One change we introduced recently is the increased user ‘pressure’ to log in. A few people have contacted me to raise this as an issue and it made me realise we’ve added a barrier to use of Trip but we’ve not communicated why. So, here goes…
Ultimately it’s part of a longer-term strategy to improve Trip and this requires us to better understand our users (which requires the user to be logged in).
Some background; my partners Dad was an eminent Professor of Anaesthetics (now retired) and I showed him Trip, and he said he’d use it for a bit. He came back unimpressed! His interest was in awareness, and a search for awareness on Trip (click here) returns no articles on awareness under anaesthesia, which was his interest/intention (see for yourself).
While this is an extreme example it does highlight that, without knowing the user, how can we optimise the search results? Our system should have realised that the user was an anaesthetist and adjusted the results accordingly. We’re doing lots of work on this area and are making real strides. I blogged about in March with the article The important breakthrough which contained the following image:
As you can see from the results (in this experimental test system) we have detected the example user as a dentist and adjusted the results accordingly. For an information retrieval ‘nerd’ (like myself) this is amazing. I can think of no other innovation Trip has introduced that will come close to improving the search results as this.
And there are loads more things we can do if we know the user. For instance improved email alerts – better linking users with evidence that is likely to be interesting and useful, as opposed to our current crude efforts!
But for it to work we need to know the user, which requires logging in.
Trip Database Blog 
July 14, 2015 at 12:54 pm
Terrribly sensible … but a bugger for teaching sessions … can we sneak a Tutor Login to share & delight?
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July 17, 2015 at 8:20 pm
Thank you for explaining. I had suspected this change had to do with helping you to better understand your users. Now that I understand the true significance, as a health information professional aka medical librarian, I find this extremely concerning. The control should be in the hands of the searcher and not of an algorithm that decides how one should see the results. All searchers should be able to see the same results with the same search. What happens if a librarian conducts a search? How are those results skewed and how can we trust that what we have found is the best result to share with our clinician-patrons? What else alters the search results? Location? Previous searches?
Improved results can best be achieved by a combination of good indexing and search skills. Without undergoing specialized training, your dentist could simply add a keyword to the search and retrieve results of higher relevance.
The fact that searches are no longer anonymous is also of concern. Since TRIP is a free resource, some of your users are likely members of the public who do not wish their searches to be tied to their identity/ contact information.
Over the years I have often recommended TRIP to my patrons as a high quality evidence-based resource. I now must add a caveat when doing so.
Hoping you will reconsider,
FF
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July 17, 2015 at 10:54 pm
Too much of a barrier for teaching. Students are not speciallists – they role through all of the medical subjects. Trying to tailor a system to a student who is searching cardiology today and msk tomorrow is useless. Might make sense for people established in their practices, but it is the student phase when practitioners establish what tools they like and will use. If they have to remember yet another password, they won't bother.
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July 18, 2015 at 1:59 am
I very much agree with Francesca Frati's comment. Privacy of searches is important to many. Getting the same-results-from-same-search is also really helpful.
I don't see why the dentist and anaesthetist examples show need for logging in? I (non-anesthetist) can search for “Awareness” in clinical area: Anesthesiology, and Trip gives several results on “intraoperative awareness.” How is logging in different? If people are not aware of how to use clinical area, then Trip could list the specialties outright, instead of hiding them under “By clinical area” many inches down the page. It was not clear to me how to remove the clinical area, once selected, and not clear how to bypass my own specialty after I logged in.
I like that Trip wants to know what problems we have, and a box “Tell us what you had trouble finding” would give that feedback, even if Trip could only analyze a sample of the answers.
On the issue of privacy, two outsiders already watch everyone's search on Trip: Google Analytics and Twitter (since code includes “platform.twitter.com/widgets.js”). If I search without logging in, then Google Adsense also watches my searches, and I can't filter on clinical area. Those huge companies will use the data every way they can for their own huge revenue needs. They already know who each searcher is by his/her IP address, which those companies have seen many times before in many contexts. It would be best if Trip omitted these trackers, as do FollowMyHealth, Pacer.gov and Docfinder. Privacy may not matter to doctors searching in their own specialties, but doctors might prefer privacy when they search in other specialties, as patients would.
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July 20, 2015 at 12:58 pm
Coincidentally, I am a dentist so this example highlights a concern of filtering results for the user's work area. I need to keep up on the general medical field as well so I do not necessarily want to limit my searches. As well, there are many medical issues outside my field that will impact my treatment of a patient.
Perhaps having an unfiltered and filtered button would be useful.
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August 7, 2015 at 1:52 pm
Me again! I just wanted to look up Canadian guidelines, one of the most frequent types of searches I used to do in TRIP. Alas I have forgotten my password, and since I can't use the filters without logging in, it seems I will have to go through the “forgot my password” reset process. *sigh*. One more argument in favour of letting people opt-in to the “added value” of tailored results! I think that is a great suggestion by David Kerr.
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September 16, 2015 at 12:38 pm
I agree with the others on not wanting a forced login. Not having to log in was a big plus with TRIP whenever I taught it. Improved clinical area tagging would be more useful to users.
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