Spotlight on.... the Trip Database

Trip is a free search engine used to find clinical evidence and  research in the fields of medicine, dentistry and health.

Used by health professionals and members of the public alike the interface is easy to use and incorporates some useful tools, such as a PICO search option where you can easily apply your PICO analysis to generate your search results, and the still developing 'Trip Rapid Review' search option which allows you to analyse multiple research articles at once.

From the simple and advanced search options it's also easy to find a whole range of different types of material. Using the tabs along the top of your search results you can limit your search to resources such as clinical evidence, images, videos, educational tools or patient information sites. The options on the right-hand side of your search results also allows you to further limit the clinical evidence results to resource types such as systematic reviews, case reports or guidelines etc. 

With results including evidence from pubmed, the cochrane database and NICE the quality of the search results seems to be high but remember to always use your own judgement and appraise the evidence for yourself. 

http://www.tripdatabase.com/ 

Jade Goody: Depraved or deprived?

Jade Goody: depraved or deprived?
Famous for merely being famous, Jade Goody has been a part of our everyday culture since she was catapulted to fame by the Big Brother series in 2002. Her death this week, at the tragically young age of 27 made headline news in every national paper. Love her, loath her or have an insistent indifference, it is difficult not to have a view.

It is easy to pass judgment on Jade's lifestyle, her antics have had parents the length and breadth of the country shuddering with disbelief. But, would any of us actually have been all that different if we had been exposed to the social circumstances which dominated Jade's young life?

Jade's hugely public death from cervical cancer has increased health checks amongst young people in our society in a way that most clinicians or politicians can only dream about.

It is indeed good news that Pap smears have risen by 20% since Jade used her case to promote uptake. However, if it is a truism that there is no more powerful therapy than prevention perhaps what we, as a society, might do is to look at the research evidence on aetiological (causation) factors of Jade's ill-health and use this in a non-judgmental way to help the young and vulnerable people in our society.

To retrieve best evidence on the aetiology of disease search Medline and use the term 'risk' in combination with a MeSH search of your disease.

The screenshots below show you how.

For someone who has been dismissed repeatedly as an uncouth, uneducated non-entity Jade Goody has had more influence on the health of the nation in her short lifetime than whole teams of healthcare workers seem able to achieve in their entire careers. Jade Goody: depraved or deprived? But for the grace of God go I ...

Vic

Retrieving evidence on the aetiology of disease

1. Connect to Ovid Medline via MUSE-Library-Subject databases-alphabetical list-O-OvidSP-Connect-Medline 1950-2009 (for the full archive)


2. Select Advanced Ovid search to facilitate MeSH searching, enter the condition and click on search. MeSH (thesaurus) searching is recommended because of the increased recall facilitated by the inclusion of all synonyms.

Are citrus fruits the answer?

Today in Helsinki, medical librarians from all over Europe had the opportunity to consider how we might deal with uncertainties.

Why, for example, did it take 40 years to acknowledge that the issue of lemon juice on ships would be beneficial in the treatment of scurvy?

Uncertanties? Are we all certain about what is uncertain? You know, it is ok to say that we are uncertain about what the effects of a treatment might be. In fact, if there is no systematic review of the evidence on a topic or if the only systematic reviews are inconclusive then we have no choice but to say “we are uncertain”. DUETs (the Database of Uncertainties about the Effects of Treatments) has recently been introduced under the aegis of the James Lind Alliance.

So, if you have a clinical question for which you cannot find an answer from the evidence base, that doesn’t necessarily mean that you are searching incorrectly or that you are asking the wrong question. It may be that your question constitutes an uncertainty and that further research is necessary. Find out about registering your question with DUETS by visiting the website at http://www.duets.nhs.uk .

This may help to get your question onto the research agenda and to ensure that research reflects the questions that appear at the cutting edge of medicine. Influence how research grants are allocated by registering gaps in the evidence base. In doing so you may make a real contribution to improving patient care.

Alison and Vic

Partying and conferencing in Helsinki. Don't tell our Director about the former ;-)

 

Evidence based medicine: a soft option?

Evidence based medicine: a soft option?

On Saturday I went along to Weston Park Museum to visit the Medical Students’ Teddy Bear Hospital.



Green Teddy visits Radiology!

As a medical librarian I was keen to find out if clinical decisions in the teddy bear hospital were being made according to the best evidence!

Take Green Teddy for example, brought in by my 6 year old daughter Annabel who was concerned that his obstinate refusal to go in the washing machine set him at high risk for contracting an infection. Fortunately a thorough consultation was undertaken by Dr Hannah who quickly spotted that poor old Green Ted was also suffering from what appeared to be the early signs of alopecia. She was rightly concerned that washing Green Ted might aggravate his alopecia and that this was perhaps a contraindication in his care.

I spoke to Teddy Hospital organisers, final year medical students, Abi Jones and Emily Lees to find out how their decision making was influenced and if they would use the research available from the Health Sciences Library to influence their decisions!

As Abi quickly pointed out, the evidence base for treating soft toys is very limited and is largely based on the judgement and experience of the teddy bear doctors!
However I was assured that clinical guidelines, systematic reviews and randomized controlled trials would be used to influence their decision making, whenever they were available.

The library might not always be able to help with soft toy medicine but it is here to support evidence based practice in the clinical setting. We can guide you through the hierarchy of evidence to support your clinical practice. Here are some resources that you might use …

The National Library of Guidelines is the index to retrieve all clinical guidelines
www.library.nhs.uk/guidelinesfinder/

The Cochrane Library indexes all systematic reviews
www.thecochranelibrary.co.uk

Ovid Medline is the key resource for searching for randomized controlled trials (retrieving just rcts from Medline can be done using the publication type limit)
Connect via MUSE-Library-Databases

Thank you Abi, Emily and all involved, for organising the Teddy Bear Hospital. My children and their friends had a fantastic time. As for Green Teddy … we have settled on a gentle hand wash :-)


Dr Abi and Dr Emily with a 'patient'