Trip Database Blog

For my ease I’m placing all the TILT slideshares in one place:

• Your first TILT http://www.slideshare.net/JonBrassey/your-first-tilt
• Making TILT social http://www.slideshare.net/JonBrassey/making-tilt-social
• Use for appraisal http://www.slideshare.net/JonBrassey/tilt-use-for-appraisal

Does this work ok?

I’ve been mentioning TILT in this blog over the last few months.  It was actually live last week, but we started publicising it yesterday. You can see it at http://tilt.tripdatabase.com.  If you’re already registered with TRIP then you can log into TILT using your TRIP details.

What is TILT?  At the simplest level it’s a way for an individual to record their clinical learning (we encourage simple snippets of information).  However, the real beauty is that this learning is shared within the community.  There are lots of nuances associated with TILT, too many to post here now (while I’m still pushing hard to get TILT ‘out there’) but I’m sure I’ll add more thoughts over the coming months and hopefully years.

Go to TILT, interact and let me know what you think.

Earlier this week we created a short survey to try and understand what impact TRIP might have on patient care. There were 4 questions:

• On average, how often do you search TRIP each month?
• Do you ever use TRIP for helping you manage your patients or yourself?
• On average, what percentage of your searches are related to patient care?
• Of those searches that you use for improving patient care or your own care what percentage do you find TRIP actually helps?

We linked to the survey from two places: As a link from the TRIP Database and also from our various social media ‘outlets’ – Facebook, Twitter and this Blog. 

The results were very similar across both data collection methods.  For the sake of clarity I’ll show an average result and in brackets place the separate results from TRIP and then from the social media:

• 14.4 searches (17.2, 11.5)
• 79.1% (74.2, 83.9)
• 72.9% (74.3, 71.5)
• 70.7% (72.3, 69.0)

So, what do all these figures mean? 

Firstly, the methodology is far from ideal, so the results are speculative/dubious.  However, I feel reassured that the figures have been relatively stable from very early on in the data collection.

If we wanted to work out the impact of say 1,000 searches here’s how I’ve approached it:

• 1000 searches of which 79.1% are from users who manage patients or are patients themselves = 791 searches
• Of these 791 searches, 72.9% relate to patient care = 576.6
• Of these 576.6 searches, 70.7% help improve patient care = 407.7

In other words 40.8% of searches on TRIP result in improved patient care.  That’s significantly higher than our estimates and also, what I think is equally significant, is that 70.7% of users actually find TRIP is useful for patient care.

What is clearly needed is some more research (I typically hate seeing that in the discussion of a research article) to try and get a more accurate figure for TRIP’s impact and I’d welcome any comments on the most appropriate methodology.

But, in the interim, I’m happy (with the above reservations) to say that 40.8% of searches on TRIP help improve patient care

I’m really trying to understand the impact of the TRIP Database.  If you care about TRIP please take this very brief survey http://www.surveymonkey.com/s/JJKH25W

Thank you in advance.

At Evidence2010 I was a aware of a number of themes (in reverse order):

• The whole publishing model is wrong.
• Clinicians needs support in using the evidence ie what to do once they read a trial and know an intervention works, how do they actually use or administer it!
• Conflicts of interest (COI) are widespread. Pharma is an obvious COI but also in academia there are significant issues.
• There’s no more money – the healthcare systems in ‘the West’ have no more money to keep pumping into healthcare.
• Need to work more closely with patients to help make them better decision makers.
• Clinicians need to say this phrase more often – I don’t know.
• There’s an awful lot of love for TRIP 🙂

Obviously, I’m very pleased about the last one. Overall, a  very good, thought-provoking conference!

I had the pleasure of attending the Evidence2010 conference.  One role I undertook was to tweet about the presentations, in a way sending a summary of the presentations.  One talk, by Paul Glasziou, highlighted the diversity of conditions a GP will see (compared with specialists). He reported that 30 ‘conditions’ accounted for 50% of consultations.  A number of people wanted to see the 30 conditions and Paul has sent me a spreadsheet.  It’s actually 32 (not 30), so here goes:

1. Hypertension*
2. Upper_respiratory_tract_infection
3. Arthritis—all*
4. Diabetes,_non-gestational*
5. Depression*
6. Lipid_disorders
7. Osteoarthritis*
8. Back_complaint*
9. Immunisation—respiratory
10. General_check-up*
11. Asthma
12. Oesophageal_disease
13. Acute_bronchitis/bronchiolitis
14. General_immunisation
15. Contact_dermatitis
16. Anxiety*
17. Gastroenteritis*
18. Female_check/papsmear*
19. Sleep_disturbance
20. Urinary_tract_infection*
21. Sprain/strain*
22. Medication/script
23. Sinusitis
24. Solar_keratosis/sunburn
25. Cardiac_check-up*
26. Ischaemic_heart_disease*
27. Oral_contraception*
28. Pregnancy*
29. Malignant_neoplasm_skin
30. Acute_otitis_media/myringitis
31. Results_tests/procedures_NOS
32. Viral_disease,_other/NOS

Interestingly (!) the top 10 account for 27%