Trip Database Blog

As TRIP moves to free access we are removing our classic ‘title’ or ‘title and text’ search distinction. When TRIP initially started it was a title word search only. Then we started spidering content and we added a text search as well. However, our various search analyses have shown this method to be problematic. For instance if you wanted to search for ‘asthma and steroids’ you would need to search for ‘asthma’ as a ‘title’ word, ‘steroids’ as a ‘title and text’ word and then combine them. This equates to three steps (two searches and then a combined search). As Dean highlighted in his recent blog entry – searchers are using more search terms per query and expressing more complex information needs.

Google, the main general search tool, allows users to add multiple terms and normally returns very good result sets. Google is setting the standard for how users search.

So what’s the coincidence?

The NLH have announced a new search format – adopting our current (but soon to be moved to advanced search) search method – of ‘title’ and ‘title and text’ distinction – see screen shot. I can’t help feeling flattered with them adopting TRIP’s search method. However, I feel its potentially a wrong move…..

I received the test version of the site on Friday and – no real content to search – the indexing of content had failed! We’ve still got problems with the indexing but these should be fixed by the end of the day. Other problems include the test server being woefully underpowered to test the site, no advanced search, no content from the big five journals (NEJM, JAMA, Lancet, BMJ, Annals of Internal Medicine). Irrespective of these issues we should still be live for the start of September!

As means of a progress report I’ve posted the above picture. Missing text and graphics – but no ‘title’ and ‘title and text’, separate tabs for ‘Medical images’ and ‘Patient information’ and a few other ‘bits and bobs’. Roll on September……

A BioMed Central article looks at Cochrane systematic reviews and whether updating them improves the reporting and methodological quality. The biggest surprise to me was the comment:

“The overall quality of Cochrane SRs is fair-to-good.”

Only fair-to-good…..

Its always nice to see TRIP being quoted in the peer-reviewed literature. This recent systematic review (click here) used TRIP as one of the search resources.

I was expecting some big announcements from MSN yesterday. What has come out (from here) is:

Microsoft on Wednesday announced that it will offer software for use in the health-care industry—a shift toward providing industry-specific applications instead of the Redmond, Wash.-based software giant’s typical business model of supplying operating systems, software and tools for other firms to build onto

The report later reports:

The company’s first effort under the new initiative is to buy software developed by physicians and other researchers from Washington Hospital Center, a not-for-profit hospital, according to the Times. Gates Inc. will also hire two of the three doctors who created the software system, as well as 40 members of the development group, the Times reports.

The software, called “Azyxxi,” is used to cull and rapidly display medical information on patients from a handful of sources, including EKG records, X-rays and MRI scans, according to the Times.

“This represents a change in our strategy,” said Peter Neupert, Microsoft’s vice president for health strategy, according to the Times. “This is the start for Microsoft. We’re just getting started.”

Answering Physicians’ Clinical Questions: Obstacles and Potential Solutions. Another paper on Q&A from the Ely, Osheroff (et al) stable.

I’m still puzzling over the concept of an answer….

It would appear from the above paper that an answer is judged by the doctors. I suppose the issue being, does it help remove their uncertainty. However, the removal of uncertainty has little relevance to a ‘correct’ answer.

So a doctor might be uncertain which drug to give A or B to a patient with condition X. The doctor finds the first paper on Medline which suggests drug A is better. So they decide to use drug A. However, 5 papers down is a systematic review that shows B is superior to A. So the doctors uncertainty has been plugged by seeing a paper supporting drug A. However, the ‘correct’ response (from an EBM perspective) would be to use drug B. Ironically, for the patient in front of the doctor drug A might actually work better – but that’s another story!

Thanks to Dean for highlighting this story.

The first look at the new search results page, not quite there but nearly!

The tabs for nvigating between EBM, Medical Images and Patient Information needs alterating. Also, as the Big Five journals (JAMA, NEJM, Lancet, BMJ and Annals of Internal Medicine) are being integrated into the main search that category will be removed.

“Evidence Matters (EM) is an award-winning, venture-backed company which has created a novel knowledge management system for the medical field. ” or so the blurb says.

As the subscription market gets more crowded by groups who hope to squeeze money out of health organisations I can only rejoice at our decision to move away from that particular business model. Evidence Matters has had some significant investment around $1.5 million (Canadian dollars I assume).

One of the most poignant comments for me, regarding the move to free-access for TRIP, came from Brian Alper (who heads up another subscription ‘knowledge’ thingy). He basically said that people are not expecting to pay for search. I tend to agree with Brian. However, who will be right – us or the venture capitalists?