Sunday, January 11, 2009

The Tag Cloud of Clinical Uncertainty

NOTE: We recommend you read our other recent blog on this topic 'How to use the Tag Cloud of Clinical Uncertainty', it'll help you orientate yourself!

NOTE 2: It appears the Tag Cloud of Clinical Uncertainty isn't behaving itself. When I click on the diabetes tab I get taken to one place (click here) while others report being taken here. All users should be seeing what I see. So one for the techies to sort out next week - SORRY!

Over the years our team has answered over 10,000 clinical questions and our life is made easier when we find recent research/evidence to answer questions. Unfortunately, this is frequently not the case.

Historically, the most frequently asked question has been the frequency of vitamin b12 injections in pernicious anaemia. In the UK the recommendations are typically every 3 months (although recent guidance has lowered this) while in North America the suggestion is monthly. We have never been able to find any substantial evidence to support this. What is needed is a relatively simple RCT of 1 month versus 3 month injections, but that has not been done. There are a large number of other examples, all genuine clinical uncertainties, all requiring research. It was because of my desire to try and influence the research agenda that we got involved with DUETs an Iain Chalmers initiative to map out clinical uncertainties.

When we created TRIP Answers we introduced a scoring system for each Q&A and this allowed us to easily identify questions with little or no research to answer them. As well as being utilised by DUETs it allowed us to visualise uncertainties via the wonderfully named Tag Cloud of Clinical Uncertainty. While utilising a different methodology (and hence getting different results) to DUETs we have been very successful in highlighting hotspots of uncertainty. A 'thumbnail' of the main tag cloud can be seen below but it's best seen via the site (click here).

Ultimately, our desire with the Tag Cloud of Clinical Uncertainty is to highlight real clinical uncertainties, promote debate and who knows – improve research procurement/production. In the interim, we’d love you to visit the Tag Cloud of Clinical Uncertainty (click here) and explore the uncertainties, you’re in for a few surprises!


Laika said...

I've looked at your Tag Cloud of Clinical Uncertainty before. And I think it is a great initiative. Now only, how to get this research done? Have you contacted the James Lind Alliance?

Jon Brassey said...

Hi Laika,

I'm involved in DUETs and that is seen as a tool for use by the James Lind Alliance. Iain Chalmers (he who helped set up the Cochrane Collaboration) heads up both.

Who knows how it'll help stimulate research. However, I think the more people/organisations that highlight real uncertainties (e.g. DUETs, TRIP) the better.

I want research that ultimately answers the questions clinicians have. I know too many academics whose research is stimulated by personal interest and has little relevance to the wider world!

Laika said...

I didn't know you were involved in both TRIP and DUETs. I admire Iain Chalmers for trying to get the most needed research done and agree with your point of vue.

Jo Brodie said...

Well it is interesting but I'm not sure I understand it; I've not really used tag clouds before so perhaps that's why :)

If I click on a tag I'm taken to a slightly different tag cloud with different words highlighted - does this mean that if I've clicked on X I'm taken to a page of X-related items and a large tag on the next page is an area of uncertainty for X?

Basically how do I "read" this information?

Thanks to Laika for retweeting this by the way, might have missed it otherwise!