Trip Database Blog

Liberating the literature


January 2009

New and updated resources

A great new resource from Scotland has been brought to my attention – Hands on Scotland – and we’ve added to TRIP patient information. The site reports:

“The HandsOnScotland Toolkit is an online resource for anybody working with children and young people.

This website is designed to help you make a difference to children and young people’s lives, by
giving you tools to respond helpfully when they are troubled.

It is a one-stop shop for practical information and techniques on how to respond helpfully to children and young people’s troubling behaviour, build up their self-esteem and promote their positive mental wellbeing.”

Also, last week I posted that I’d updated the British Association of Dermatologists guidelines. Unfortunately, I forgot about their patient information leaflets, which I’ve now updated. These should be fully searchable on Monday morning.

The Inauguration

Not related to TRIP, but two blog posts relating to yesterday’s inauguration:

Blog’s can give perspective that mainstream media often avoids or is too slow to get to! This follows on quickly from twitter being quicker to report on the recent plane crash in the Hudson.

Whether speed is always crucial or even welcome is another issue. I don’t remember, as a child/teenager, being too bothered by there being no internet, 3/4 TV channels (that’s ‘3 to 4’ not 0.75 ) and a hand-delivered newspaper!

What creates the ‘popping’ when you ‘click’ your joints?

TRIP has a long-standing interest in answering clinical questions.

We’re wondering if the large number of users of TRIP can be used to help us with clinical Q&As. We aim to test this over the coming weeks, starting with this difficult question:

  • What creates the ‘popping’ when you ‘click’ your joints?

As you will see (the link is below) the existing answer highlights a high degree of uncertainty. What we want people to do is to read the Q&A and leave suggestions via this blog or via the comment form at the bottom of the answer.

To see the existing answer click here.

Evidence-Based Health Care and Knowledge Translation

Around 5 years ago I had the pleasure in visiting the College of Medicine at King Saud University, Riyadh, Saudi Arabia. I visited to present and help run a EBM conference. Since that time I have kept a keen interest in their work (and I’m an ‘international advisor’ to the group). They have recently released a new website (click here) which you may enjoy.

New content on TRIP

As part of our monthly update of TRIP we have just added 587 new articles.

In addition we have ‘refreshed’ the content of the following providers due to URL changes:

Examples of twitter use

I’ve been on twitter for a few months now, but only recently have I started to take it ‘seriously’. To be fair you shouldn’t take twitter too seriously. When you post a message (a maximum of 140 characters) it’s actually called a tweet. Below are a selection of the tweets I’ve appreciated and posted myself (I’m JRBtrip). As you’ll see there are tweets covering a wide variety of subject areas. For me twitter allows a great way of keeping up to date, sharing in other people’s experiences and finding random serious and not so serious links.

mdconsult FDA launches program to improve safety of drugs and active drug ingredients produced outside the US

TechCrunch Yahoo Search Adds Deep Links To Wikipedia Via Search Monkey

markhawker In fact, the whole OurNHS YouTube channel is pretty good

AllergyNotes Women living in poor countries are 300 times more likely to die during pregnancy or childbirth

AllergyNotes Food allergy as “Yuppie anxiety”? — Food allergies are nothing to laugh about

amcunningham understanding students (non)use of IT

JRBtrip Twitter set for its mainstream telly moment on Jonathan Ross’s comeback show

JRBtrip Twitter set for its mainstream telly moment on Jonathan Ross’s comeback show

JRBtrip SIGN’s new stroke guideline & they do a gr8 job of haemorrhagic stroke – most tend 2 focus on ischaemic (4Mb!!)

stephenfry Funny how loyal to your cities you Aussies are. And not content with loving Melbourne, Brisbane etc, you have to diss Sydney. Love them all!

JRBtrip Can you improve on this Q&A on the etiology of the popping when you click your joints

brownleader @JRBtrip discussed this with 3 GP’s who I work with and none of us could shed any light on the aetiology of popping/clicking joints

As you’ll see from the last two tweets that I asked a question (which can be viewed by all the people who ‘follow’ me) and brownleader responded. So twitter can be social as well.

If you’re tempted to get involved drop me a line and I’ll happily be your guide.

Surgical checklist ‘saves lives’

The BBC report:

“Using a simple surgical checklist during major operations can cut deaths by more than 40% and complications by more than a third, research has shown.”

While the full article “A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population” has been published on the NEJM site.

A few quick observations:

  • It’s not a randomised trial, which could have been very easy to arrange.
  • Not all outcomes in every site are favorable.
  • Significant positive results for ‘any complication’ were seen in only half of the organisations.
  • Pharma sponsored trials are often criticised for not using absolute risk reduction, I note that this trial also avoids that statistic.

Irrespective of the above, brief criticisms, any article that helps highlight simply ways to improve quality of care has to be applauded.

Twitter: an introduction to microblogging for health librarians

Twitter: an introduction to microblogging for health librarians well worth a rea to whet your appetite. Courtesy of Dean Giustini’s UBC Academic Search – Google Scholar Blog

Q&As in Dermatology

This post starts with an apology to Douglas and Hywel at the Centre for Evidence Based Dermatology up at Nottingham, UK. Our analysis of dermatology Q&As should have been finished early last year. No excuses really, other than my inability to write papers!

Regular readers of the blog will know I’m very interested in better ways of procuring research, be it primary research (e.g. clinical trials) or secondary research (e.g. systematic reviews). In answering real questions from front-line clinicians the ideal is to offer good solid research. Unfortunately, all too often, the evidence is either not there or of poor quality.

My experience (of answering over 10,000 clinical questions) is that all too often the research isn’t particularly focussed/designed to answer clinicians questions. It was one of my reasons for getting involved in DUETs and for creating the Tag Cloud of Clinical Uncertainty. The idea behind both these initiatives is to highlight gaps in the research with a view to improving the way research is commissioned.
One approach we’re using (to highlighting gaps in the evidence) is to analyse the clinical questions we’ve answered and to look for themes. In this instance we’re matching real questions against the existing research to see how good that is. I’m involved in the NLH’s specialist library for skin disorders so selecting that area seemed sensible. We decided to analyse all the clinical questions ATTRACT and the now defunct NLH Q&A Service have answered over the years. In total that’s 357 questions from primary care health professionals, the vast majority being general practitioners.
One ‘quick win’ is to place all the questions (just the Q’s not the answer text) into wordle and see what we get. There’s a thumbnail below but you can see the full cloud by clicking here. Certain junk words have been removed but that’s mainly to enhance impact. This type of visualisation is so powerful in visualising themes.

May the rest of the analysis move quickly from now on!

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