Trip Database Blog

An article from last week’s Guardian – Top of the heap.

A very interesting look at user preferences for search results. Apparently, on Google the top result gets 42% of the clickthroughs while the second result gets 11%. As the article points out the top two results account for over half the click throughs. The article proceeds to expand on this phenomenon.

Is this replicated in TRIP? I have no idea and no mechanism, as yet to measure it. I would like to think our users are more ‘discerning’. However, it does emphasise the need to continually improve on our search algorithm. Getting the best results at the top. We do a pretty good job but I would not say perfect, so there is still work to do.

When I worked, on a daily basis with GPs (family physicians) one particularly cynical one told me that if he searched he’d pick the first article that supported his hunch. Since hearing that (probably 8+ years ago) I have come to appreciate the problems faced by clinicians searching for clinical literature. They generally haven’t got time to do a full literature search, they haven’t time to appraise etc. This theme “please no more training on searching and appraising, just answer our questions for us” is still as strong today as it was when ATTRACT started. However, it also reinforces that if s/he does search then they need the ‘good stuff’ at the top.

How one defines the ‘good stuff’ needs considering another day.

Steve’s tragic death (click here for more details) has had a dramtic impact on our search records. For the first four and a half days of September the article most visited from TRIP, by a factor of 400%, is the eMedicine article on Stingray Envenomations

Yesterday we added the links to 2880 articles in ganfyd. Ganfyd is a collaborative medical reference by medical professionals and invited non-medical experts. As the site says:

Ganfyd.org was set up to act as a free repository for the vast amount of knowledge that doctors carry around in their heads, both of a factual nature (for example, the causes of Infective endocarditis) and of a practical nature (how to take blood from somebody with difficult veins, or how to deal with an abusive patient, or even how to ensure you don’t become dehydrated on your first day as a doctor).

All contributors are volunteers and come from either the UK, Canada, Ireland, Australia or New Zealand. As with any wiki ganfyd is ‘work in progress’.

It may not meet the strict definition of being ‘evidence based’. However, the value of ganfyd cannot be stated highly enough. Clinical knowledge has an immense value and much of what is written is owned, and controlled, by people/organisations whose first interest is frequently not patient care.

By including ganfyd records in TRIP we hope that there will be a mutual benefit. We will get good content and ganfyd will get increased exposure and therefore volunteers, making the resource even better. If you read a ganfyd article and think it can be improved – make the effort!

Growth predicted in clinical decision support market

Two pieces of wiki news:

1) Dean Giustini has started the UBC HealthLib-Wiki (A Knowledge-Base for Health Librarians):

The idea is to provide a forum for best practice for health librarians, and other information professionals around the world…….We believe this open-model will more accurately reflect the “wisdom of the field” and bring significant value to the wiki’s knowledge-base.

2) Ganfyd, the clinical wiki, is still going strong and an amazing amount of content is now in there. Due to the distractions of getting the TRIP Database re-designed and free I’ve neglected my input. However, as well as being able to contribute I have, at last, found a way of importing data from ganfyd into TRIP. It’s not a hugely robust way but it should end up covering the vast majority of the content fairly quickly.

We’ve had an awful lot of e-mails thanking us for moving to free-access. One of the first (within 3 hours) was from a UK health librarian:

“This is good news! It’s already helped me to find a piece of guidance I hadn’t found by any other route.”

Protocol for the Quick Clinical study: a randomised controlled trial to assess the impact of an online evidence retrieval system on decision-making in general practice . Although I feel more research is needed in this area I’m not hugely convinced about the meaningfulness of any results from this trial. One can predict that those that used ‘Quick Clinical’ will help change clinician behaviour and support clinical decisions. But, more importantly, it won’t check on patient outcomes.

If we want doctors, nurses etc to incorporate ‘evidence’ into their practice we need them to use it routinely, make it very easy to use and supply ‘nuggets of evidence’. I really don’t think that is controversial.

On an unrelated note and following on from earlier blog-entries about USA about citywide wireless access, Norwich, UK is doing the same (click here for BBC News story). I’m still convinced that wireless access to the internet will be widespread (at least in the ‘developed’ nations) in the not too distant future.

The re-indexed material was added at 9am this morning and so far things are working well with no obvious problems.

Well the site is now live, which is a relief. Alas, not all the content decided to join us! Therefore, we’re currently re-indexing things. As it stands all the titles, URLs, publication information are there. However, we’re missing a small (but significant) proportion of text from the body of some publications.

Still it should all be there in time for our scheduled launch date of tomorrow!