Trip Database Blog

We’ve just answered the question “When is the earliest a patient safe to fly following a diagnosis of tuberculosis?” (click here to view answer). Having just come back – via a plane – from holiday it hadn’t entered my mind the recirculation of ‘germs’. Fortunately, in the case of TB, the chances of catching TB appear fairly remote. So back to worrying about turbulence!

http://pmid.us/17678212

An interesting blog post about Dr Microsoft and Dr Google click here.

Given my previous post I thought I’d compare a few of the larger guideline collections:

• CMA Guidelines Infobase (Canada) – 750 guidelines (approx)
• NLH Guidelines Finder (England) – 1,200 guidelines (approx)
• National Guideline Clearinghouse (USA) – 2,200 guidelines (approx)

TRIP contains all the above guidelines plus collections from New Zealand, Australia, Scotland, Holland, South Africa and a few other guidelines from around the globe. In total TRIP contains 4, 964 guidelines, this should exceed 5,000 by the end of the month.

I got back towards the end of last week and already I’m looking forward to the start of September, when the new version of TRIP will be ready! Various updates on that, plus some other news – mostly trivial.

New Sites

• I’ve not been shown the new algorithm with the ability to switch between our ‘relevancy’ score and date. This works very well, so things are looking very good on that front.
• As mentioned previously we’ll be releasing 26 baby TRIPs at the same time. The software is written, we just need to grab the content. The slight downside is that this new content is very large – it triples the current size of the database. Due to this size increase we are having to buy new hardware and software (oops, more spending). We’ve been expecting to have to do this for a while now, given the large volume of traffic coming to our site.

Guidelines

We cover a large number of guidelines, I have little doubt we allow users to search the largest collection of guidelines on the web. Curiously, this publication type seems to have the most unstable URLs! With the arrival of the new site I thought I should update as many as possible and have managed to tidy up the various Royal College’s guidelines. However, the worst offenders seem to be those offered via the CMA Infobase. This is a large collection of guidelines (nearly 800) and had been ‘lumped’ together as one publication. However, given the relative instability I have created separate entries for the largest publishers. As such we now have the following publications in TRIP:

• CMA Infobase
• British Columbia Reproductive Care Program
• Canadian Paediatric Society
• Cancer Care Ontario
• Clinical Practice Guidelines and Protocols in British Columbia
• Society of Obstetricians and Gynaecologists of Canada
• Thrombosis Interest Group of Canada
• Toward Optimized Practice

The 7 new publications will allow us to update more rapidly if they choose to alter their URLs.

I think I’ve manually added and edited over 1000 guidelines over the last 2 days – tiring but rewarding!

It’s that time of year, so my last post (not sure that this counts as a post) till around 9-10th August.

I’m leaving in 30 mins, but this AM I had the final specification meeting with the web-company regarding the latest upgrades to TRIP. These documents will be finalised for me to read on return. Once I’ve signed them off there’s around 2-3 weeks of development before I get a test version. So we’re looking at an early September deployment. To re-cap two main changes:

• Improvement to the search algorithm, much better results as well as the ability to arrange results by date (the most frequent request we get).
• Baby TRIPs. We should launch with 25 specialist search engines. Each specialist search will search the core TRIP content PLUS content specific to that speciality. This is not trivial content, we’re talking about 5-20,000 area specific content in each baby TRIP.

Bye for now…

An important question that is as relevant to Q&A as to systematic reviews. This Annals of Internal Medicine article (click here) attempts to answer this question. The important bit, for me was this:

“This survival analysis of 100 meta-analyses indexed in ACP Journal Club from 1995 to 2005 found new evidence that substantively changed conclusions about the effectiveness or harms of therapies occurred frequently within relatively short time periods. The median survival time without substantive new evidence for the meta-analyses was 5.5 years. Significant new evidence was already available for 7% of the reviews at the time of publication and became available for 23% within 2 years.”

A mixed bag to end the week:

• As someone who studied social networks I was fascianted by this NEJM article “The Spread of Obesity in a Large Social Network over 32 Years“. This was blogged on the Clinical Cases and Images site (click here).
• I’ve just broken my record for number of questions answered in a day – 18 – and still a few hours to boost that. I think I’ve overdone it.
• Talking of Q&A we recently extended our contract with the NLH for a further year, supplying up to 50 answers per week.
• Great news on the redevelopment front, we should be have the test version by the third week in August, with probable (?possible) deployment in early September. I’ve already mentioned the new and vastly improved search algorithm (click here for more details). The other development is the creation of a significant number of specialist TRIP search engines. More details when I get a moment…

Another glance at our webstats brings pleasing news. I’ve analysed how people get to TRIP, the top five being:

1. No referral – 72.02%
2. www.google.com/search 10.77%
3. google.co.uk/search 6.72%
4. search.yahoo.com/search 1.37%
5. ww.google.ca/search 1.01%

The top ‘referrer’ being ‘No referral’, this means people who have bookmarked the site or type in the TRIP URL directly. So last week, of the 110,000 searches, over 79,000 came from regular users of the site.

I suppose it’s difficult to know if that’s god or not. I suppose I’ve just been ignorant of the ‘loyalty’ of TRIP users. Over 72% seems pretty loyal. Of the remaining 28% how did they get to TRIP? Perhaps via searching for TRIP Database, perhaps searching other terms!

Given our server strain it might be wise to stop Google spidering our content, that will buy us some breathing space, one to ponder!