Trip Database Blog

At the weekend my broadband broke so I was left with my thoughts. On Sunday morning I has a ‘Eureka’ moment and worked for about 3 hours on a new project, codenamed ‘Socrates’. I presented my work on Tuesday morning to a potential partner. Today they called me to say they were ‘in’.

So work will start on Socrates almost immediately.

It’s too soon to give out details and these will filter out, via this blog, over the coming months. But I’m hoping that it’ll be released early 2007. It has the potential to be truly massive.

Watch this space.

Following on from the earlier post on Google diagnosis I have come across a paper using the Isabel system. The paper Diagnostic omission errors in acute paediatric practice: impact of a reminder system on decision-making is available as a provisional PDF. This gave the following results and conclusion:

Results: Subjects attempted to access the diagnostic aid on 595 occasions during the study period (8.6% of all medical assessments); subjects examined diagnostic advice only in 177 episodes (30%). Senior House Officers at hospitals with greater number of available computer workstations in the clinical area were most likely to consult the system, especially out of working hours. Diagnostic workups construed as ‘unsafe’ occurred in 47/104 cases (45.2%); this reduced to 32.7% following system consultation (McNemar test, p<0.001).

A thought provoking article, especially given the recent debate surrounding the Google diagnosis story.

I wrote on the 7th August about the NLH’s plans to revamp their site and more specifically their search. Well it has just gone live (click here). They’ve introduced the ‘title’ and ‘title and text’ distinction. As I mentioned previously I’m flattered with them copying the old style TRIP method.

But I’d be interested to see the rationale for the changes. Our move from ‘title’ and ‘title and text’ to the current method has dramatically improved our search results.

Aside from that I do like the new layout and colour scheme.

This article will no doubt feature highly in the blogs (click here) and create much controversy! It reminded me of the Isabel decision support tool.

Basically, the authors took a years worth (n=26) of diagnostic cases from the NEJM and, after reading the article, they selected 3-5 pertinent search terms. Added these to google and somehow selected the 3 most likely diagnoses. They then compared these 3 diagnoses with the actual result from the NEJM.

Overall result – ‘correct’ in 58% of cases (CI – 38-77%).

I’m not sure if I find this disturbing or not, it’s certainly too small to make conclusions. But once again Google (not deliberately on their part) have set a standard…..

Another record, this time in Q&A. Today – my birthday – saw the NLH Q&A Service answer and published 22 questions. The previous record was 17.

Happy birthday!

It has been two whole months since we went free. Before going free we averaged 22,500 searches per month. In September we were searched 132,538 times. For October, another huge increase – 191,581 searches. This represents a increase of nearly 50% since September and over 800% increase from our subscription days!

Onwards and upwards!

1. Chickungunya fever (Ganfyd) – viewed 396 times.
2. Guidelines for the administration of blood components (ANZSBT) – 342
3. Failure to thrive (Ganfyd) – 276
4. Guidelines for Blood Grouping & Antibody Screening in the Antenatal & Perinatal (ANZSBT) – 272
5. Asthma (PRODIGY) – 254
6. Rheumatoid Arthritis: Diagnosis and Management (British Columbia Medical Association Guideline) – 251
7. Nutrition support in adults (NICE) – 214
8. Moxibustion (CAM) – 214
9. Diabetes services for adults (RCN) – 201
10. Good practice in infection control (RCN) – viewed 197 times.

Found by Ben and a very useful intro (click here). I’m seriously considering using a wiki in at least one new project I’ve got in the pipeline, possibly TRIP Answers.

A bit of a grand title, but what happens when we get a question that has potentially very serious consequences? We had one yesterday. The question:

“A friend presenting with raised ESR, spontaneous bruising and temporal arteritis – any ideas, please? Awaiting haemo consult which could be two months hence.”

I saw it and initially was unhappy as it was about the persons friend. So I asked our medical director for his view. Well, he felt it could be a medical emergency (especially as the GP seemed to have a two month timescale). Apperently, in TA there is a danger of blindness unless suitably managed.

The dilemma we had was how directive we should be? Our answer can be seen by clicking here. I also sent a separate, private e-mail, to the GP reinforcing the need to take this seriously.

I wonder if we’ll hear any feedback from the GP!