Trip Database Blog

Why do I like this article?

Save you all clicking to view the abstract, here it is:

Locating the desired evidenced-based literature via the internet is usually time-consuming and not particularly straight-forward. Websites offering evidence-based information should be accessible, efficient and user friendly. Many of these websites, however, only make their own content available, making it necessary to change websites in order to get a complete picture of the required information.The so-called website of ”Turning Research Into Practice” is a positive exception.This website makes it possible to search the whole range of evidence-based publications on a certain subject with 1 search action, is straight-forward and practical to use, and the presentation is exceptionally good.

…Are More Likely to Be Answered by UpToDate Than PubMed has just been published in the Journal of Medical Internet Research. This is proving an interesting journal. Due to the wide coverage I find many articles of little interest, but the occasional gem appears.

Perhaps unsurprisingly the authors conclude:

“Specialists and residents in internal medicine generally use less than 5 minutes to answer patient-related questions in daily care. More questions are answered using UpToDate than PubMed on all major medical topics.”

If you asked 100 information specialists to predict the outcome, I’d be surprised if many would have thought PubMed would do better!

The results were more interesting:

“We analyzed 1305 patient-related questions sent to PubMed and/or UpToDate between October 1, 2005 and March 31, 2007 using our portal. A complete answer was found in 594/1125 (53%) questions sent to PubMed or UpToDate. A partial or full answer was obtained in 729/883 (83%) UpToDate searches and 152/242 (63%) PubMed searches (P < .001). UpToDate answered more questions than PubMed on all major medical topics, but a significant difference was detected only when the question was related to etiology (P < .001) or therapy (P = .002). Time to answer was 241 seconds (SD 24) for UpToDate and 291 seconds (SD 7) for PubMed."

I’d be interested to know if clinicians were satisfied with partial answers. The authors state “Whether an answer is partial or complete is a subjective qualification. We therefore combined partial and full answers when determining significance of our findings” – am I the only one thinking that’s inappropriate? At least give us the results separately as well as combined and let us make draw the conclusions.

Another issue, not restricted to this paper but all papers on Q&A, is the assumption that the clinician knows that they’ve answered the question. They may well have found an answer, but whose to say it’s right?

Anyway, if anyone reads the article, I’d be interested to hear what you make of it.

I want a treadmill desk.

A while ago it was pointed out that the NEJM was missing from TRIP. We had an e-mail from an embarrassed librarian who had been demonstrating TRIP to a visiting academic. When the academic tried to find their premier paper in the NEJM they failed. The librarian wanted to know what she’d done wrong. Basically, nothing – it was all our fault! All the big 5 journals (NEJM, JAMA, Lancet, BMJ and Annals of Internal Medicine) were missing.

We’re not exactly sure how it happened and its taken a while to fix, but they’re back now.

Unfortunately, it looks like TRIP Answers won’t be going live this week. The site is ready to go and there’s load of content. We loaded it onto the ‘live’ server but that was one load too much for our servers and it – effectively – stopped working.

So the solution:

• Temporary – we’ll try and get it added to a different server.
• Long-term – increase our hardware capacity by purchasing some new servers. This will take some weeks to achieve, hence the need for the temporary measure. This increase in server capacity will also increase the speed of the TRIP Database.

There is a chance TRIP Answers will go live this week, but it’s more likely the first week of October.

Developing websites can be such a pain!

With a huge amount of relief the site is very nearly ready to go live. We may be able to sneak it out tomorrow, if not it’ll be Monday/Tuesday next week. As I look at the site there are 4,325 Q&As, all tagged and quality scored.

We’ve already secured the agreement of a number of collaborating organisation to publish their Q&As on the site, the list is as follows:

• ATTRACT (Wales)
• FSRH (UK)
• Clinical Cases and Images (USA)
• RCOG clinical queries (UK)
• TRIP
• Univadis (UK)
• Norwegian Electronic Health Library (Norway)
• Ma’aneh Larofeh – Clalit Health Services (Israel)
• Evidence Direct, Melbourne (Australia)

The international flavour is particularly exciting and I’m looking forward to these questions being available.

Watch this space…

This is a really brief introduction to recently launched TRIPanswers. The aim is to orientate you around the site so you can use it more efficiently. For further information view the ‘About’ section (link from the top of the page). So, a few points about TRIPanswers:

• It’s a collection of clinical Q&As from around the World
• Each question has been tagged (tags are roughly the same as keywords). They help describe the question and are useful in browsing and refining searching
• Tags are displayed in tag clouds. These are collections of tags and the more prominent the tag, the more times the tag has been used
• If you click on a tag it restricts the Q&As to those with that particular tag. NOTE: A Q&A is typically tagged with multiple tags
• Search is an alternate to browsing via tags. One way is to search using your broad topic area (e.g. myocardial infarction) and then click on a tag (in the tag cloud) that matches your interest e.g. clopidogrel
• Check out the Tag Cloud of Clinical Uncertainty
• Still confused? Let me know via the form at the bottom of the Interact page.

Below are images (click on image to make bigger) of the key features of the homepage and an individual question.

Homepage

Answer page

User experiences of evidence-based online resources for health professionals: User testing of The Cochrane Library