Trip Database Blog

David Rothman has been to the Medical Librarian Association meeting and taken a video camera (click here).

This is a great use of technology…

As is this telectroscope.

I see that PubMed have rolled out a beta version of advanced search (click here).

While I play with the new features I really need to turn my attention to TRIP’s advanced search. Relative to the other part of the site it’s ‘weak’. Something for the last half of 2008!

I spotted a semantic web product called Calais a while back on (Reuters Wants The World To Be Tagged). Basically, it takes any document and ‘marks it up’ with various semantic web tags. I didn’t give it much thought till a blog post this morning Reuters Launches Calais 2.0 – Now With Pop-Culture which reports support for the pharmaceutical and medical world.

You can use this Calais Viewer link to try it out.

I enjoyed using it, but it still has a long way to go, the number of terms it recognises is limited.

Given my lack of vision I’m not sure how you can utilise knowing that ibuprofen is a ‘product’ and feverish illness is a ‘medical condition’. Perhaps one day it’ll become obvious…

Further to a post last Friday (click here).

• Why will you cease operations on 27th June? Is there any point inlobbying to try & keep your service available? If so, who should I contact (from a v satisfied customer!)
• Why is the clinical Q&A service being axed? It is excellent and will be sorely missed
• What a desperate shame this service is to discontinue! I have only just discovered it and have found it enormously useful because it is evidence based. Please feel free to pass this message on to anyone who has influence over this decision.
• Why is the NLH Q+A service ceasing operations? Has the funding been pulled? Will there be an alternative service?
• This service has greatly improved my practice it has been a great resource i cant believe its being withdrawn i will find it a great loss
• Interesting- found this site via google- I see it’s a pilot and about to be withrdrawn. I never heard of it- was it something that we should have been informed of? muight have been useful (or not) but if we had known about it we might at elast had the chance to try it out. More wasted NHS money on something not discussed with users and not properly tried and evaluated?
• We will miss your service greatly! Is it migrating somewhere else/what alternatives are there?
• Is there a replacement once the current service close in June? it has been a very helpful service for lots of us in primary care

I’ll add extra comments as and when I get a decent batch….

At the start of the week I had the pleasure of presenting at the 2008 Clinical Librarian Study Day. I was tasked with talking about quality standards in Q&A. This was a tough subject to do justice. I’ve worked hard for ten years on Q&A yet had never really thought about ‘standards’. So it took a while to distill my thinking into reasonable standards.

I came up with two types of standards:

• Easy
• Real

Easy standards are the ones I consider self-evident e.g.

• Competency in searching various databases
• Return answers in an agreed time
• Keep responses to a reasonable (brief) length
• Answers should be referenced

But adhering to these standards means very little.

Real standards are the ones I think mean something and are perhaps less obvious and I came up with 7:

1. Competency of answerer
2. Transparency
3. Communication
4. Feedback
5. Correctness of answer
6. Boundaries of Q&A
7. Quality control

Competency of answerer. It’s relatively straightforward to search medline and learn to appraise. However, it’s much harder to understand the clinical context. This involves trying to understand the motive for the question, what it actually means, the sort of evidence required and knowing when the question has been answered.

Transparency. This is not as simply as linking to an article informing users about the process. It’s ensuring that they actually know what the process is and potential shortcomings.

Communication. Linked with transparency this relates to simple things such as using a clear narrative to more interesting challenges – such as explaining uncertainty.

Feedback. Is there easy feedback from the user but also from others viewing the service? We receive a small amount of feedback, we should get more!

Correctness of answer. Is the correct answer given? A tough question to answer..

Boundaries of Q&A. A bit vague this one, but when/where should a ‘quick and dirty’ Q&A service operate. I often worry that we spend too little time on questions, rushing off to answer the next one. Other areas worry me such as high-risk questions – but then we pass them through to our clinical director to check. But every now and then I worry that we’re going beyond what we should be doing.

Quality control. Is there a QC system? We have internal and external systems, I’m pretty sure they’re robust – but an important standard all the same.

With ATTRACT and the NLH Q&A Service we could improve, I’m thinking particularly of transparency and feedback. We’ll be addressing both these issues (and others) with TRIPanswers.

Of the seven I think the two really important standards are Competency of answerer and Transparency.

Yesterday, TRIP was searched 51,021 times, the first time we’ve been searched over 50,000 times per day.

This increase must be down to the significant increase in users who are coming back on a more regular basis.

What’s the next milestone? 2 million searches per month, 400,000 per week or 75,000 per day….

We occasionally get requests from users for new features. Where possible we try and accommodate these wishes – assuming they make sense to us and we’ve got the money. One feature has recently been requested more than any other is the ability to export TRIP results.

Separately, in the development of the Spanish version of TRIP, it was ‘showcased’ to the Spanish Ministry of Health and they too wanted an export feature.

Bottom line: We’re creating an export feature.

All the results in TRIP will have a tick box and users will be able to select the ones of interest. They will then be able to export the selected records to file or e-mail to a colleague.

This should be out by the start of June

The saddest thing for me about the ending of the NLH Q&A Service is the reaction of the users. We’ve just placed a notice on the site alerting users to the ending of the service. Two comments received within 35 minutes of it the notice going live:

“I have just found this answering service through a colleague. I think it is absolutely brilliant. I have just found the answer to a question within 1 minute which would normally have taken me hours, maybe days of research. I am paid £40k p.a. so this time saving is bound to be very valuable to the NHS when multiplied by all the people who use it. Why is the service ending???”

“Hello. As an EBM practitiopner I am disappointed to read that as of June 27th the NLH Q&A Service will cease operations and be unable to answer any new questions. Could you kindly inform me of the reasons behind this decision, and what will replace this very important and I think successful primary care service. Thanks,”

I’m so proud of what we’re achieved and the fact that clinicians are prepared to contact us to express surprise and disappointment is impressive. The NLH suffers from a lack of engagement with primary care health professionals, an area that needs more support that secondary care (that has access to librarians). By removing of this key service it further hampers engagement.

Still the secondary care clinicians will still have their services…

I’ve been worried about the search speed for some time. The removal of the number of results for each individual category was meant to improve things, it didn’t.

Yesterday (see previous post) I introduced a system that removed search results which we considered not relevant. As well as improving the search relevancy it reduced – dramatically – the number of search results returned. By accident this has resulted in a huge increase in search speed.

Not all accidents are bad!