Saturday, June 7, 2014
Wednesday, February 20, 2008
Online on-the-spot searching...
Online on-the-spot searching increases use of evidence during consultations in family practice.
An interesting approach/methodology that compared a dutch guideline database, BMJ, CE and TRIP. Interestingly they employed a hierarchy whereby they started with the guidelines and then went to another resource if they couldn't get an answer to the question.
An interesting approach/methodology that compared a dutch guideline database, BMJ, CE and TRIP. Interestingly they employed a hierarchy whereby they started with the guidelines and then went to another resource if they couldn't get an answer to the question.
Tuesday, February 19, 2008
What would Google do?
When mulling over improvements to TRIP I frequently find myself asking 'In this situation, what would Google do?'. As part of the debate we're having it dawned on me that we could do far worse than to look at what the mainstream search engines do to demonstrate their worth.
Two blog posts should be of interest (the first links to the second):
Two blog posts should be of interest (the first links to the second):
- Yahoo Makes Big Customer Satisfaction Gains In Search
- Search Engines: Intense Competition Drives Better User Experiences
One other point, we had Paul Glasziou and his team evaluate TRIP and this paper is available via PubMedCentral (click here).
Re Martin's question re outcomes (and I'd want to do a literature search before going any further of course):
But setting that aside, and this may be incredibly naïve, but are there four categories, and are each important?
1. Process measures: in this case, how many clinical questions asked and successfully answered; or time to answer a predetermined question; or quality of answer to preset question (e.g. if the question is about antibiotics in otitis media if the "search engine" doesn't put Paul et al's Cochrane review at or very near the top it doesn't get many marks from me).
2. Qualitative. Too obvious for this group but you know what I mean. Participant experience is an important measure. And I'd include both patients and healthcare practitioners of course.
3. Quantitative. Here I'd be looking for data relating to at least a change in clinical practice. Pragmatically it might have to be measured on a before and after basis but surely we can focus on some key gaps between evidence and practice and try and bridge them by making "search engines" available and discussing how to use them "optimally" on those areas?
4. Pastoral. Different, I'd argue from qualitative. Here I'm thinking about how individuals feel about their work and role (or from patient's perspective how they feel about their illness) in a holistic sense, taking a much more rounded view about their worth, approach to CPD, staying up to date, how consultations are going now. Qualitative approaches likely, but much deeper questions.
I too have a summer student but only for 3 weeks, but I think we could be persuaded to play in the sandpit as long as this is reasonably small scale.
Neal Maskrey
But setting that aside, and this may be incredibly naïve, but are there four categories, and are each important?
1. Process measures: in this case, how many clinical questions asked and successfully answered; or time to answer a predetermined question; or quality of answer to preset question (e.g. if the question is about antibiotics in otitis media if the "search engine" doesn't put Paul et al's Cochrane review at or very near the top it doesn't get many marks from me).
2. Qualitative. Too obvious for this group but you know what I mean. Participant experience is an important measure. And I'd include both patients and healthcare practitioners of course.
3. Quantitative. Here I'd be looking for data relating to at least a change in clinical practice. Pragmatically it might have to be measured on a before and after basis but surely we can focus on some key gaps between evidence and practice and try and bridge them by making "search engines" available and discussing how to use them "optimally" on those areas?
4. Pastoral. Different, I'd argue from qualitative. Here I'm thinking about how individuals feel about their work and role (or from patient's perspective how they feel about their illness) in a holistic sense, taking a much more rounded view about their worth, approach to CPD, staying up to date, how consultations are going now. Qualitative approaches likely, but much deeper questions.
I too have a summer student but only for 3 weeks, but I think we could be persuaded to play in the sandpit as long as this is reasonably small scale.
Neal Maskrey
Monday, February 18, 2008
How do we define the outcome
WHAT do we use for the "O" without sliding back into expert mode??
from Fred Tudiver
from Fred Tudiver
points raised
How do you arrive at the questions? Using contrived questions will introduce an academic bias. As you know we answer lots of genuine clinical questions and find academic resources such as Cochrane pretty rubbish. My view is that the topics selected by Cochrane have little relevance to clinicians 'at the coalface'. A recent analysis of our dermatology questions - 327 in total - Cochrane reviews answered 2!
Outcomes - very interesting! Do we use 'real' clinicians to rate if the search engine helped them answer their question? If so that doesn't mean the answer is correct. So do you have two outcomes - one relating to user satisfaction and the other to answer accuracy? Again a problem is what's the right answer? I'm sure you saw the NEJM results when they presented a hypothetical clinical scenario and got readers to vote on the suggested management - wide variety of results suggesting there is no clear answer.
from Jon Brassey
Outcomes - very interesting! Do we use 'real' clinicians to rate if the search engine helped them answer their question? If so that doesn't mean the answer is correct. So do you have two outcomes - one relating to user satisfaction and the other to answer accuracy? Again a problem is what's the right answer? I'm sure you saw the NEJM results when they presented a hypothetical clinical scenario and got readers to vote on the suggested management - wide variety of results suggesting there is no clear answer.
from Jon Brassey
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