Many of the answers we give on the Q&A service have only one reference. In other words we feel that the answer has been adequately answered with that single resource. Often these are from excellent sources such as PRODIGY. I’m meeting the clinical lead for PRODIGY, Sharon Smart, on Monday to hopefully forge closer links between PRODIGY and the Q&A services.

Aside from that, what does it mean when the user doesn’t find the information we do?

  • Are they ‘unmotivated’ to try the search?
  • They try the search and can’t find anything?
  • They try the search, find something promising but can’t find the information within the document?

One problem, linked with the last point, is that documents such as PRODIGY is their sheer size. It’s fine to find the document you’re interested – but in a document that size how do you find the ‘needle in a hay stack’? The PRODIGY guideline is split into many sections. For instance the PRODIGY guideline on antiplatelets answers many specific questions e.g.

  • How do antiplatelet drugs reduce cardiovascular risk?
  • How should I manage people who develop an ulcer while on low-dose aspirin?
  • What should I do if a person on aspirin is at increased risk of gastrointestinal adverse effects, or develops severe dyspepsia?

My view is that these should be separate documents. As well as a global ‘Antiplatelets’ guidelines why not have small documents such as “How do antiplatelet drugs reduce cardiovascular risk?” with just the specific text associated? PRODIGY have moved towards that with their structured view. However, it’s not particularly user friendly and doesn’t allow users to get straight to the ‘good stuff’ – the fewer the clicks the better.

This principle could easily be extended to other documents e.g. other guidelines, NICE documents, systematic reviews ie what questions do these documents answer?

I remember Ben Toth (his blog) talking about this a good few years ago! Always a great source of information and advice!

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