Trip Database Blog

I like to analyse what people look at via TRIP. Given the Q&A services we run (ATTRACT and NLH Q&A service) I decided to see what articles users follow via TRIP – so restricted the analysis to just those two services:

– What is the duration of treatment when adding clopidogrel to routine aspirin short-term post CABG and post coronary artery stenting in IHD.
– Are influenza vaccinations effective in older people?
– *What is the length of time a patient can remain on Dianette provided that there are no contraindications?
– What are the recent guidelines/evidence regarding the treatment of prostate cancer?
– What treatments are available for someone with a ruptured Bakers cyst?
– *What is the reason for stopping dianette a few months after skin condition resolve?
– Can the drug amlodipine cause atrial fibrillation?
– What causes a yellow tongue, and what is the best available treatment?
– *What are the risks of using Dianette as an oral contraceptive, over and above the risks associated with a 3rd generation oral contraceptive pill?
– What skin preparation if any is recommended when taking blood or giving an injection?
– *What therapies are available for women with PCOS with hirsutism other than Dianette?
– *What is the recommended length of time a woman should be on Diannette for acne, should any blds be checked, should there be any break in-between treatments?

What immeadiately struck me was that of the top 12 questions 5 related to Dianette. What does that tell us about Dianette?

For the first 3 months of 2006 the following are the top ten most popular ‘destinations’:

eMedicine
Clinical Answers
DARE
Guidelines.gov
ATTRACT
NHS EED
Cochrane
HTA
PRODIGY
Bandolier

The new search algorithm is still performing well and I actually use it as my default search for answering current clinical questions. But, even before this is released, I’m thinking of the next set of improvements, I have two in mind:

1) Popularity. Giving papers an additional score based on how often they have been viewed. In effect our users choices will help decide the ranking. Suggested by Dean Giustini.

2) Location. I’ve been toying with this idea for a while and saw a nice blog entry on the subject earlier today. If you’re searching from the Australia you’d probably want to see Australian guidelines before UK or Canadian guidelines. So the general idea is to see where the searcher comes from and give their countries guidelines a scoring boost.

So, the new algorithm will be released (when we go free in September) and then we can try and incorporate the above improvements sometime early 2007.

I had an interesting chat with Ben from the NHS eLibraries blog. He suggested trying to tie-in with Google, as part of their Google Health ‘initiative’. One option in Google Health is ‘For health professionals’ – TRIP could form the backbone of a new tab ‘Evidence-based medicine’.

We frequently get very positive praise via our Q&A feedback mechanism. Every now and then we get comments which stand out (for one reason or another):

“Very impressed, very useful. I was however, quite alarmed at some of the other questions posted i.e people asking for guidance on issues which you would have hoped as health professionals they would be extremely familiar with, I suppose you could see that as a good thing, as if this service didn’t exist, presumably they would stay uninformed and at least they are asking questions which will improve their practice.”

In a trial of 8 ‘proper’ clinical questions we rated which search located results best:

Current live system – 1
New test system – 4
No difference – 3

I think the first round goes to the new test system.

Not 100% sure why the authors chose to ignore convention and remove the space between ‘clinical’ and ‘questions’. I’m sure it seemed a good idea at the time!

However, that doesn’t detract from the site (http://clinques.nlm.nih.gov/JitSearch.html) which is a collection on 4,500+ clinical questions. No answers, just the questions. Not sure why I like it so much. It’ll be useful in testing the new search algorithm!

When testing a search appliance it seems sensible to try ‘real’ searches. We’ve received a question about SLE (Systemic Lupus Erythematosus) and statins – should all patients with SLE receive statins.

I entered the search ‘sle AND statins’ and the first result was what I was looking for. On the current ‘live’ system the same search would return one result. However, the user would be required to click on the ‘Clinical Questions’ link. It’s only one click but the new search is showing great promise..

At last, the final installments of the potential new TRIP algorithm have been delivered! We’ve got 35 volunteers testing it alongside a number of staff…