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The changing format of Web-based medical information

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The changing format of Web-based medical information
Arthur C. Huntley, M.D.
Dermatology Online Journal: 3(1): 11


Electronic publishing is relatively new and a proper on-line format has not established. Dermatology Online Journal was created in part to develop an appropriate format for rapid easy access to image-rich medical education information on the Web. The standard layout for paper does not take advantage of some of the strengths of the computer (hypermedia and database handling). Furthermore, text is more difficult to read and images are less clear on a computer monitor. Each issue of the previous issues of the Journal used the strengths of networked computing to develop new concepts in the way information is presented, such as multiple versions (or languages), the medical photoessay (the use of hundreds of color images), and information on demand (Limited Information, Full Text on demand or LIFT). The changes in this issue borrow three items from paper format that do adapt well to the computer screen and enhance the ability of the reader to access information: black print on a white background, narrow columns, and leading.
Current trends of on-line applications notwithstanding, black print on a plain white background appears to be the easiest setting for the reader to assimilate information. Although a background is easily tiled with images or textures, these may detract from the text and make it harder to read. Black on white, apparently because of the high contrast, makes discrimination of letters and words easier.

Perhaps because computer windows can be resized by the user and the space available may differ from system to system, browsers will ordinarily adjust the length of text lines to fill the open window. If the browser window is set to the full size of the screen, it will ordinarily result in a very long lines of text which require much more eye movement and some difficulty in finding the beginning of the next line. That shorter lines are easier to read is well known in the publishing industry, one of the reasons newspapers use narrow columns. When it is crucial to maintain formatting (especially for commercial applications), information can be published as a preformatted page to be displayed by a "reader" application (Adobe Acrobat), but the use of hypermedia with this is still a bit awkward and the reader application is not universally available. The solution we have used here was to simply define the width of one column of text to be displayed.

Traditional paper media present text with a line spacing greater than the single spacing, the default of the current generation of browsers. Increasing the spacing between lines, so-called leading (from the lead used by the printer to separate the lines) makes the text easier to read. The text being viewed here has increased spacing of the lines produced by space requirements of a transparent (invisible) file inserted every few words. (compare to old format)

Fig. 1: Line spacing comparison.
Several lines of text presented here in single-spaced format. It may be more difficult to read, especially on a computer monitor. Compare the line spacing of the text within this box to the "leaded" text on the right side of this box. Here is a similar amount of text that is presented in leaded format. The vertical spacing is increased by the inclusion of invisible images with vertical space requirements

Trivial as all these items seem to be, the coding used to produce these changes is greater than the associated text. At some point in the not too distant future, web browsers will undoubtedly evolve to support leading and multiple columns. After all, computer hardware and software (including browsers) are evolving even faster than medical knowledge. And as the need to access medical education information increases because the rapid growth of that database, hopefully the improved software and hardware used in networked computing will permit providers of medical information to deploy a proper format to provide the greatest access.

© 1997 Dermatology Online Journal