Saturday, April 29, 2006

The Lancet

As part of the preparation to include the big 5 medical journals (NEJM, JAMA, Lancet, BMJ and Annals of Internal Medicine) I've been doing some preliminary work. As feared the Lancet still does not allow direct linking to their abstracts on the the Lancet website. I can see no good reason for that - they make you register and login to view them. I think this makes them unique!

So what are the options for inclusion in TRIP? The most obvious is to link to their PubMed records. Hardly ideal. The one advantage is that this could be automated via the PubMed XML tools. But then do I include the other 'big 5' via this method or link to the abstracts on their respective sites? It invariably looks better going to the sites, but it is more work....

Wednesday, April 26, 2006

Adding peer-reviewed material (part 2)

Further to my post of the 18th April....

I shared my views of adding the big 4 journals (JAMA, NEJM, Lancet, BMJ) with Paul Glasziou from the Centre for Evidence-Based Medicine. Paul carried out a large evaluation of the TRIP Database in 2005 and is someone I have huge respect for. Paul's view was that it might be better to add Annals of Internal Medicine as well. The reason for this is that these 5 journals (plus Cochrane who we already have on the site) account for over 50% of the articles seclected as part of the Evidence-Based Medicine journal (which Paul edits).

So I'm getting increasingly drawn to the idea of adding these 'big 5', irrespective of the workload. However, I may, to begin with just add articles from 2000.

Tuesday, April 25, 2006


I came across a nice site, Visual Thesaurus, which is unfortunately not free-access! But offers a few trial goes. It reminded me of the TouchGraph feature in HubMed. I'm not sure how useful these things are, but they interest me.

I'm still keen on introducing a relationship function on the TRIP Database. I see it working like Amazon's 'People who bought this....'. So it's be something like 'People who viewed this article also looked at these'. However, as with the visualisation features above I'm not sure how useful it'd be!

Monday, April 24, 2006

Popular Papers - March 2006

Below are the top ten papers reached via the TRIP Database for March 2006.

1) Abdominal ultrasound in the diagnosis of childhood appendicitis (BestBets)
2) Geriatric Care and Treatment (SBU)
3) Osteoporosis (Patient UK)
4) Routine antenatal care for healthy pregnant women (NICE/RCOG)
5) If a patient with osteoporosis is unable to take calcium supplements, are bisphosphonates as effective as when a patient is able to take calcium supplements? (NLH Q&A Service)
6) Day Case Laproscopic Cholecystectomy (British Association of Day Surgery)
7) Evaluation of the patient with sore throat, earache, and sinusitis: an evidence based approach (DARE)
8) Burkitt Lymphoma (eMedicine)
9) Acute Pain Management (National Health and Medical Research Council)
10) Effective Medical Treatment of Opiate Addiction (NIH Consensus Statement)

I was pleased to see a NLH Q&A Service answer in the top ten - shows other people are, at least, interested in them. In March over 3,000 visits to NLH Q&A Service answers were 'facilitated' by the TRIP Database.

Saturday, April 22, 2006


An interesting site spotted by Ben (NHS eLibraries blog) - LactMed. Its a site dedicated to drugs to which might have an effect of drugs taken during lactation. I'm sure it's very useful although one search for simvastatin returned a record whose first sentence was "No relevant published information exists on the use of lovastatin during breastfeeding"

A UK related site is the UKMI (UK Medicines Information) site Drugs in lactation

Tuesday, April 18, 2006

Adding peer-reviewed material

Does it have a role in TRIP? Dean Giustini's re-named blog serves up more food for thought. He highlights 5 main sources of medical information:

1) Medline - core
2) Big four (BMJ, JAMA, NEJM, Lancet) - inner core
3) High impact factor journals
4) Embase - alternative core
5) EBM material.

TRIP definately does 5 - that's its main purpose. We also have created an automatic search of PubMed that covers 1, 2 and 3. I don't think we can do much about 4.

However, the medline coverage is not 'core' to TRIP, it's bolted on as a separate search. Can we integrate both systems? A few years back we had a separate category called 'primary research' where we incorporated 25(ish) journals, big 4, AMA, BMJPG journals and select others. The criticism we received related to potential publication bias. 'Hooking up' to PubMed allowed us to improve the coverage and save ourselves much time.

Is it time to consider re-integrating some primary research articles into the main search? I'm thinking of how it might work to incorporate the 'inner core' of medical journals. It would be relatively straightforward. However, it raises the main issue pre-occupying the current development workload at TRIP - weighting and the search algorithm. Where would a 2006 journal article appears relative to a 2003 Cochrane SR, a 2004 clinical guideline or a 2005 clinical question?

Wednesday, April 12, 2006

Search habits

Not sure how applicable these results are to medical search....

"The study found that 62 percent of search users click on a link within the first results' page, up from 60 percent in 2004 and 48 percent four years ago. Additionally, nearly all searchers--90 percent--click on a link within the first three pages, up from 87 percent two years ago and 81 percent in 2002."

"When researchers asked users at what point they either revised their queries or moved to another search engine, 16 percent replied that they did so after reviewing the first few entries, and 25 percent said after the first page. An additional 27 percent changed either their queries or search engines after the first two pages, while 20 percent did so after three pages; just 12 percent stayed with the search terms and/or engine beyond three pages."

See here for more details.

Windows Live Academic

WLA (or WLAS or MAS or MLAS?) has been released (click here). Disappointed to see it doesn't cover medicine as yet. It's only available as a beta-version and covers "computer science, physics, electrical engineering, and related subject areas."

Monday, April 10, 2006

Fewer charges for website content

The TRIP Database moving to free access appears part of a larger trend in freeing-up content across the internet. See this BBC news article (click here)

Microsoft Academic Search

See Dean's blog on the 'rival' to Google Scholar (link in side-bar) ...

But what will Dean call his blog (currently Google Scholar Blog)?

Friday, April 07, 2006


Google has been chosen to provide free wi-fi access to San Francisco (Click here). It reminded me of a time, farily recently, when a large American publishing house approached TRIP with a view to potentially buying 'us'. One of the main stumbling blocks related to our inability to store our records on a PDA. I suggested that it won't be long before most places will be wi-fi enabled allowing 'live' searching of TRIP. They weren't convinced! San Francisco's plans seem to be a major step forward in this direction.

The storing of databases on a PDA reminds me of when Medline was available on a load of CDs. Who would go back to that arrangement now you can search on a live updated version (via PubMed or HubMed)?

Wednesday, April 05, 2006


When answering a clinical question I frequently think of how useful that might be in ganfyd. We got asked, again, about the use of statins in the eldery (click here). As we re-answered this question the link needed updating in ganfyd (click here). Similarly a Q on nitric oxide (NO) in asthmatics (click here) gets added to the NO entry in ganfyd (click here).

This recycling of clinically useful material makes perfect sense and highlights the syngergies between the projects.
In answering clinical questions we occasionally see examples of practice that could be considered wrong. Yesterday, we had two within 20 mins - making it stand out! I say 'wrong', that's probably too harsh. It would be more accurate to say 'practice considered contrary to best evidence'. But then isn't that what the Q&A site is all about?

  • One was about using a stool test to re-test for H. Pylori eradication. The GP had used one 2 weeks after eradication therapy. In reality, according to the guidelines, you should only use a breath test. For more details click here
  • The other example was a 2-year old child being given the Pnuemovax vaccine. In the under fives it should have been Prevenar. For more details click here

Saturday, April 01, 2006

Positive feedback

A small selection of feedback we've received this week, mainly from the NLH Q&A Service:

  • I've used this service for a few months and find it superb, long may it continue.
  • fantastic resource.
  • I'd really value this service long-term and not just as a pilot- its far more useful for GPs than a lot of the information sources we have access to.
  • I think this is an excellent service and would definately use this service again in the future, the answer was very indepth and extremely helpful. Thank you
  • I love you Jon!

We get these comments all the time (except the last one). Makes the 'job' very rewarding.


When the TRIP Database goes free access we need to ensure we obtain an income to pay for upgrades, maintainance etc. The main ways we've identified are:

  • Sales of meta-data
  • Adverts

The former we do already and hopefully, as we get more prominent due to our free nature, we'll be able to increase this side of things. In the case of the latter our initial plan is to create our own in-house adverts which would allow us total control of what is advertised. We envisage these being displayed at the top of the search results page. However, is their a place for a google ads panel towards on the right-hand side of the search results? I have reservations, but the BMJ does it...