Trip Database Blog

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While TRIP was closed to all but subscribers, the subscriptions helped us develop the site. However, if you remove the subscriptions you remove the revenue. The bottom line is that for TRIP to survive and continue to improve it needs a revenue, hence the adverts and sponsored links.

Adverts via Google ads. These are positioned in a relatively minor part of the site and are unlikely to generate a significant income. However, as we’re testing the business model we thought we should try this method. We are currently being searched around 15-20,000 times per day (likely to increase significantly) and if 0.1% click on adverts per day that should make for an interesting income.

Sponsored links. This system allows users to purchase a keyword so that when someone searches on, say, hypertension the sponsors messages gets displayed. This is an interesting experiment to see if anyone likes this method. We’re hoping it’ll be of some interest, especially given our volume of usage.

In an ideal world we’d prefer not to have adverts at all. We’re hoping it’s a small price to pay for free-access

EBM, Medical Images and Patient Information Tabs have been introduced, previously all the content was mixed into one search interface. As the number of results categories increased so the usability started to suffer.

An analysis showed that there were distinct search types, represented by our three search tabs. These tabs allow for easy movement between these domains.

EBM – our core material.

Medical images – an area we’re not renowned for but this is an excellent feature and is probably the largest, free, searchable collection of medical images on the internet.

Patient information leaflets – The principle aim in TRIP is to support clinicians in answering their clinical questions. However, these same clinicians frequently have a desire to locate patient information leaflets to give to their patients.

Tabbing is seen in most general search engines and the inclusion in TRIP will further enhance usability.

Each day between now and launch I will be highlighting a new feature on the site. With 7 days to go I’ll highlight the inclusion of selected peer-reviewed journal articles. These are being taken from 2 routes:

1) The big five general internal medicine journals – NEJM, JAMA, Lancet, BMJ and Annals of Internal Medicine. All articles, published within the last 5 years, will be included. We’re harvesting the content automatically from PubMed via the eUtilities.

2) BMJ Updates. I never fully appreciated the scale of this project. Basically, they scan over 100 ‘premier’ clinical journals and extract only those of high quality and of clinical relevance and interest (as judged by at least 3 clinicians from around the globe).

TRIP has historically focussed on secondary-review material and that will remain to be our focus. Our search algorithm will give precedence to secondary material but the system will ensure that highly relevant articles from these two sources are near the top of the results. The two sources will offer highly relevant material for our clinical users.

We have now solved the last major issue with the new version of TRIP. Only a few really minor issues are outstanding. Not wanting to tempt fate but getting it all sorted with more than a week to spare – I think that’s a record for us!

We’re starting to get excited as, with the new tweaks, the search algorithm is behaving wonderfully. We genuinely believe this will be a significant ‘new’ tool for clinicians seeking answers to their clinical questions.

A couple of interesting snippets….

First, EBM and Fascism. An article that appeared in the International Journal of Evidence-Based Healthcare ‘Deconstructing the evidence-based discourse in health sciences: truth, power and fascism‘….

Second, the ‘official’ Google blog has reported on the ‘related articles’ feature on Google Scholar. I’ve always liked the related article feature on PubMed and the GS version appears to work as well. Whether it would be as useful on TRIP is another matter. Related article style features have traditionally relied on latent semantic indexing (see wikipedia article for more detail). This approach can also be used for all sorts of other useful semantic ‘tricks’ such as synonym analysis.

I often wondered if the related article feature could be used to keep the Q&A answers up to date. In other words, use the LSI technique to look for new articles in PubMed published since we published our answer. The idea seems plausible but implementing it is a significant issue and quite possibly not worth the potential gain…

As mentioned in previous posts we get lots of positive comments from users of the service. Currently we are experiencing high volumes in the NLH Q&A Service and have had to, temporarily, stop taking new questions. This has resulted in a few e-mails, one in particular caught my eye:

“Pity that you are inundated with questions! This is one fo the few worthwhile services we as GPs have, and has a TREMENDOUS IMPACT ON CLINICAL PRACTICE for busy GPs. It wouold be shame to be constrained by staff shortage. I have disseminated the usefulness in many meetings. Perhaps – we should stop informing GPs!!”

While away the web people have been busy beavering away and getting closer to the finished article. A few graphics and some text need dropping in. I was confident enough to send test URLs to two colleagues whose opinion matters a great deal to me. Fortunately, they got back to me with useful constructive criticism and a general positivity about the site.

Another glimpse, this time of the results page with a new feature the ‘drug box’ which highlights drug interactions, warnings etc. As well as the ‘standard’ results.

The new site is nearly, functionally ready (some design needs dropping in), with my web-people working for a few more hours before I head off on holiday. In other words they have a few more hours to correct one problem. Basically I had the algorithm set-up pretty well on the test harness. However, now we’re using the algorithm on the new site with updated content something’s gone wrong. I’m hoping it’s not a big deal.

When they’ve fixed that I can relax and enjoy the holiday. I’ll send the test URL to a number of tame users – mainly a load of trusted Q&A people from ATTRACT and the NLH Q&A Service as well as the TRIP clinical director (whose also a general practitioner and TRIP co-owner). They’ll give it some heavy use over the week. Then, on my return, I can pass on any issues to my web-people. Hopefully giving them 2 weeks to finalise any changes.

Sounds so simple……

Mixed results for this test of the city-wide wi-fi roll out in Mountain View, California – supplied by Google. As the author of this piece on the BBC News website said:

“After several hours grilling Google’s Mountain View wi-fi network I realised both the power of the service, but also the present-day limitations and youth of the technology.

While the service was ubiquitous throughout the city, it’s not as reliable, as fast, or as easy to use, as my home internet connection or my cell phone. Not yet anyway.

Start-up companies and major manufacturers are working on all these issues. They just take time”

As wi-fi takes off and expands we really must invest in optimising TRIP for searching on laptops, PDAs, mobile phone……