Trip Database Blog

Wow, I can really see just how much time the NLH Q&A Service took. It stopped answering questions at the end of last week and I’ve already managed to empty my e-mail inbox, the first time in years!

There have been a number of e-mails with new content waiting to go on TRIP, the most notable being the rather nice York Health Economics Consortium.

Talking of NICE (tenuous I know) the Darzai review (click here) has indicated an expanded role for NICE. It looks like they’ll be responsible for a new service/organisation NHS Evidence:

“NICE will manage the synthesis and spread of knowledge through NHS Evidence – a new, single portal, through which anyone will be able to access clinical and non-clinical evidence and best practice, both what high quality care looks like and how to deliver it.”

I can only surmise that the NLH will end up moving (again) to fall within NICE’s clutches. What that means for Q&A I wouldn’t like to say. I’m seeing Peter Hill tomorrow and that might shed some light on things.

The extra time on my hands has been spent harassing our web-developers and we’re fixing a number of niggling problems relating to advanced search, truncation, apostrophe’s. In addition – for some reason – the big 5 core journals (NEJM, JAMA, Lancet, BMJ, Annals of Internal Medicine) have disappeared from our search. These should be back soon.

TRIPanswers is progressing very well and the beta should be available within a fortnight. It should be as good as finished then but I just need to add a load of content. I’m hoping to launch with over 5,000 Q&As, reaching 10,000 by the end of 2008. I haven’t thought much past then. Each Q&A will be quality marked and have various other bits and bobs to transform Q&A; at least a little bit!

I’m also starting to research various semantic tools to improve various aspects of the TRIP site. I’m hoping to get some sort of system set-up to allow me to play around with these. I see these tools as allowing things such as semi-automated updating of Q&As, allowing natural language searching of TRIP and TRIPanswers. I even thought we could allow users to add text that they are interested in and use that as a basis to find ‘related articles’ within TRIP.

I’ve been a long-standing fan of PubMed’s related articles and getting this close to trying similar tools on TRIP is very exciting. I’ve often carried out searches of PubMed and found articles of interest only to find even more by using ‘related articles’.

Jumping back to TRIPanswers, if anyone wants an invite to the beta, let me know via http://www.tripdatabase.com/ContactUs.html

“Which is the most accurate test for diagnosing genital chlamydial infections in men, DNA amplification test on a first void urine or a urethral swab?”

Was the first question posted to the NLH Q&A service in November 2004. Nearly 6,500 questions later, this question closed the service:

“Is there any difference in upper GI side effects with risedronate compared to alendronate?”

A sad day…

This is the final week for the NLH Q&A service. I’ve been overwhelmed by the response from GPs and apparently there has been a lot of chatter on GP mail-lists moaning about the decision to close the service. So much so it came to the attention of a health journalist and I had a chat with them earlier this week. You can read the story here. I don’t think my opinions were fully represented, but then that’s the nature of journalism. Interestingly, the same GP chatter stimulated a call from BMJ-land.

I have mixed feelings about the end of the NLH Q&A Service.

On one hand I’m sad for:

• The users of the service. I have been so humbled by the feedback I’ve received, it really has been great. I think it’s a missed opportunity to not – somehow – keep the service running.
• Rosalind. She has worked on the Q&A service from near the start and has been wonderful. She made a load of brave decisions to come and work with me on Q&A. I’d like to think she’s learnt a lot from the experience. Fortunately, she’s got a new job but it will necessitate a move from Aberystwyth to London. I suppose I’m sad that I’ll not be working with her for the foreseeable future.

On the other hand I’m getting so excited by the new Q&A development (TRIPanswers) which will launch in the summer. I’ve had the website to play with for a few weeks now and have been testing it fairly extensively. I’ve just sent another batch of feedback to our web-developers, so I’m hoping the work will be as good as completed by the first week of July. However, the launch won’t happen then as I need to populate the site with data – which is a long, hard, manual task.

I’ve also been making new relationships with various Q&A providers around the globe and that will all help support TRIPanswers. I genuinely think TRIPanswers will be bigger than the TRIP Database…

Well, the extra RAM is now in the system and there is no obvious improvement in speed. It’s invariably quicker at certain times of the day (peak times when memory was an issue).

The analysis of speed and the identification of bottlenecks is booked in to start mid-July. This will highlight code inefficiencies that can either be fixed as they go along or will need further work. Fingers crossed it’ll be the former.

I’ve noticed (and no doubt lots of others have as well) the pretty awful speed of TRIP in the last week or so. Just to say SORRY and that we are addressing the issues:

• As a short-term measure we are quadrupling the memory in our servers. This should boost speeds considerably and hopefully this will be in by either the end of this week or the start of the next.
• On a more medium term basis we are carrying out some sophisticated analysis of the site to identify where the bottlenecks are. We’re hoping that, once this has finished, we will be able to allocate resources at the problems. If we’re lucky the extra memory might sort everything out!

I use TRIP everyday so am acutely aware of the need for speed – we’ll get there….

Alexa is a leading resource for looking at the popularity of a website. Given the demise of the NLH Q&A I thought I would compare the NLH Q&A service with the NLH itself (click on image for larger size):

They say a picture is worth a thousand words!

There are some caveats associated with those figures (isn’t that always the way). But it’s certainly worth pondering.

I’m aware that this blog has been slow over the last week or so, the reason is simply I’ve been too busy with ‘all things TRIP’ to contemplate what to write about. Specifically, I’ve been heavily involved in 4 significant chunks of work:

• TRIP Spain – should launch very soon.
• TRIPanswers – I’ve been given the site to play with and/or test. I’ve started adding questions and answers and I’m very pleased. So far I’ve added 250 questions, only another 5,000 before we lauch (in about 2 months).
• Advertising – we’ve moved to a new advertising providers, I’m having to manually assign search terms we receive on TRIP to the advertisers advertising categories. This is very labour intensive, but it’ll hopefully be worth it!
• Winding up the NLH Q&A. Not much to do really, I’ve already started relaxing and moving my mental efforts to TRIPanswers…

I imagine I’ll start more regular posting soon(ish)

A great article on where search MAY be heading – Search 4.0: Putting Humans Back In Search

I’ve been intrigued by the notion of human search and the site Mahalo was/is of interest. The main interest has stemmed from the following:

• I feel the tweaking of search algorithms can only take you so far.
• Most users will only visit the first page of results.
• Given the experience within TRIP we have a pretty good idea what would constitute a good set of results.
• We have some experience in this area. A while back (so not up-to-date) we created a number of reviews e.g. statins or knee osteoarthritis.

The big problem is scale. We could create human-powered search results for the top 100 searches – but that’s scratching the surface. Perhaps I’ll do some mock-up and get users to ‘vote’ to see which they prefer.

Watch this space.

That’s according to Jakob Nielson (click here)!

…people are becoming much less patient when they go online.
Instead of dawdling on websites many users want simply to reach a site quickly, complete a task and leave…..Instead, many are “hot potato” driven and just want to get a specific task completed…..

The above has got me very excited as it fits in with my view based on observations over the years of running fairly successful websites. It’s also something Bandolier have long advocated with their frequent references to nuggets of evidence.

So what does the above suggest? Give small bite-sized chunks (nuggets) of evidence. More than that it’s giving people nuggets of evidence AND making them easy to find.

The NLH Q&A Service is great as it gives individuals rapid answers to their questions. The site is let down though by a poor search mechanism. So it’s not so great for others.

Resources like Clinical Knowledge Summaries have great content (arguably they are a large collection of nuggets) but again findability is a real issue.

Is there a solution? We hope so, and the launch of TRIPanswers in mid-summer will reveal our hand…