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TRIP in press

TRIP gets a mention as part of this newly published systematic review:

Comparison of retropubic vs transobturator approach to midurethral slings: a systematic review and meta-analysis.
Am J Obstet Gynecol. 2007 Jul;197(1):3-11.

The abstract states:

“We searched PUBMED, OVID, EMBASE, CINAHL, POPLINE, Web of Science, Cochrane Collaboration resources, TRIP, Global Health databases, and abstracts from relevant meetings from 1990 to 2006.”

We’ve noticed more occurrences of this – TRIP being mentioned in publications – we’re very pleased seeing TRIP getting taken so seriously. With our latest batch of improvements due mid/end September, with a vastly improved search algorithm we’re getting very excited!

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Most frequently viewed questions and answers

The ATTRACT website has a very interesting feature, lacking in the NLH Q&A site – the ability to see which questions/answers on the ATTRACT website have been most frequently viewed. In order:

  1. What are the risks of flying while pregnant? – viewed 19,427 times
  2. Should you treat a low Ferritin (
  3. What is the evidence for the recent press about statins and grapefruit juice being harmful? – 10,956
  4. What is the best treatment for pompholyx (dyshidrotic eczema, vesicular palmoplantar eczema) of the feet? – 9,494
  5. What treatments are available for sebaceous hyperplasia? – 8,793
  6. Does carbonated water, flavoured or otherwise, cause dental erosion? – 7,846
  7. What is the cause of a black tongue? – 7,653
  8. What is the likelihood of malignancy in a unilaterally enlarged tonsil? – 7,481
  9. Is there any information on the Novasure system for treating menorrhagia? – 7,330
  10. What is the best treatment for benign positional vertigo (BPV)? – 7,066

The feature that sticks out most for me is the staggering volume some of these answers have been viewed.

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Journal of Q&A

Following on from yesterday’s post I sent a quick e-mail to Dean (Giustini) over at Open Medicine asking about their software platform. They use Open Journal Systems, which is free, obviously robust and fit for purpose. I’m intrigued by their document “OJS in an Hour”

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Q&A as peer-reviewed journal

Q&A services support clinicians by offering clinically relevant information with minimal effort. One of my most frequent moans (aside from middle-lane hoggers on the motorway) has been the poor sharing of answered questions.

Many of our questions are dealt with ‘sorry, we found no evidence’, which may seem a poor answer, but clinicians seem to be happy with these. However, a number also receive more complex answers with multiple evidence sources.

Why not create a journals to formalise these answers? Why not have our answer followed by a ‘commentary’ by a clinician (be it a generalist or specialist)? The format of the journal ‘Evidence-Based Medicine’ springs to mind (see for an example). This has the abstract followed by a commentary. See below for truncated image.

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On finding the studio banjo

Another ‘random’ title for a blog entry – I’ve been looking for an excuse!

Things have been fairly hectic of late. The NLH Q&A Service continues to move on with an expansion in questions we can answer (35-50 per week). The new arrangement also gives us greater flexibility, which suits us all very well.

My encounter with Facebook is proving interesting. Still not 100% sure why, although I’ve recently been contacted by a friend I lost track off after college (1991).

I’m very excited about a meeting next week – to finalise the next update to TRIP. There are 3 main planks, the first I’ve discussed before, a significant overhaul in the search algorithm. One of the others I’ve mentioned in the past – the content/quality slider. However, the big enhancement I’ll leave for another day.

Finally, I’ll be gone for most of this week, at the Manchester International Festival.

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NEJM Clinical Decisions – Results

I blogged about this a while ago in relation to our Socrates project. Well, the results are now out (click here) and make fascinating reading.

There were 3 treatment options (see article for more details) and the results were split fairly evenly (37.5%, 37.4% and 25.2%). I wonder what that indicates about the roll of evidence? How much does it influence practice?

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TRIP in press

A recent review of TRIP in Comprehensive Ophthalmology Update (click here for PubMed entry) was very flattering. Some of the snippets:

“..it is clear that the number of sources included in the database is impressive in both quantity and quality”

“…this is really an exhaustive resource for virtually any clinical scenario you can imagine.”

“The TRIP Database is a remarkable combination of simplicity and expansive depth. It is hard to imagine that a physician looking for evidence-based information on any entity likely to be encountered in clinical practice would ever need another resource other than the TRIP page.”

Another recent article (Click here for PubMed entry) looked at TRIP’s performance compared to a number of other high profile resources. It used an interesting methodology (perhaps strange would be a more accurate description). Basically, it used two main resources to answer clinical questions and then, if the answer was not found in these, the other resources (including TRIP) got used by the clinicians.

In short, TRIP answered more questions than any other single resource. This is made all the more impressive in that TRIP was only used when ‘easier’ questions had already been answered by the two ‘main’ resources.

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Facebook

I’m not sure why but I’ve started using Facebook. I think my profile is available via this link http://www.facebook.com/profile.php?id=759565005. However, you need to login to Facebook to see some of the stuff and need to be ‘my friend’ to see all the stuff.

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NHS Choices

The NHS Choices website has launched, it’s a patient-focused site “that aims to put you at the centre of your healthcare.” It looks nice and has some interesting areas that help users to find suitable health services. It also gives you an online health check. Apparently I have no risks for cardiovascular diseases. There is also as extensive list of patient information leaflets, which I may have to add to TRIP (after checking they are not copies of those on NHS Direct).

My main interest is in search, so that’s what I’ve spent most time on. A search for prostate cancer was interesting. The ‘hottest’ part of the results page was a set of options showing me what my GP was reading (and similar options). Lower down you actually get to the results, which seem appropriate. It seems strange that, as a user, the main results are not displayed in the most obvious part of the page. However, given the prominence of the link, I imagine an awful lot of people will be interested in what their GP was reading. The 2 results are below

  • Clinical Knowledge Summaries: Clinical topics full list Breast cancer — suspected … GI (lower) cancer — suspected … Prostate — benign hyperplasia
  • Clinical Knowledge Summaries: Clinical knowledge DH referral advice for suspect cancer

As a patient I would find that list slightly alarming! So, he’s looking at breast cancer, GI cancer, BPH – surely he should be looking at information relevant to my condition!

Apparently, my GP is reading the following in relation to my search of hypertension:

  • Diabetes — hypertension
  • Diabetes — hypertension … Hypertension … Hypertension in pregnancy
  • Alcohol — problem drinking
  • Alcohol — problem drinking

This site has obviously had large sums of money spent on it (I hear £3.5 million), it just seems a shame that it is let down by the poor implementation of search….

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