Trip Database Blog

TRIP has been busy recently with 3 major projects due to launch by the end of the summer. The Spanish version of TRIP should be out very soon, TRIPanswers will be out by the end of August and TRIPcpd should be out by the end of September.

In addition, we’ll be rolling out a small upgrade to TRIP soon, with the ability to export records and e-mail to a colleague.

The TRIP speed issue is also being worked on with a final report from our web-people due soon.

So, while we’ve been busy, most of them are under control and nearing completion so we can start thinking about our next batch of work – an upgrade to TRIP. We’ve got a number of ideas for the upgrade, but we want your help. What would you like to see?

Please contact us (click here) with any ideas you may have. No matter how big or seemingly trivial, we want to hear.

Over to you to help improve TRIP

TechCrunch has just posted an article on Ologeez!. Ologeez! is an alternative front-end to PubMed (but has plans to include other databases as well) and mixed in with ‘social’ features.

Two things sprang to mind when reading this coverage:

• Alf Eaton already has a pretty impressive ‘version’ that has been around for years – HubMed. It was nice to see someone else highlighting this in the ‘comments’ section.
• Aside from HubMed there are loads of other PubMed ‘versions’ – yet it was this one that gets a mention in TechCrunch – a Stanford bias perhaps?

You can see Ologeez! by clicking here. It’ll be interesting to see if it succeeds, I have my doubts. Our playing with this sort of thing (courtesy of gwagle) was an interesting failure. As mentioned above there are numerous other websites offering social functionality coupled to PubMed, yet none are successful. I can’t see anything in Ologeez! that makes me think they’re particularly special. Perhaps the TechCrunch link will help (it certainly can’t hurt).

I suppose one day someone will crack it….

One quick thought, instead of having one site trying to monopolise this social space, why not get together a significant number of ‘players’ in the area – be it medicine, be it biomedical – and create a single space that all users can contribute to. Imagine if TRIP, Cochrane, Medline, NICE, CRD, eMedicine, BMJ etc etc all worked to one standard and created a single ‘space’ – now that would be powerful and powerfully useful. One to ponder.

Much is written about bias in relation to EBM. The overwhelming focus is on methodological bias in creating primary or secondary reviews. However, little is written about a bias that is arguably as important – search bias.

What’s the point of spending huge amounts of money creating beautifully crafted pieces of research for them to be overlooked by a clinician looking for robust information to inform their decision making process?

The TRIP Database uses an algorithm which is a compromise and I would never claim it was perfect. The debacle with the NLH’s search 2.0 highlights further problems. Medline is a nightmare to use. In short there is no perfect clinical search engine.

So what does that mean for a practicing clinician? Do we want them to search multiple databases? I suppose, ideally, yes. But I’m far from convinced it is practical. There is an onus on clinical search engines to improve and meet the needs of the users. But the important message is that bias is not just about research methodology, it applies in equal measure to how clinicians access the research.

Wow, I can really see just how much time the NLH Q&A Service took. It stopped answering questions at the end of last week and I’ve already managed to empty my e-mail inbox, the first time in years!

There have been a number of e-mails with new content waiting to go on TRIP, the most notable being the rather nice York Health Economics Consortium.

Talking of NICE (tenuous I know) the Darzai review (click here) has indicated an expanded role for NICE. It looks like they’ll be responsible for a new service/organisation NHS Evidence:

“NICE will manage the synthesis and spread of knowledge through NHS Evidence – a new, single portal, through which anyone will be able to access clinical and non-clinical evidence and best practice, both what high quality care looks like and how to deliver it.”

I can only surmise that the NLH will end up moving (again) to fall within NICE’s clutches. What that means for Q&A I wouldn’t like to say. I’m seeing Peter Hill tomorrow and that might shed some light on things.

The extra time on my hands has been spent harassing our web-developers and we’re fixing a number of niggling problems relating to advanced search, truncation, apostrophe’s. In addition – for some reason – the big 5 core journals (NEJM, JAMA, Lancet, BMJ, Annals of Internal Medicine) have disappeared from our search. These should be back soon.

TRIPanswers is progressing very well and the beta should be available within a fortnight. It should be as good as finished then but I just need to add a load of content. I’m hoping to launch with over 5,000 Q&As, reaching 10,000 by the end of 2008. I haven’t thought much past then. Each Q&A will be quality marked and have various other bits and bobs to transform Q&A; at least a little bit!

I’m also starting to research various semantic tools to improve various aspects of the TRIP site. I’m hoping to get some sort of system set-up to allow me to play around with these. I see these tools as allowing things such as semi-automated updating of Q&As, allowing natural language searching of TRIP and TRIPanswers. I even thought we could allow users to add text that they are interested in and use that as a basis to find ‘related articles’ within TRIP.

I’ve been a long-standing fan of PubMed’s related articles and getting this close to trying similar tools on TRIP is very exciting. I’ve often carried out searches of PubMed and found articles of interest only to find even more by using ‘related articles’.

Jumping back to TRIPanswers, if anyone wants an invite to the beta, let me know via http://www.tripdatabase.com/ContactUs.html

“Which is the most accurate test for diagnosing genital chlamydial infections in men, DNA amplification test on a first void urine or a urethral swab?”

Was the first question posted to the NLH Q&A service in November 2004. Nearly 6,500 questions later, this question closed the service:

“Is there any difference in upper GI side effects with risedronate compared to alendronate?”

A sad day…

This is the final week for the NLH Q&A service. I’ve been overwhelmed by the response from GPs and apparently there has been a lot of chatter on GP mail-lists moaning about the decision to close the service. So much so it came to the attention of a health journalist and I had a chat with them earlier this week. You can read the story here. I don’t think my opinions were fully represented, but then that’s the nature of journalism. Interestingly, the same GP chatter stimulated a call from BMJ-land.

I have mixed feelings about the end of the NLH Q&A Service.

On one hand I’m sad for:

• The users of the service. I have been so humbled by the feedback I’ve received, it really has been great. I think it’s a missed opportunity to not – somehow – keep the service running.
• Rosalind. She has worked on the Q&A service from near the start and has been wonderful. She made a load of brave decisions to come and work with me on Q&A. I’d like to think she’s learnt a lot from the experience. Fortunately, she’s got a new job but it will necessitate a move from Aberystwyth to London. I suppose I’m sad that I’ll not be working with her for the foreseeable future.

On the other hand I’m getting so excited by the new Q&A development (TRIPanswers) which will launch in the summer. I’ve had the website to play with for a few weeks now and have been testing it fairly extensively. I’ve just sent another batch of feedback to our web-developers, so I’m hoping the work will be as good as completed by the first week of July. However, the launch won’t happen then as I need to populate the site with data – which is a long, hard, manual task.

I’ve also been making new relationships with various Q&A providers around the globe and that will all help support TRIPanswers. I genuinely think TRIPanswers will be bigger than the TRIP Database…

Well, the extra RAM is now in the system and there is no obvious improvement in speed. It’s invariably quicker at certain times of the day (peak times when memory was an issue).

The analysis of speed and the identification of bottlenecks is booked in to start mid-July. This will highlight code inefficiencies that can either be fixed as they go along or will need further work. Fingers crossed it’ll be the former.

I’ve noticed (and no doubt lots of others have as well) the pretty awful speed of TRIP in the last week or so. Just to say SORRY and that we are addressing the issues:

• As a short-term measure we are quadrupling the memory in our servers. This should boost speeds considerably and hopefully this will be in by either the end of this week or the start of the next.
• On a more medium term basis we are carrying out some sophisticated analysis of the site to identify where the bottlenecks are. We’re hoping that, once this has finished, we will be able to allocate resources at the problems. If we’re lucky the extra memory might sort everything out!

I use TRIP everyday so am acutely aware of the need for speed – we’ll get there….

Alexa is a leading resource for looking at the popularity of a website. Given the demise of the NLH Q&A I thought I would compare the NLH Q&A service with the NLH itself (click on image for larger size):

They say a picture is worth a thousand words!

There are some caveats associated with those figures (isn’t that always the way). But it’s certainly worth pondering.