DynaMed & Swine Flu

DynaMed is normally a subscription only service so I was very pleased when they announced that their swine flu resource is being made freely available (click here). Given the nature of the panic I thought this was a nice touch. Well done DynaMed and well done Ebsco (the publishers).

I've also updated the entry on the TRIP list of swine influenza resources (click here).

Swine influenza

Find below a list of links that might be of useful to those concerned with swine influenza. If you can think of any we've missed, please let us know.

General Information

• CDC swine influenza centre
• CDC latest news on swine influenza (has RSS feed, so very useful)
• World Health Organisation swine influenza centre
• USA Pandemic Flu centre
• Wikipedia article on swine influenza
• National Library of Medicine has LOTS of great links, including material in Spanish, a YouTube webcast and podcast,
• DynaMed has an article on the topic. This is freely available, which is a nice touch for a subscription website.
• Carry out a TRIP search for pandemic flu, LOTS of great resources - click here.
• NaTHNaC advice for travellers (UK)
• RCGP have updated their guidance on Pandemic Flu
• BMA have waded in with information/links
• How to Prepare for a Pandemic a great list of links

Governmental press releases

• Canadian Public Health Agency press release
• UK Health Protection Agency press release
• Other HPA press releases
• USA Homeland security

Related research articles

• Non-pharmaceutical public health interventions for pandemic influenza: an evaluation of the evidence base, BioMedCentral 2007
• Physical interventions to interrupt or reduce the spread of respiratory viruses: systematic review, BMJ 2007

Specific Patient Information

• NHS Choices
• Behind the Headlines Q&A
• Medline Plus

Others

• Responsive Q&A on swine influenza (Spanish)
• View real time comments on twitter & also see this blog article on disinformation on twitter via David Rothman's blog.
• Google Maps
• HealthMap
• BBC News mapping, looks the best to me!
• Clinical Correlations blog article

Swine Flu Spreads Panic Over The Web

Another interesting TechCrunch article (click here), this time on swine flu. It's interesting how they've used Google Trends to chart people's interest in the topic.

I keep thinking, when these health scares hit the news, that TRIP could do something more. Perhaps a 'Top ten resources for swine flu' which would be more dynamic than the current search system. I suppose I could create a blog article and link to it from TRIP - now there's an idea.....

Call for voluteers

One idea we've got for TRIP is to allow domain experts (clinician or information specialist) to highlight important papers/organisations related to a particular search term. These 5-10 links would appear on the results page and sit aside from the main results.


So, an expert in hypertension (say) would volunteer and essentially create a list of links that would enhance the TRIP main search results. As a crude example they may link out to the following:

• British Hypertension Society
• American Heart Association
• NICE guidance on hypertension
• Escardio
• Investigating hypertension in a young person (from the 6th April 2009) - ie an important recent paper
• An important recent news item
• etc

I would see the expert be given pretty much free-range over what they add (subject to certain conditions).

Two questions:

• Would these links be a useful addition to the main results?
• Would people volunteer to help?

For both questions I think yes! I have little doubt the human expert links will be pertinent and useful.

The bigger question is the desire of people to volunteer. I would like to think that there would be relatively little work in creating the list (given the volunteer would be an expert in that area), updating would be minimal. The volunteer would help improve the search results on TRIP making the million plus users per month gain better results.

I suppose that's the real question - is improving the search results on TRIP motivation enough for people to volunteer a few minutes a month?

Please let me know via this blog or e-mail jon[@]tripdatabase[.]com

April update

I've just added the latest monthly update to TRIP with 588 new records.

This figure is slightly mis-leading as it represents only those records that I add manually. We also import records via RSS and XML - so we probably add double that every month.

That aside, these new records will be searchable sometime over the weekend.

Bandolier

Rats, Bandolier have abandoned their 'old' URL and moved to a new one! Therefore, until all the old links are updated (manually by me) the old articles will go to no-where....

TRIP as a recommendation engine

As we roll out the new changes to TRIP in a few months, one area we're keen to explore is targeting clinicians in a given clinical speciality. We'll be making a big deal about the My-TRIP feature and one aspect of this is allowing users to select which speciality they belong to.

Might it be helpful for a clinician to highlight articles they found useful and these can be seen by others in the same speciality? Technically, it's relatively straightforward to introduce such a system, but is it worthwhile? Would the benefit extend to articles over a certain age?

For instance, a cardiologist might search for an article, look through 5 or 6 and decide that 1 or 2 are great articles. They could then hit a 'noteworthy' button against the 1 or 2 articles and this could then be flagged up to other cardiologists. If there are 100 cardiologists sending through recommendations one could create a league table of most recommended for other cardiologists to view.

I can see the benefits but I'm not sure of the downside (assuming people don't take the recommendations too seriously).

Clinical Evidence

We have just updated our Clinical Evidence records.

Unfortunately, CE seem less inclined to work with TRIP than previously so access is limited to our spidering systems. Therefore, the search won't be optimised. It's unclear to me who will benefit from CE's reticence.

Irrespective of that, I still believe having the records updated will benefit many users of TRIP.

Evidence in the courts

I've only just heard about this (click here). It appears that the British Chiropractic Association have taken exception to an article written in a national newspaper.

Scary stuff!

Making over the Pharma Industry

A nice blog post from the FT (click here) highlights an article that Iain Chalmers and Silvio Garattini have recently published in the BMJ (click here). In it they propose 4 suggestions to improve the way the pharma industry carries out research, they are:

1) Patients to be involved in shaping the research agenda - in other words, making sure research questions have resonance in real life and real-world situations

2) Legal requirements for research to be published, including trial protocols, by all (mandatory publication of trial data has had legal backing in the US since late 2007; no such protection for patients currently exists in the UK)

3) Independent evaluation of drugs. As the paper says: “The monopoly that the drugs industry has in evaluating its own products, and the secrecy surrounding this process, leads to biased evidence that is currently only rarely questioned by independent studies.”

4) A requirement to demonstrate “added value” for all new drugs - is this drug better than the current best drug treatment, or does it benefit in addition to it, and is it better than non-drug treatments? Too often, trials are done comparing a new treatment to placebo where there is a known intervention which is better than placebo. This means that uncertainty about how to use it best persists.

Two great posts on EBM

Laika's blog is a wonderful source of commentary on EBM and the wider role of a medical/clinical librarian. Her blog includes two recent posts, the first by herself and the second is a guest post:

• How Evidence Based is UpToDate really?
• Evidence Based Medicine: The Facebook of Medicine?

I highly recommend them both!

Inside professional P2P healthcare communities

A great post that I heartily recommend - Between a rock and a hard place: inside professional P2P healthcare communities. I liked it so much I added a big comment on it! In reading it I'd also recommend looking at the medical economics article highlighted in first sentence (Behind doctors' social networking websites).

Farewell to the NLH

A number of bloggers have highlighted the 'sort of' end (as of yesterday) of the NLH:

• Bye bye National Library for Health
• NHS Evidence
• Farewell then NLH

Over the years TRIP worked on a number of projects, first with the NeLH and then the NLH. Initially we provided a search solution, various bits of project work and finally on the Q&A service.

I'm wondering if the NLH is (or will be) considered a success or not. I remember, near the start of the NeLH, I saw Muir Gray discuss the aims of the site. He said something like people will have access to top quality material within 3 clicks. I don't believe it came close to this. I also think the view of the NLH will be shaped by the success or not of NHS Evidence.

What does concern me about NHS Evidence is that it's a search solution using accredited sources of information. I return to the theme of what do the users want? Do the people in NHS Evidence understand why people search for information?

Probably the most likely reason for a clinician to search NHS Evidence is because the have a clinical question. In an ideal world, if you have a question which would you prefer:

• A list of 10-20 hyerlinks to accredited documents
• An answer using the best available evidence

If you're a busy clinician and you have a choice of asking a colleague (as we know most clinicians do) or searching and trying to find the answer from multiple documents human nature suggests the former is more likely. And most people will acknowledge the problematic nature of search.

This is not about me wishing to reinstate the Q&A service, this is about wanting to support clinicians to practice evidence-based healthcare. Give clinicians the answers they want, make their lives easier. The more barriers you place in the way of practicing with 'best evidence' the less likely it is to be practiced.

By the end of this month NHS Evidence will have launched with their super-duper new search engine. I genuinely hope they introduce some innovative features that we (at TRIP) can learn from. However, search is only part of the solution. From my perspective the sooner they realise that the better.

In saying farewell to the NeLH/NLH one name has gone unmentioned - Ben Toth. He was instrumental in setting up the NeLH and he achieved great things.