Tuesday, July 31, 2007

Holiday time

It's that time of year, so my last post (not sure that this counts as a post) till around 9-10th August.

I'm leaving in 30 mins, but this AM I had the final specification meeting with the web-company regarding the latest upgrades to TRIP. These documents will be finalised for me to read on return. Once I've signed them off there's around 2-3 weeks of development before I get a test version. So we're looking at an early September deployment. To re-cap two main changes:
  • Improvement to the search algorithm, much better results as well as the ability to arrange results by date (the most frequent request we get).
  • Baby TRIPs. We should launch with 25 specialist search engines. Each specialist search will search the core TRIP content PLUS content specific to that speciality. This is not trivial content, we're talking about 5-20,000 area specific content in each baby TRIP.

Bye for now...

Monday, July 30, 2007

How Quickly Do Systematic Reviews Go Out of Date?

An important question that is as relevant to Q&A as to systematic reviews. This Annals of Internal Medicine article (click here) attempts to answer this question. The important bit, for me was this:

"This survival analysis of 100 meta-analyses indexed in ACP Journal Club from 1995 to 2005 found new evidence that substantively changed conclusions about the effectiveness or harms of therapies occurred frequently within relatively short time periods. The median survival time without substantive new evidence for the meta-analyses was 5.5 years. Significant new evidence was already available for 7% of the reviews at the time of publication and became available for 23% within 2 years."

Friday, July 27, 2007

Uffington Wassail

A mixed bag to end the week:

  • As someone who studied social networks I was fascianted by this NEJM article "The Spread of Obesity in a Large Social Network over 32 Years". This was blogged on the Clinical Cases and Images site (click here).
  • I've just broken my record for number of questions answered in a day - 18 - and still a few hours to boost that. I think I've overdone it.
  • Talking of Q&A we recently extended our contract with the NLH for a further year, supplying up to 50 answers per week.
  • Great news on the redevelopment front, we should be have the test version by the third week in August, with probable (?possible) deployment in early September. I've already mentioned the new and vastly improved search algorithm (click here for more details). The other development is the creation of a significant number of specialist TRIP search engines. More details when I get a moment...

Saturday, July 21, 2007

How do people find TRIP?

Another glance at our webstats brings pleasing news. I've analysed how people get to TRIP, the top five being:

  1. No referral - 72.02%
  2. www.google.com/search 10.77%
  3. google.co.uk/search 6.72%
  4. search.yahoo.com/search 1.37%
  5. ww.google.ca/search 1.01%

The top 'referrer' being 'No referral', this means people who have bookmarked the site or type in the TRIP URL directly. So last week, of the 110,000 searches, over 79,000 came from regular users of the site.

I suppose it's difficult to know if that's god or not. I suppose I've just been ignorant of the 'loyalty' of TRIP users. Over 72% seems pretty loyal. Of the remaining 28% how did they get to TRIP? Perhaps via searching for TRIP Database, perhaps searching other terms!

Given our server strain it might be wise to stop Google spidering our content, that will buy us some breathing space, one to ponder!

Friday, July 20, 2007

New algorithm

From now on I'll be using the new algorithm for all my searches of TRIP. I was convinced by the latest question I answered Should someone with a history of proven ischaemic heart disease, and who abuses alcohol be on a statin?. Using the old TRIP found lots of useful material but it took a bit of wading through. Using the new algorithm found all the material in the top ten results - I was deeply impressed (trying to maintain some attempt of objectivity)!

I wish I could roll out the improvements in the next week or two. Unfortunately, this will have to wait till mid/end of September. As we're introducing a number of other changes the web-company is keen we roll-out all the changes in one go. We could overrule that, but it'd cost significantly more to do so!

In the interim I'll be in the luxurious position of having sole access to the best TRIP ever!

Monday, July 16, 2007

New Content

TRIP is always looking for good content to link to and this week three new publications have been added and are now searchable:

  1. Clinical Evidence - Not new and have been on TRIP for a while! However, we have worked with CE to allow users of TRIP to get access to the first page of the relvent chapter, which is great news.
  2. The Green Book - I'm not really sure why we haven't added this before. We use the Green Book extensively in our question answering work. Better late than never!
  3. Australia and New Zealand Horizon Scanning Network - I like this site....

With great content adding to great content and a significantly improved search algrithm just around the corner this is a great time for TRIP and it's users!

Wednesday, July 11, 2007

Reducing my embarrassment

The TRIP algorithm is the source of much pleasure and some embarrassment.
Why the latter emotion? Simply put, every now and then the system returns awful results? Not convinced, try this search menopause libido. The top result in a PRODIGY guideline on Parkinson’s.


I’ve posted before why this happens, but a refresher. In the case of the above guideline it is picked up by the search as it contains both terms. Even though it scores really low on ‘text relevancy’ it scores highly for being a recent document, being published in PRODIGY and being in the guidelines category.

For a fair few months now I’ve been trying to get a better system in place and yesterday I finally took ‘delivery’ of a test-bed for a new algorithm. This is a no thrills version on the site which allows me to see what the new algorithm can do. It does a number of things differently.

So how does that affect the above search – see the results below. Still needs a bit of tweaking, but it’s a vast improvement. The new system won’t be released until mid-September (with a number of other new features), we can’t wait.

Tuesday, July 10, 2007

TRIP in press

TRIP gets a mention as part of this newly published systematic review:

Comparison of retropubic vs transobturator approach to midurethral slings: a systematic review and meta-analysis.
Am J Obstet Gynecol. 2007 Jul;197(1):3-11.

The abstract states:

"We searched PUBMED, OVID, EMBASE, CINAHL, POPLINE, Web of Science, Cochrane Collaboration resources, TRIP, Global Health databases, and abstracts from relevant meetings from 1990 to 2006."

We've noticed more occurrences of this - TRIP being mentioned in publications - we're very pleased seeing TRIP getting taken so seriously. With our latest batch of improvements due mid/end September, with a vastly improved search algorithm we're getting very excited!

Monday, July 09, 2007

Most frequently viewed questions and answers

The ATTRACT website has a very interesting feature, lacking in the NLH Q&A site - the ability to see which questions/answers on the ATTRACT website have been most frequently viewed. In order:

  1. What are the risks of flying while pregnant? - viewed 19,427 times
  2. Should you treat a low Ferritin (<10)>
  3. What is the evidence for the recent press about statins and grapefruit juice being harmful? - 10,956
  4. What is the best treatment for pompholyx (dyshidrotic eczema, vesicular palmoplantar eczema) of the feet? - 9,494
  5. What treatments are available for sebaceous hyperplasia? - 8,793
  6. Does carbonated water, flavoured or otherwise, cause dental erosion? - 7,846
  7. What is the cause of a black tongue? - 7,653
  8. What is the likelihood of malignancy in a unilaterally enlarged tonsil? - 7,481
  9. Is there any information on the Novasure system for treating menorrhagia? - 7,330
  10. What is the best treatment for benign positional vertigo (BPV)? - 7,066

The feature that sticks out most for me is the staggering volume some of these answers have been viewed.

Friday, July 06, 2007

Journal of Q&A

Following on from yesterday's post I sent a quick e-mail to Dean (Giustini) over at Open Medicine asking about their software platform. They use Open Journal Systems, which is free, obviously robust and fit for purpose. I'm intrigued by their document "OJS in an Hour"

Thursday, July 05, 2007

Q&A as peer-reviewed journal

Q&A services support clinicians by offering clinically relevant information with minimal effort. One of my most frequent moans (aside from middle-lane hoggers on the motorway) has been the poor sharing of answered questions.


Many of our questions are dealt with 'sorry, we found no evidence', which may seem a poor answer, but clinicians seem to be happy with these. However, a number also receive more complex answers with multiple evidence sources.


Why not create a journals to formalise these answers? Why not have our answer followed by a 'commentary' by a clinician (be it a generalist or specialist)? The format of the journal 'Evidence-Based Medicine' springs to mind (see for an example). This has the abstract followed by a commentary. See below for truncated image.


Sunday, July 01, 2007

On finding the studio banjo

Another 'random' title for a blog entry - I've been looking for an excuse!

Things have been fairly hectic of late. The NLH Q&A Service continues to move on with an expansion in questions we can answer (35-50 per week). The new arrangement also gives us greater flexibility, which suits us all very well.

My encounter with Facebook is proving interesting. Still not 100% sure why, although I've recently been contacted by a friend I lost track off after college (1991).

I'm very excited about a meeting next week - to finalise the next update to TRIP. There are 3 main planks, the first I've discussed before, a significant overhaul in the search algorithm. One of the others I've mentioned in the past - the content/quality slider. However, the big enhancement I'll leave for another day.

Finally, I'll be gone for most of this week, at the Manchester International Festival.