Wednesday, November 24, 2010

Adding a TILT button to other sites

You can see in the top right of this blog a TILT button, if you press it it opens up TILT with the URL embedded - making it very easy to TILT about a particular page.  We've added it to the actual blog, but there's no reason it couldn't be added against every article that appears on a website.

Either way, it's very easy!  Simply paste the following code into your site and you're TILT enabled...

<script type="text/javascript" src="http://tilt.tripdatabase.com/scripts/refer.js"></script>

Tuesday, November 23, 2010

The impact of TRIP: Part 2

Earlier this month we posted results of our survey of users which revealed that 40.77% of searches improve patient care.  For the full methodology read the post - click here.

Since it's start in 1997/8 TRIP has been searched over 51 million times.

So, 40.77% of 51 million =  20,793,000 times TRIP has helped improve patient care.

Is the answer 20,793,000?  Probably not!

But there are good reasons why this figure is too high and reasons why it is too low!

Reasons why the figure is too high
  • Methodology weak: relatively small sample size, self-selecting participants (?more likely to be favourable to TRIP), non-validated questionnaire.
  • TRIP has improved. The figure of 40.77% assumes that TRIP has always been as good as it is now while it's likely to have been relatively poor to start with.  However, to be fair to TRIP it has been consistently good for a number of years and the bulk of our searches have been in these latter years.
Reasons why the figure is too low
  • TRIP has actually been searched more than 51 million times.  The 51 million refers to people coming to the http://www.tripdatabase.com/ site.  We allow 3rd party sites to search TRIP and return results in their sites.  We have a number of these for examples in clinical portal sites, EMRs etc.  Also, we do various other automated information support systems (such as displaying related articles against 3rd party clinical articles).
  • It assumes that the information gained via TRIP is only used once.  If each clinician searches TRIP based on a patient-query I imagine the knowledge gained is used in dealing with subsequent patients.
Irrespective of an accurate figure, I doubt anyone can question that TRIP has had a significant impact!

Wednesday, November 17, 2010

TILT is out there

I've been mentioning TILT in this blog over the last few months.  It was actually live last week, but we started publicising it yesterday. You can see it at http://tilt.tripdatabase.com.  If you're already registered with TRIP then you can log into TILT using your TRIP details.

What is TILT?  At the simplest level it's a way for an individual to record their clinical learning (we encourage simple snippets of information).  However, the real beauty is that this learning is shared within the community.  There are lots of nuances associated with TILT, too many to post here now (while I'm still pushing hard to get TILT 'out there') but I'm sure I'll add more thoughts over the coming months and hopefully years.

Go to TILT, interact and let me know what you think.

Friday, November 12, 2010

The impact of TRIP

Earlier this week we created a short survey to try and understand what impact TRIP might have on patient care. There were 4 questions:
  • On average, how often do you search TRIP each month?
  • Do you ever use TRIP for helping you manage your patients or yourself?
  • On average, what percentage of your searches are related to patient care?
  • Of those searches that you use for improving patient care or your own care what percentage do you find TRIP actually helps?
We linked to the survey from two places: As a link from the TRIP Database and also from our various social media 'outlets' - Facebook, Twitter and this Blog. 

The results were very similar across both data collection methods.  For the sake of clarity I'll show an average result and in brackets place the separate results from TRIP and then from the social media:

  • 14.4 searches (17.2, 11.5)
  • 79.1% (74.2, 83.9)
  • 72.9% (74.3, 71.5)
  • 70.7% (72.3, 69.0)
So, what do all these figures mean? 

Firstly, the methodology is far from ideal, so the results are speculative/dubious.  However, I feel reassured that the figures have been relatively stable from very early on in the data collection.

If we wanted to work out the impact of say 1,000 searches here's how I've approached it:
  • 1000 searches of which 79.1% are from users who manage patients or are patients themselves = 791 searches
  • Of these 791 searches, 72.9% relate to patient care = 576.6
  • Of these 576.6 searches, 70.7% help improve patient care = 407.7
In other words 40.8% of searches on TRIP result in improved patient care.  That's significantly higher than our estimates and also, what I think is equally significant, is that 70.7% of users actually find TRIP is useful for patient care.

What is clearly needed is some more research (I typically hate seeing that in the discussion of a research article) to try and get a more accurate figure for TRIP's impact and I'd welcome any comments on the most appropriate methodology.

But, in the interim, I'm happy (with the above reservations) to say that 40.8% of searches on TRIP help improve patient care

Tuesday, November 09, 2010

The impact of TRIP

I'm really trying to understand the impact of the TRIP Database.  If you care about TRIP please take this very brief survey http://www.surveymonkey.com/s/JJKH25W

Thank you in advance.

Thursday, November 04, 2010

Reflections on Evidence 2010

At Evidence2010 I was a aware of a number of themes (in reverse order):

  • The whole publishing model is wrong.
  • Clinicians needs support in using the evidence ie what to do once they read a trial and know an intervention works, how do they actually use or administer it!
  • Conflicts of interest (COI) are widespread. Pharma is an obvious COI but also in academia there are significant issues.
  • There's no more money - the healthcare systems in 'the West' have no more money to keep pumping into healthcare.
  • Need to work more closely with patients to help make them better decision makers.
  • Clinicians need to say this phrase more often - I don't know.
  • There's an awful lot of love for TRIP :-)
Obviously, I'm very pleased about the last one. Overall, a  very good, thought-provoking conference!

Wednesday, November 03, 2010

Top 30 consultations in primary care

I had the pleasure of attending the Evidence2010 conference.  One role I undertook was to tweet about the presentations, in a way sending a summary of the presentations.  One talk, by Paul Glasziou, highlighted the diversity of conditions a GP will see (compared with specialists). He reported that 30 'conditions' accounted for 50% of consultations.  A number of people wanted to see the 30 conditions and Paul has sent me a spreadsheet.  It's actually 32 (not 30), so here goes:

  1. Hypertension*
  2. Upper_respiratory_tract_infection
  3. Arthritis—all*
  4. Diabetes,_non-gestational*
  5. Depression*
  6. Lipid_disorders
  7. Osteoarthritis*
  8. Back_complaint*
  9. Immunisation—respiratory
  10. General_check-up*
  11. Asthma
  12. Oesophageal_disease
  13. Acute_bronchitis/bronchiolitis
  14. General_immunisation
  15. Contact_dermatitis
  16. Anxiety*
  17. Gastroenteritis*
  18. Female_check/papsmear*
  19. Sleep_disturbance
  20. Urinary_tract_infection*
  21. Sprain/strain*
  22. Medication/script
  23. Sinusitis
  24. Solar_keratosis/sunburn
  25. Cardiac_check-up*
  26. Ischaemic_heart_disease*
  27. Oral_contraception*
  28. Pregnancy*
  29. Malignant_neoplasm_skin
  30. Acute_otitis_media/myringitis
  31. Results_tests/procedures_NOS
  32. Viral_disease,_other/NOS
Interestingly (!) the top 10 account for 27%