Trip Database Blog

As you know money is always in short supply at TRIP. Our ideas always outstrip our income!
We’ve discussed asking for donations in the past and we’re still tempted. However, might asking people to sponser/adopt a search term be better? For instance, someone could sponsor ‘diabetes’ and everytime there is a search for diabetes a message appears somewhere on the results page ‘This search has been sponsored by…………..’.

What do people think?  Alternatively, has anyone else got any suggestions to increase our income?

Remember, TRIP is free to access, has made a massive contribution to healthcare (over 50 million searches) and has no significant backers.  All the income we get has to come through small, separate contracts where we can get them.

We’d like to think the many users of TRIP might like to help support us…..

Any specific ideas can be added via comments or emailed directly to me at jon.brassey@tripdatabase.com

The above applications are widespread and TRIP has a presence on them all!  They all offer a way of TRIP to reach out to users and those with a shared interest.  It’s the blog that gives me the greatest worry, as I feel I should blog more regularly.  There’s no external pressure, I just feel I should blog once a week.

However, there lies the problem – I see blogs, Facebook and twitter in a different light.  Our Facebook presence gets the most attention and I think that’s due to the size of the posts (so I post more) and the possibly more interactive audience on Facebook (where it’s very easy to interact – just press a button).

I see the blog as a place for publishing longer pieces, twitter for very small and Facebook in between.  This medium size suits me as I’m not a big writer, if I can say something in 50 words I’ll do so, as opposed to some who’d prefer to use 500.

But, perhaps I need to precis what I’ve written on Facebook, here in the blog, so the blog audience doesn’t ‘miss out’. 

So, since the last blog article I’ve ‘Facebooked’:

• I went and gave a hands on workshop at a CEBM training conference.  Once nice bit of feedback, from a clinician was – ‘before I found TRIP I was ploughing the field with a trowel, now I’m using a tractor’.
• Reported on a meeting with the lovely Glycosmedia.
• Revealed that we’ve now got 3,172 medical videos in TRIP.
• It looks like we’re very close to secure an African version of TRIP, which I’m very excited about and follows on from our crowdsourcing of evidence for the developing world.
• We had a little twitter experiment with the European Respiratory Society.
• Highlighted that a training course was being undertaken in Chile as we had 20 registrations from Chile in the space of ten minutes.
• Finally, reported on a ‘spring clean’ of all the UK Royal College’s clinical guidelines to fix broken URLs and to ensure the content was actually fresh.

Having summarised the Facebook activity I think it works quite well!  It’s good to see a summary of our activity.  Now, I must rush – I’ve got a meeting with our techie (Phil) and designers about our new project – TILT!

I was recently invited to attend a workshop held by the Centre for Evidence-Based Medicine in Oxford.  This wasn’t a formal demonstration of TRIP, it was more an informal chat to allow people to ask about TRIP various aspects of TRIP e.g.

• How often is the site updated? Answer: most content is weekly or fortnightly and the rest on a monthly basis.
• What is involved in updating the site? Answer: Most content is automatically added via various clever bits of technology.  However, for a number of sites I still have to visit them monthly and manually add the content.
• How does the boolean work?  Answer: Use the advanced search to show you – as this builds the boolean for you.

Then, a person who had used TRIP for years said they weren’t aware of this feature.  Over the course of the session people highlighted they hadn’t seen:

• Advanced search
• PICO search
• Free-text search
• Sources searched by TRIP
• Synonyms – the list of synonyms used for a search are displayed at the foot of the results page (see below)

It’s an interesting issue/problem.  It’s trying to get the balance right between making features visible and not over-powering.  I’m really not sure how to resolve this!  Possibly create a monthly ‘Feature’ area which would allow me the ability to focus on a given feature. One to ponder!

One very memorable quote was from a clinician who said:

‘before I found TRIP I was ploughing the field with a trowel, now I’m using a tractor’

I’ve not mentioned NHS Evidence much and it’s a coincidence that I mention them twice in 6 weeks. I last blogged about them then (click here) to highlight that their searches are massively more expensive than TRIP’s.

My interest in NHS Evidence goes back longer than 6 weeks! I have contacts (and had contracts) with the predecessor to NHS Evidence (National Library for Health) and was keen to see how NHS Evidence would change things. Unfortunately, I was disappointed by their lack of ambition and innovation. Although, I’m still hoping to be proved wrong and they’ll do something special – clinicians (and patients) deserve it (especially with their budget of nearly £25 million).

But, the reason for this post, relates to some advertising NHS Evidence produced earlier this year. I saw it in the middle of March in the Health Service Journal. In that advert they claimed two things which I felt were inappropriate:

• The most dependable clinical and non-clinical information online
• answer all your clinical and non-clinical questions

It makes me shudder that this got past any internal processes. As a gateway for evidence surely they should be able to substantiate any claims they make. Both claims, to me, were absurd. I could go on, at length, as to why the claims are so foolish and if people are unclear then please contact me separately (jon.brassey@tripdatabase.com) and I’ll explain. 

After seeing these adverts I felt quite strongly that NHS Evidence shouldn’t make such statements and therefore complained to the Advertising Standards Authority. I recently received a letter telling me that NHS Evidence has confirmed that the advert has been withdrawn and that they will not repeat the claims.

It’s a small victory.

But here’s a challenge to NHS Evidence – fund some comparative research and compare yourself to other products. Not just TRIP, but DynaMed, NHS Scotland’s rather nice Knowledge Network and others. Help everyone learn from the strengths and weaknesses of others. If it helps we’ll part-fund it (we’ll give 0.5% of our budget if you match that with 0.5% of your budget).

As it happens in another freedom of information request NHS Evidence (where I asked about any comparisons they make with other search engines) they reported:

“we don’t compare our performance against other services”

This last quote is quite simply scandalous.

I sometimes feel there is a pressure to blog, to write something, just to show people we’re still here and thinking of them!  While things may appear quiet (we’ve not blogged, twittered or Facebooked much) we’re still very busy.  However, much of the work is behind the scenes as we gear up the development of our TILT project.  I’ve been busy finalising the specifications and have as good as signed off on these.  TILT is pretty much in stealth mode so what can I say….

• It’s a way to record and share learning
• While search focuses on known unknowns (you need to know you don’t know something before searching for it) TILT will focus as much on unknown unknowns as known unknowns!
• When I talk about search, in TILT, I’m not referring to document search – something far more useful and concise.
• At it’s core is clinical usefulness, it’s a bottom-up approach.

Well, I hope that’s whetted people’s appetites.

It’ll launch, probably as a beta towards the end of October.

Changing tack, if you’re on Facebook please visit our page (TRIP on Facebook) and ‘Like’ us 🙂

Another month and another manual upload of 600 plus records.  TRIP actually imports more records than that, the majority come via automatic methods.

In addition to the monthly upload we’ve completely revamped (due to URL changes) the following sites:

• Diabetes UK
• British Thoracic Society
• British Association of Dermatology
• British Society for Rheumatology
• European Association of Urology
• Washington University Division of Emergency Medicine Journal Club

A busy month, but well worth the effort.

I’m very pleased to announce that TRIP now has over 10,000 registered users. 

The vast majority of these users are health professionals enrol and there’s pretty much an even split between doctors, information specialists and other health professionals.  The users are from all around the globe, highlighting TRIP’s global appeal and reach.

To celebrate we’ll be rolling out a significantly enhanced e-mail alert system.  Previously, if a user had recorded, say, ‘prostate cancer’ as an area of interest they would simply get an e-mail reporting how many new articles matched this keyword.  Following feedback we have improved this so the results are broken down into EB Synopses, Systematic Reviews, Guidelines (pertinent to your country), Core Primary Research and Extended Primary Research (see below) 

The number of articles suitable for the developing world (click here for further information) continues to grow and appears to be speeding up.  As of today we have identified 288 articles.  It’s not a massive number, but a review of these reveals a high level of accuracy – so I’m happy that things are moving in the right direction.

We never envisaged this initiative being ‘the’ answer, but part of something bigger.  In relation to that we have a number of ongoing discussions and if/when these come to fruition we’ll announce them here.

NHS Evidence was created to replace the NHS’s National Library for Health.  I was disappointed when it was released as it appeared little more than a clone of TRIP.  I was hoping for something more innovative to help support clinicians better and also to push the search agenda along – there is nothing like robust competition to stimulate innovation.

I have undertaken a number of Freedom of Information requests and have found out some interesting facts (click here to see the requests and responses).

What I found is as follows:

• The budget for NHS Evidence in 2010/11 is £24,438,000
• The number of searches this year is 15,811,716 (based on the average monthly figures for February to April 2010 multiplied by 12)
• This means a cost per search of 154p

By comparison, this is how TRIP stacks up:

• The budget for 2010/11 (for our search engine) – £45,000
• The number of searches this year is 8,058,648 (worked out using the same figures and method as above.
• This means a cost per search of 0.56p

Therefore, each search on NHS Evidence is 276 times more expensive than TRIP!

Why I raise this is not to rubbish NHS Evidence, although the figures are unflattering.  It’s more a feeling that it highlights the limitations of search.  Is this the law of diminishing returns?  Is search really the answer to clinical uncertainty?  I’m increasingly convinced that search is not the solution, irrespective of how much money you throw at the problem.

I’d love to have any comment on the above, are my conclusions sound?  Do the figures add up?