DOI: 10.1111/j.1471-1842.2009.00844.
x
Using evidence
Blackwell in practice
Publishing Ltd
Using evidence in practice
Using evidence in practice
Fahrenheit 451?: a ‘burning question’ on the
evidence for book withdrawal
Andrew Booth
Introduction
With space at a premium in most libraries,
particularly those located in a health service
context, the health librarian frequently encounters
pressures to withdraw outdated items from their
library book stock. Should this be left to the
experience and expertise of the ‘librarian on the
spot’? Or is there, perhaps, a body of evidence to
inform this process—making it more systematic
and rigorous? This question came to my mind
recently. Indeed, it reawakened distant memories
of a Regional Stock Withdrawal Initiative which I
coordinated in South East Thames.1 As 20 years
might be construed a decent enough interval
between uses of a terrible punning title (although
some readers will disagree!) I have allowed this
book-burning analogy to rise phoenix-like within
the collective health librarian consciousness.
Before formally considering the evidence base,
we should at least acknowledge that ‘books are
different’. First, given the variety of topics covered
by your average health library, it is not desirable to
implement some standard cut-off date regardless
of discipline. Books do not have a ‘sell-by date’ to
be implemented across every shelf. Nevertheless,
particularly within a health context, information
within books is consistently volatile. As Antman
and colleagues demonstrated,2 textbooks are
particularly inefficient in capturing current know-
ledge. It is not exaggerating to say that outdated
health information can kill, although fortunately
the frequency with which such instances are
reported (note, I do not say occur!) is low enough
not to require our taking out indemnity insurance.
We should also appreciate that updating of editions
© 2009 The author
Journal compilation © 2009 Health Libraries Group. Health Information and Libraries Journal, 26, pp.161–165
of popular textbooks is almost exclusively deter-
mined by commercial considerations and not by a
philanthropic desire to refresh prevalent medical
knowledge at appropriate intervals.
A second factor relates to recognition, to
misquote John Donne, that ‘no book is an island
entire of itself’. Each item in a book collection
must be considered in relation to the collection as
a whole. A library with many alternatives to a
particular book considered for withdrawal may be
less ‘forgiving’ than one where no such alternatives
exist. Collection development policies also imbue
an individual book with greater collective signifi-
cance when it is designated to an area of the
collection labelled as ‘core’. The existence of such
policies provide an important antidote to unwelcome
connotations of ‘weeding’ that evoke vacuuming
up Cochrane’s classic Effectiveness and Efficiency3
and replacing it with a pocket guide to evidence-
based medicine!
Finally, we must acknowledge factors in favour
of book withdrawal. Some suggest that weeding
of a book stock has a positive effect on the use
of the collection that remains, although this
phenomenon remains contested. Furthermore a
‘do nothing’ option is not cost neutral—librarians
rarely consider that an item lying unused on a shelf
is costing space, light, heat and cleaning, not to
mention opportunity costs.4 Of course, this must
be weighed against the time and effort required to
remove it from the shelves and, sometimes, the
equal time and effort it takes to remove it from the
catalogue. Deferring a decision to a later date may
betray a lack of professional courage rather than
reflecting prudent management. In my first profes-
sional post, I relegated old volumes to the plentiful
shelves of our postgraduate centre’s breakout
rooms, only to discover later that I had removed
any possibility that these items would be used,
although they still figured on the catalogue. I had
also perpetuated an ongoing waste of space
161
162 Using evidence in practice
and added a supernumerary interim stage to the
process of throwing the volumes out for good!
Context for the question
Recently, I re-encountered a posting to the lis-medical
Jiscmail discussion list dating back about a year
and a half: ‘Hello all, I am looking at formalizing
my collection management policy in the light of
both a monster weed we are undertaking and work
to shift various aspects of our collecting into a
more electronic world’.5
Putting aside the B-movie connotations of the
‘monster weed’, I was reminded that one of the
exemplar ‘burning questions’ identified by Eldredge6
was: ‘When weeding a hospital library collection,
how does one determine the publication year
before which materials can be weeded from the
collection?’. I therefore formulated the following
hypothetical scenario.
Scenario
A health librarian working in a multidisciplinary
education centre library built 15 years ago is
concerned at the lack of bookshelf space
remaining for new acquisitions. The librarian
decides to examine the evidence base for book
withdrawal, specifically within a health library
context. To initiate the search, he or she formulates
the following SPICE question:7
Setting: Looking at a multidisciplinary
health library ...
Perspective: ... from the perspective of the pro-
fessional members of staff ...
Intervention: ... are research-based methods of
book withdrawal ...
Comparison: ... superior to professional
judgement ...
Evaluation: ... with regard to both efficiency of
process and subsequent use of the
bookstock.
The evidence base?
A search of Library and Information Science
Abstracts ( lisa) using ‘withdrawals’, of
cinahl using ‘weeding’ and ‘withdrawals’ and
Journal compilation © 2009 Health Libraries Group. Health Information and Libraries Journal, 26, pp.161–165
the Library, Information Science and Technology
Abstracts (lista) database using ‘Weeding’ and
‘DISCARDING of books, periodicals, etc.’ com-
plemented by a simple targeted Google Scholar
search (e.g. ‘weeding and health and libraries’)
reveals only six relevant items published in the
decade between 2000 and 2009 (Table 1). Such a
disappointing yield attests that book withdrawal
in health libraries, arguably more critical given the
volatility of health information, has received less
attention than in the more ‘politicized’ domains of
public and school libraries.
This Using Evidence in Practice feature is not
intended to offer mini-reviews of the evidence
base, so the interested reader is referred to individual
items in Table 1 and the reference list. Instead, we
will illustrate more generalizable observations
about the quantity and quality of the evidence
base. Including the specific setting of a health
library, considered an important feature of a
focused question,7 was particularly detrimental
for the number of items retrieved. Clearly, there is
a significant trade-off between relevance and
availability of the evidence. If we broaden our
question to other contexts, which do we include or
exclude on the basis of relevance? While excluding
public and school libraries may be justified, how
do we allow for possibly confounding disciplinary
differences if we admit small academic libraries?
More significant is the mismatch between the
type of material that I was seeking to address my
question and that retrieved from my ‘quick and
dirty’ search. I was looking for a methodology by
which I might implement a weeding policy. Overall
items I retrieved were rich on ‘know-how’ but poor
on evidence. They also tended to focus on macro-
level considerations for the process as a whole
rather than on the micro-level operational detail of
conducting the weeding. Interestingly, one item
draws parallels with a physician’s diagnosis and
treatment, making it easier to argue that weeding
is legitimately viewed as a facet of evidence-based
practice.8
Several items were retrieved through multiple
database routes (lisa/lista/cinahl). However,
two of the most useful items, a report in a regional
newsletter of an MSc Project11 and possibly the
profession’s most unobtrusive randomized
controlled trial in a research section newsletter,9
© 2009 The author
 Using evidence in practice 163

Table 1 Articles on stock withdrawal in a health library context (2000–2009)

Identifier Geographical Study design/

(date) Setting area article type Main conclusions

Cox & University Indiana Process Staff used ‘appropriate’ bibliometric strategies,
Gushrowski Dental Library University description measures and resources to effectively facilitate process
(2008)8 (USA)
Eldredge University University of Randomized First reported use of RCT in this setting. It appears
et al. (2002)9 Health Sciences New Mexico controlled trial adaptable to weeding and other collection resources
Library (USA) (RCT)/reported applications. Rejects hypothesis that weeding
from poster increases usage. Adjusted data involving removal of
popular titles does not confirm hypothesis either
Gushrowski University Indiana Process Follow 6-step process: develop plan and be prepared to
(2007)10 Dental Library University description deviate from it; keep project manageable by working on
(USA) reasonable size portions of collection and involving as many
staff members as possible; determine which data to collect;
determine objective criteria; keep expectations reasonable;
have disposal plan for de-accessioned items and be aware
of any restrictions library is under
Scott Primary care Scotland (UK) Brief literature Weeding criteria included amount of use item received,
(2004)11 National review and relevancy, value (both financial and intellectual), age and
Health Service case study condition. A method was devised to carry out task. Excel,
Library Endnote and Heritage Library Management System
manipulated to yield relevant information
Shisler Nursing library Ursuline Overview Proposes basic criteria for historical materials and for
(2007)12 College, illustrated by purchase. Presents checklist of eleven questions used in
Ohio (USA) case study weeding older materials. Provides reference resources and
discusses benefits of lean but varied collection
Tobia Academic University of Descriptive Weeding project reclaimed shelf space, removed
(2002)13 health sciences Texas at case study out-of-date and duplicate materials and identified books
library San Antonio needing repair or replacement
(UTHSCSA)
(USA)

were more difficult to identify. The former was
located through a Google search and not covered
by any of the formal databases. The latter was
located not through library-specific databases but
through cinahl. This account from a poster has
not subsequently been published in the peer-
reviewed library literature. As this is a randomized
controlled trial, I subsequently conducted a
known item search to see if it was included in the
Cochrane Library—with no success. A search on
‘weeding’ on the Cochrane Library yields only a
single record—on seasonal allergic rhinitis!
Regarding the contexts of the included articles,
two were multiple accounts of a single dental
library initiative,8,10 one related to a nursing
library12 and two were academic health sciences
libraries.9,13 The single most relevant item, the
MSc project account,11 was conducted in the UK
National Health Service so scored best on imme-
diate relevance. However, how do we handle the
signal-to-noise balance, given that the newsletter is
unlikely to have been peer reviewed? On the posi-
tive side, four of the six articles (from Interim,11
Hypothesis9 and two from Journal of the Medical
Library Association12,13) were easily accessed in
full-text format without charge. However, the item
most likely to hold the potential to resolve my
scenario, the Masters dissertation itself,14 would
likely prove more challenging to obtain.
Despite the unsatisfactory nature of my evidence
quest, unexpected benefits were derived during the
course of the search. For example, I am reminded
that book withdrawal should not be tackled in
isolation, but should be fully integrated within the

© 2009 The author

Journal compilation © 2009 Health Libraries Group. Health Information and Libraries Journal, 26, pp.161–165
164 Using evidence in practice
wider context of collection management.15 This
includes more strategic issues such as identifying
core collection areas in the first place, as well as
‘preventive’ strategies, such as including a policy
for gifts and donations. Such features make the
subsequent process of weeding much easier in the
long run. More importantly, a key theme I had not
expected, emerged relating to the importance of
communication with readers about what you are
doing and why you are doing it.16 Arguably, this
aspect of ‘public relations’17 is far more critical to
the success of the weeding process than technicalities
regarding cut-off dates and areas for exemption.
Indeed, we might go further to suggest that involving
users in the decision-making process, including
eliciting suggestions for new acquisitions, could
turn around perceptions of the weeding event
from a negative ‘purge’ to a much more positive
‘collection refreshment’. Certainly, we would not
expect users simply to anticipate plumes of black,
or white, smoke at the library windows to signal
the professional staff’s collegial activity!18
Conclusion
This brief case study of a burning question from a
realistic health library setting vividly illustrates
limitations of the existing evidence base. Not that
the evidence base is unhelpful. Arguably, if we
were to consider a wider range of generic
articles,19,20 and even the classic textbook on the
topic (assuming it has not been thrown away!),21
we might obtain the necessary ingredients for a
successful stock withdrawal policy, together with a
significant fund of practical wisdom and know-how.
In fact, the most interesting item of research, as
opposed to more discursive ‘evidence’, demonstrates
that adding multiple entry points to a catalogue
record did not translate into an increase in
circulation.22 No doubt, too, a wider search would
yield more systematic methodologies for stock
withdrawal, such as the CREW method used in
public libraries.23 Such methodologies may well
translate to a health library context. It is clear too
that, if our decision making incorporates
consideration and review of even a small body of
the available evidence, we will achieve a more
holistic, considered and justifiable outcome than
reliance alone upon librarian expertise, experience
Journal compilation © 2009 Health Libraries Group. Health Information and Libraries Journal, 26, pp.161–165
and intuition. This is illustrated in our recognition
of the user perspective, even where this is only
acknowledged as requiring better communication
concerning what is going on. What is apparently
missing is what is most desired—a rigorous, context-
sensitive methodology that is easy to implement
and that can simply be taken ... off the shelf!
References
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2 Antman, E. M., Lau, J., Kupelnick, B., Mosteller, F.
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Journal compilation © 2009 Health Libraries Group. Health Information and Libraries Journal, 26, pp.161–165