Trip Database Blog

We’re currently very busy – so the blog may go quiet for a while! So what are we working on:

1) Gwagle. Gwagle is getting close to its alpha-test launch (1-2 weeks). If you’re interested in taking part let us know via the TRIP Database ‘Contact us‘ form. Gwagle will be open to clinicians (doctors, nurses, pharmacists, PAMs etc) as well as information specialists working in the health sphere.

2) TRIP Updates. The latest round of upgrades are currently being deployed to our test server. The main updates are:

• Improvement to algorithm
• RSS feeds for search results
• Snippets (small summaries of the main document, displayed on the search results page)
• Conclusions. The conclusions of a number of resources will be viewable via the results page. Resources such as NHS CRD, Cochrane, Evidence-Based Medicine, BMJ Updates have conclusions we can grab.

These enhancements should be available within 6-8 weeks.

3) Correcting TRIP errors. Unfortunately, some of the search modification functions (brackets, some boolean and quotation marks) have decided to stop working. So we’re working to get these back!

In January we were searched, as mentioned previously, 365,855 times. But we can now give some more detail as to how people use us:

• Advanced search was used 12,834 times (3.5%)
• Our spelling correction function was used 12,774 times (3.5%)
• Medline articles were viewed 6,988 times (1.9%)
• The Medline search was ‘specialised’ 1,825 times (0.5%)

This suggests that users tend to use the core TRIP content and rarely follow the links to Medline and even less use the specialisation feature. This might be because it isn’t highlighted well (I tend to think not). Alternatively, our inclusion of certain key Medline articles (JAMA, NEJM, Lancet, BMJ, Annals of Internal Medicine and BMJ Updates) which means the ‘best’ material is captured by TRIP. Another possibility is that users simply want TRIP for evaluated, secondary material and if they wanted PubMed, they’d use it.

The large number of mis-spellings shows the worth of investing in our auto-spelling correction function. I’m proud that we were one of the first (if not the first) large clinical database to incorporate this feature (2 years earlier than PubMed).

Our new round of updates is currently underway and one area I’m hoping to improve is the advanced search, it doesn’t perform to the standard I expect. Is the realtively low useage a sign of the greatness of the main search algorithm (so users have no ‘need’ for the advanced search OR a reflection of the poor experience of users attempting to use the current advanced search?

Now this really does seem an interesting technology (click here).

The TRIP Database search algorithm works pretty well most of the time. But the biggest annoyance to me is the ‘over promotion’ of eTextbook records. eTextbooks have their place, but at TRIP we try to offer the highest quality material first and then users can work down the ‘quality’ scale.

We’ve identified the cause – the overly high weighting caused by title term density – I will explain!

Our general view is that if a document contains the search term(s) in the title it is likely to be more relevant than a document that mentions it only in the text. As a result we give a higher weighting to the title score. The problem we have is that our underlying software (Lucene) incorporates a title word density score. So if you have two documents:

1. Prostate cancer
2. Blah blah blah prostate cancer

The first gets a very high score (100% match) while the second gets a lower score (40% match). Typically users search using 1-2 terms and eTextbooks, typically, have 1-2 terms title. While resources such as Cochrane, Bandolier etc have much longer titles. This has caused much frustration and we’ve even considered creating our own, bespoke, search mechanism (which would be costly and much slower).

However, a reading of Alf Eaton’s HubLog show’s he has more than a working knowledge of Lucene. A quick e-mail to Alf (he’s helped with advice on TRIP in the past) and he’s suggested a couple of fixes. We’re currently creating a testing system to test these. With any luck these alterations will be in place shortly.

Although we may be tempted to wait until the current round of upgrading is over and roll everything out in one go!

An interesting e-mail landed on my desk asking me to remove a guideline from the TRIP Database. The guideline in question being Infectious Diseases Society of America practice guidelines for clinical assessment, treatment and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis. We link to this guideline via the American government’s National Guideline Clearinghouse. The reason for this request:

“I feel it is wholly inappropriate that this document is still on this website and being used as reference guide. The authors of this document have been subpoeaned by Conneticut Attorney General in the US over the likelihood of the breaking antitrust laws because of biased and warped content of this document, furthermore the document does not take into account of any other medical practises for the treatment of Lyme Disease and is not peer reviewed, please remove this document immediately as their could be legal consequences ensuing by practioners following this protocol.”

It caused me some concern as this is the first time someone has asked for material to be removed. So I did a bit of digging round:

1) It does appear that the Connecticut DA is looking into this.
2) There appears to be a great deal of controversy around Lyme disease (see, for instance The Dirty Truth About Lyme Disease Research or wikipedia entry The Lyme controversy).
3) The person contacting me stated that the guideline had not been peer-reviewed, yet I found that the peer-reviewed journal ‘Clinical Infectious Diseases’ published the guideline in 2006 (click here).

Some final thoughts:

• Ultimately, we (at TRIP) are not in a position to arbitrate on this one, the Connecticut DA appears to be.
• The statement “innocent until proven guilty” springs to mind.
• Unless anything substantial appears as long as the National Guidelines Clearinghouse contain the guideline, so shall we.

A blog earlier this year highlighted an interesting article on the merits of tagging – focussed on accuracy. The article Patterns and Inconsistencies in Collaborative Tagging Systems: An Examination of Tagging Practices is well worth a read.

Hot on the heals of this is a BBC News article Tagging ‘takes off for web users’ which reports on the increased use of tagging by web-users.

Roll on Gwagle, shortly to hit the alpha-testing phase.

An amusing post on the SEOmoz blog. Picking out the best bits:

• Wikipedia – The encyclopedia where you can be an authority, even if you don’t know what the hell you’re talking about.
• When Wikipedia becomes our most trusted reference source, reality is just what the majority agrees upon.
• When money determines Wikipedia entries, reality has become a commodity.

Fortunately, medical blogs, such as Ganfyd, are above these criticisms.

Ben Toth frequently comments on open access issues relating to Cochrane. His most recent can be viewed here. Seeing this entry coincided with an e-mail from the rather good RD Info people. RD Info highlights new R&D funding and is often interesting to browse. One of their entries included the following:

NHS Cochrane Collaboration Programme Grant Scheme
Description: NHS Cochrane Collaboration Programme Grants will provide new funding to support the production and updating of Cochrane reviews in areas of priority or need for the NHS. The grants will build on existing Cochrane Collaboration infrastructure, supplementing rather than replacing current funding, activities and outputs of The Cochrane Collaboration.
Funding: Funding for approximately 8 grants will be available. Grants will be up to a maximum of £420,000 over three years (ie up to £140,000 pa) including institutional overheads or full economic costs at 80%. Grants will be awarded to support a coherent programme of work that includes both new Cochrane reviews and updating of existing reviews.
Amount : > £100K Closing Date : 05 March 2007 Duration : 1 year – 3 years

What struck me (and clever people like Ben have been commenting for an age on this subject) is that the NHS gives large quantities of money to Cochrane to produce the systematic reviews (as well as untold NHS staff time taken by volunteers actually producing the reviews). Cochrane (well Wiley, the publishers) then has the temerity to charge the NHS to look at them.