Google irks health librarians

An article published not too recently on HCPlive has irked a few health librarians on LIS-Medical. This excerpt in particular seems designed to rub us the wrong way:

Forget your local medical library and PubMed and use Google Scholar to search for scholarly literature published in the form of peer-reviewed pieces, theses, books, and abstracts from any number of scholarly organizations, including professional societies, universities, and academic publishers.

One librarian has responded to the piece with enthusiasm, suggesting she had become fed up with PubMed. The Krafty Librarian has sounded off about PubMed recently, to say while PubMed had always hidden the controlled vocabulary, the MeSH, it had become even more hidden with the recent revamp. Is this a full-on backlash against PubMed, or a few disgruntled individuals?

I find myself not wanting to agree with the librarians who slated the HCPlive article. I would like to think that the words ‘forget your local medical library’ are indeed fighting words (to light a fire under our sometimes complacent bums). Can our local medical libraries not compete with Google Scholar, seeing as they have must have full access to this free search engine, and many more databases and resources that may not be free or as ‘user friendly’?

I disagree with the librarian who insists that doctors are at danger of ‘wasting their time’ by engaging with new web technologies such as apps. This is downright patronising to doctors-why should they not be allowed to keep up to date on their own, if they want?

He also stated that to miss out the apostrophe in ‘Crohn’s disease’ was a calamity in Google Scholar. No it isn’t-check out the ‘Did you mean’ suggestion at the top of the results. Google is great for spell-checking!

 

 

 

 

 

 

 

 

 

 

 

 

The curse of IE6

So NHS Evidence has been upgraded?  Lets have a look.

The first thing that leaps to the eye (ahem) is that the site is broken in IE6.  Navigation menus are not aligned, the search box has drifted off to the right and the results display is variously squashed or overflowing into the wrong section of the page.  This is something of an issue given that most of the NHS still lives in a retro world of IE6 (Copyright Microsoft 1995-2004).  I am sure it will be resolved soon (and it works fine with Chrome) but testing against IE6 must be an essential for any site deployment aimed at NHS users. 

What about the changes that were actually desired?

The accreditated sources of guidance have started to come on stream and have a slightly stretched mini eye to advertise themselves in the results.  This is visually clear but practically confusing (see the widely distributed quote from the Minister which only adds to the potential confusion).  A search for diabetes reveals lots of accredited source hits – but down at number 25 is Sign Publication No55 Management of Diabetes.  This does not carry the logo even though SIGN is one of the three bodies currently authorised to use it.  Why?  It might be the age of the item (2001) or some other factor.  Certainly it will be confusing to the end user.

A facility to rate results has been added with a Likert scale followed by a free text box for opinions.   You do not have to be logged in with the new My Evidence section to use this so there is no mechanism for feeding back to those who contribute comments in this way.  I wonder how much use this will receive?  It is definitely worth a try as developers and may garner some useful feedback.

The final obvious major change (there may be some subtle ones I have missed) is My Evidence. 

It will be interesting to see the level of take up of this facility (and to consider the levels of usage that the old MyLibrary facility on NLH attracted).  James Robertson in his excellent book “What every Intranet team should know” advances that experience shows only 5-10% of users will make use of personalisation features. 

My Evidence offers a means to save NHS Evidence searches and  set up alerts from those searches.  This seems to work OK.  My test search generated an enormous and unrealistic number of hits for the first week but I guess this might be expected.  My Evidence also offers the ability to save a result which is a welcome addition.  This currently lacks the means to subsequently manage these results (folders, tags etc?) which will be necessary for this function to remain useful as more documents are added.

Less convincing is the My News Feeds feature.  This is a fairly locked down RSS reader.  You can only add feeds from a very limited directory (most categories were empty when I had a look).  When you do add them you have no control over how many entries are displayed or how much content you see initially.  You also cannot save any of the results that are particularly interesting for later reference.  In  many ways it is a more limited version of the similarly unconvincing offer included in MyLibrary on NLH.

You can also add an optional profile.  There is however no justification given at present as to why you would want to.  Perhaps social tools will follow that will make this a more worthwhile feature?

My Evidence use a widget model so it is to be hoped that more options and control will be progressively given to the user.  If the iGoogle model is followed you could create a useful alternative starting point for people.  Hopefully the next iteration of NHS Evidence will see the addition of a HLISD widget that would allow end users to find their closest library or information service. 

The final thing of note is the authentication route.  NHS Evidence have chosen to require a new registration from users.  It is to be hoped that Athens will also be enabled in a future version.  Across the NHS the push is to reduce the number of logins required.  By linking to Athens the route to paid for content could be smoothed.  Athens also links people to organisations and roles which would be a useful way to potentially segment and tailor features on the site.  Not using Athens does have the advantage of allowing anyone to register and is no doubt administratively less burdensome.  One way forward might be the model adopted by BMJLearning where you can link your site login to your Athens login.

Adding NHS Evidence Search to Google Toolbar

For some reason I have held out till now against installing Google Toolbar - more fool me.  It really is very handy.

On starting to play with it I immediately thought – I wish I could use this to launch a search on resource of the moment – NHS Evidence.  And what do you know – you can add new search targets.

Once you have Google Toolbar installed you just go to the search engine you want to add – right click in the search box and select “Generate Custom Search”. 

Well – that is the theory.  In practice my first run at it added a button to my toolbar but all it did was send me to NHS Evidence and add my search terms in the box ready to hit search.  I wasn’t satisfied with that so I bodged about with the code a bit and got this.

<?xml version=”1.0″ encoding=”utf-8″?>
<custombuttons xmlns=”http://toolbar.google.com/custombuttons/“>
  <button>
    <search method=”post” charset=”utf-8″>http://www.evidence.nhs.uk/Search.aspx?t={query}</search>
   
    <title>NHS Evidence</title>
    <description>NHS Evidence</description>
  </button>
</custombuttons>

So once you have added your initial (not quite right) search button – right click on it – select NHS Evidence Button Options – click on advanced – and replace the code with the above and save to the toolbar.

Bingo.  It still isn’t perfect by any means – if you try and do a subsequent search from the box at the top of your results you get sent back to the NHS Evidence home page.  And the icon is just a blob – though as a blue blob it looks a little like the Liquorice Allsort of doom that is the NHS Evidence logo.

I know NHSE are planning to create a smart Google style tool bar but in the mean time this does the job fine.  If they like they could set up a button that works properly (I am sure this would actually be pretty easy) and host an “add this to my Google Toolbar” link.

If anyone can fix my bodge to work better (or hosts an “add this to my Toolbar link” - let me know and I will update this post accordingly.

NHS Evidence; Google without the good bits

Our other Alan wrote a piece a couple of posts ago on, amongst other things, this article in the Nursing Times. Basically it’s a press release for NICE, written by an implementation advisor for said large, powerful organisation. It describes how NHS Evidence will be so very useful for nurses, and I suppose it could be argued that it’s useful because the odd nurse (not literally you understand) may be flicking through the magazine, scan the article, and go and try out a bit of evidence hunting themselves. Surely a happy outcome.

But I fear that our odd nurse will only try out NHS Evidence once, maybe even twice, but probably not a third time. Why? Well, according to an issue of the Eyes on Evidence Newsletter (more PR from NICE) the top five most frequently used search terms were 1) asthma; 2) prostate AND cancer; 3) evidence; 4) flu OR influenza; 5) breastfeeding, so we get an idea of the level of sophistication behind most searches. Let’s try the top one, asthma. 5026 hits, including 516 guidelines and 1627 drug information pieces. You get the general idea. The first ‘guideline’ is  “Guidelines for the prevention, identification and management of occupational asthma: evidence review and recommendations”, a pretty hardcore 88 page PDF of an evidence review, complete with evidence tables, from the British Occupational Health Research Foundation. Not at all helpful, I would’ve thought, to our odd yet eager nurse. If s/he wanted a good review of what to with someone with asthma surely they’d just go to an evidence synthesis product, such as Clinical Evidence, CKS, Dynamed or the Map of Medicine.

The problem is that NHS Evidence’s obsession with Google means that their search engine suffers exactly the same problem as Google (too many hits) but does not have the same saving grace (that the one you really want is at the top). Plus, and this is still really the crux of my problem, I still don’t have a clue who NHS Evidence is meant to be for – neither, I think, do the people behind NHS Evidence. “All things to all people” often ends up as nothing to no-one.

Patients on the Internet – choices choices

I am alerted by Hospital Doctor to an article in the latest issue of Annals of the Royal College of Surgeons of England.  Firstly – what a pleasure it is to see Hospital Doctor revived (all be it as a website only).  Fans of Jerry Nelson in particular will welcome him back.

The article in Annals examines the extent to which use of the Internet by patients tends to increase anxiety.  There are some unsurprising findings – the older the patient the lower the probability they will have used the Internet for example.    Most people (79%) were pleased with the quality of what they found.  26% were left anxious / confused.   Problems with results from Google searches are discussed.  All fairly reasonable stuff.

The proposed solution is interesting – “regulated, comprehensible patient information on hospital websites”.  The Hospital Doctor post points at the pages offered by the RCSE themselves.  Unmentioned is NHS Choices (includes health information previously offered by NHS Direct).   A quick search on that site with the terms proposed by the article returns high quality, NHS approved, patient targeted materials (even a video explaining how a hernia happens and is treated).

So we are getting there – the task is to make sure the patients (and the clinicians) both know where to look.  NHS Choices is the 5th hit on Google for inguinal hernia behind bupa and wikipedia.  While we are all aware that Google believes wikipedia is the answer to most questions (to the point that someone has created a Firefox plugin to search Google sans wikipedia) you have to wonder if the NHS shouldn’t try and out SEO Bupa.

NHS Evidence promotion – what is missing?

As part of a pattern of missed opportunity comes the latest article promoting NHS Evidence.

The notes from the NHS Evidence update to the latest NICE Board show we can expect lots more of this kind of thing over the coming months with articles to be placed in publications and a wide presence at conferences (including the three major UK political party conferences). 

The article itself is positive about NHS Evidence as you might expect.  Some would suggest that it reads a little too like a press release to be entirely comfortably presented as “Double-blind peer reviewed”.    It is interesting to put the satisfaction of the author in contrast to the recent post here.  It is a little strange to read trailers for features that are not yet present on the site.

An earlier article in E-health-insider provoked several frank comments and, ultimately, a reply from Dr Leng (NHS Evidence COO).  The Nursing Times article is certainly a step forward on that one in the accuracy stakes.

So what is missing from NHS Evidence promotion (and this latest article)?  The answer is of course recognition that NHS Evidence users are not alone in facing the challenge of finding the information they need.  No mention of the network of skilled professionals who help those NHS staff on a daily basis.   The L word is not to be uttered. 

There is some progress – the latest issue of Eyes on Evidence (NHS Newsletter number 5) does recognise that a librarian might be a good person to ask for help (in response to a request for someone to do a search for them).  But fails to make the link to any of the ways people might find that librarian.  This is a step forward on a previous issue which answered the FAQ – How do I search for journal articles?  Answer – this is how to sign up for Athens.  Not really what they asked and a question crying out for the L word answer. 

I hope NHS Evidence will soon overcome this seeming aversion to placing itself in the context of the wider NHS knowledge environment.  It is to the disadvantage of the people it seeks to help if it does not.

NHS Evidence (boo) vs Guidelines Finder (hurrah)

I haven’t really got into NHS Evidence yet, so maybe I’m missing something, but it all seems something of nightmare.

I want to look for guidelines, as you do, if you’re a medical informationy whatnot thingy. Let’s say I was looking for lower back pain and related conditions. The search “Low back or lower back or spinal pain or back ache or backache or Spondylolisthesis or scoliosis or Sciatica or “Spinal stenosis” or Lumbago” gave 1320 ‘guidelines’ (i.e. using the Guidelines filter) in NHS Evidence, 208 of which are apparently from NICE. This is silly. There’s no way that there are 1320 guidelines out there, or 208 NICE guidelines. In fact, when I look through a few of the results many of the hits were duplicates or ‘empty’ references. Do I really want to spend my time going though 1320 hits for a handful of useful guidelines. No, is the answer to that.

Now then, if I searched with the same terms in the good old fashioned Guidelines Finder (now a ’specialist collection’), I get 47 hits. Forty seven useful and relevant (for the most part) hits, something I can quickly browse though and extract the few guidelines I actually want. Perfect. Does the job.

Therefore Guidelines Finder, at least for this common situation, is better than NHS Evidence. Much better. But Guidelines Finder might be under threat from the monster that is NHS Evidence. On the front page of Guidelines Finder they write: This collection is now NHS Evidence – national library of guidelines, and you will continue to be able to access all the content and features. The existing url for the collection will remain for now, but is likely to change later in the year as the specialist collections become fully integrated into the NHS Evidence portal. “Fully integrated” – sounds scary.

Now I know that NHS Evidence and the specialist collections are fundamentally different technologies, and both may have their uses, but in the age of information overload the collections rule – don’t you think? A request to NICE – please keep the specialist collections.

Two way search

Dave Winer, the father of RSS, writes about getting the data flowing both ways.  Or, at least the potential for this, by having search engines use his blog to make results more relevant. And less random. He figures it won’t be sinister as he only reveals general stuff about himself on his blog-what city he calls home, and many other details that will help disambiguate his search query (his example: differentiating firmware driver from car driver).

He likes this idea so much that he bought the domain www.twowaysearch.com!

By the way, the tidbit above was found by going to TwitterFox (which makes Twitter much more accessible in an optional popup,  in my opinion, as it is never the main event), looking at a Guardian Tech tweet, going to a link in their article, and then finding the two way search in Jeff Jarvis’s Twitter feed on his blog here. Jeff’s blog is righteous as well-he has written a post linking to the MistakeBank, a ning site where people share and try to learn from their mistakes.

fefoo – not another search engine

I’m not sure why it’s called fefoo, but it’s quite a nice little tool. It’s not another search engine. Rather, it’s a tool through which you can search a whole range of different search engines – Google, Bing, Yahoo, of course, but also many of those funny little ones you’ve never heard of, like Viewzi (fun graphical interface), Spezify (yet more fun graphical interfaces) and LexxeAlpha (no fun graphical interfaces, but rather powered by “advanced natural language technology”, though still returns Wikipedia first).  The search pages give a little tool bar at the top that allows you quickly to try your search in another search engine. You can also look for blogs, images, torrents, people, movies etc. It’s all quite useful, to tell the truth. And finally, if you’re truly hardcore, rather than specifying in the drop down menus that you want to search Yahoo, say, you can use command line searches, in this case, for a search on ‘Tom Baker’, “:yahoo Tom Baker”, though unfortunately it does not seem that you can combine command lines searches, e.g. “:yahoo :images Tom Baker” for, you guessed it, images of Tom Baker. Oh well. It’s a nice little tool nonetheless, and helps ensure you venture beyond just Google from time to time.

‘We call it NHS Evidence provided by NICE’

Gillian Leng has spoken! In an HSJ article published yesterday (p. 16-17), Leng discussed NHS Evidence’s similarities with Google-but only as far as how easy it is to use. Of course, NHS Evidence is of superior quality and relevance to the clinician.  A user review following the article suggested that there is still some work to be done in making sure links are functioning. The reviewer asks the question: will “resources that have not been throught the [accreditation] process be dropped over time or not promoted?”

With regards to accredited resources, Leng expects a 30% success rate. A couple of potential flaws of this system are that not all good evidence will be covered by the ‘marque’ system (as not every organisation is gagging to apply) and of course, the one pointed out earlier- what becomes of the second tier evidence? The age old problem of ignoring lesser sources if there is no ‘gold standard’ evidence rears its hoary head again. You just can’t do this. You will leave health care practitioners with myriad information gaps. If there is a role for DUETs, as I believe there is, they must actually seek to answer these unanswered questions rather than omitting uncertainties in order to look authoritative. Will DUETs be accredited also?

Another information tidbit offered up by the article was that ‘Release 2′ of NHS Evidence is scheduled for October. It will include customisation functionality, in the tradition of iGoogle, for the homepage of this resource.

And, might I suggest, some sort of organised, reliable and valid qualitative research into what people make of NHS Evidence? If I may speak plainly, I find the invitation to Conduct a specialised search (along the top menu) unnerving (and I am trained to do this!) and off-putting. Hopefully others’ experiences differ.