spellings. Web trafﬁc logs provide information about the
most used pages and those that consumers use less frequently. Use statistics
guide the list of frequently requested topics on the Health Topics home
page and suggest topics for MedlinePlus home page features.
NLM also solicits active user feedback for advice on MedlinePlus im-
using the “Contact Us” link on every page. Other active methods include
online surveys, focus groups, and usability tests. Before each released im-
provement to the site, focus groups and usability testing provide staff with
insight into how consumers use MedlinePlus and how it does or does not
meet their expectations. As the Internet and Web change, so do users’ skills
and expectations, and MedlinePlus endeavors to change with consumers.
Gathering feedback via multiple methods and making improvements sug-
gested by consumers is an important key to maintaining user conﬁdence
in the quality and reliability of MedlinePlus.
Into the Future
NLM is undertaking several new initiatives to enhance MedlinePlus.
Linking consumers from authoritative health information to information
about health services in local geographic areas is the focus of the “Go Local”
project. The goal is that a MedlinePlus user on the breast cancer page using
the “Go Local” link is presented with a page listing cancer clinics, oncolo-
gists, support groups, and other providers, programs, and services. The
University of North Carolina at Chapel Hill (UNC) developed the ﬁrst Go
Local site, NC Health Info (http://www.nchealthinfo.org). The NC Health
Info team built a database of local Web sites, an input and maintenance
system, local and MedlinePlus vocabulary mappings, and a Web interface.
Since then the University of Missouri has linked its Community Connection
Web site (http://www.communityconnection.org) to MedlinePlus. Both
Missouri and North Carolina support all of the technical hardware and
software involved in providing a large-scale Web site to the public.
NLM is releasing a Go Local hosting system, which it will maintain
and their families and friends. Using this system, Go Local teams will cre-
ate and update content on a system where NLM maintains the hardware,
software, vocabulary mappings, user interface, and statistics for the site.
The NLM-supported model will be available in 2004 for Go Local sites to
begin creating new Go Local resources to beneﬁt residents of their state
or region. NLM will work with the local sponsors to release these Go Local
sites as they are ready.
MedlinePlus will also focus more on content for speciﬁc audiences.
in November 2003, they gather together materials that sponsoring organi-
zations identify as suitable for low-literacy consumers and display them by
health topic. MedlinePlus also displays pages that list links for low-vision
users. Using technologies developed for another NLM consumer health
Web site, NIHSeniorHealth, the low-vision page brings together health in-
formation with enhanced accessibility features such as the ability to change
the contrast and enlarge the font. In the future, other special pages will be
Since its inception in 1998, MedlinePlus has evolved from a handful of
Health Topics linking to NIH, other government, and nongovernment con-
sumer health information to over 650 Health Topics linking to information
from nearly 1,000 organizations. To meet consumer needs and expectations
for health information, MedlinePlus licenses drug information, interac-
tive health tutorials, a medical dictionary, and an illustrated encyclopedia.
NLM has instituted computer system and human processes that build on
the strengths of staff at NLM and elsewhere to create the highest-quality
consumer health information portal possible, and consumers continue to
respond by visiting the site by the millions. The National Library of Medicine
is committed to continuing to improve MedlinePlus so that it will remain
an authoritative, quality Web site for consumer health information.
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