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TripAnswers or Twitter?

Twitter is a microblogging tool that allows us to post 140 charachter-long messages and we do have a huge medical community there so it’s quite easy to ask medical questions and get relevant answers from doctors from around the world.

TripAnswers is a site where clinicians can ask questions.

TRIPanswers is a repository of clinical questions and answers drawn from a wide number of sources around the world and builds on TRIP’s ten years experience of answering clinical questions.  Ultimately, we want to create a resource where clinicians can easily find answers to their question and, who knows, create a clinical Q&A ‘space’ where users can share their own Q&As (it’s always struck us as wasteful that clinicians around the globe answer questions and this effort is never shared!)

tripanswers

Which one would you use to ask questions?

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9 Comments Post a comment
  1. The medicalcommunity might be on Twitter but how do I get them in my network? And if I did have them in my network would they really want to listen to my clinical tweets? Or even more to answer them?

    I like Trip and Attract. But I’m not quite sure that I understand TripAnswers.

    December 8, 2008
  2. @Anne Marie and @Berci

    Indeed, I don’t know how many medical questions are answered via Twitter, but I guess not too many. Even more so I do not know how “well” they are answered. Twitter is very useful for many reasons (exchange of thought, links, new ideas and web 2.0 questions), but in my view it is not a primary source for answering clinical questions.

    Instead of the comparison Twitter-Trip (which alliterates quite well), I would rather compare TRIP, including TRIPanswers, (evidence based database) to opinion based medicine (of which Twitter is one example).

    Anne Marie, I find TRIPanswers very comparable to ATTRACT or Clinical Questions. However TRIPanswers can be browsed, whereas ATTRACT is just one of the databases searched by TRIP. I hope the two will become integrated.

    Although it is a good idea to “share experience” and Q &A, I wonder how and if the quality will be guaranteed. Till now, the cornerstone of TRIP.

    December 8, 2008
  3. @Laika,
    I think your point about evidencebased/expertopinion is very valid. We spent a long time in medicine moving away from expert opinion towards ebm. But 2.0 tools/crowdsourcing seem on the fave of it to be without the rigour to which we have become accustomed. But what about the areas of clinical uncertainty…. and there are lots of them. Is this where crowdsourcing could be really relevant.
    EBM does not help me to manage gout http://wishfulthinkinginmedicaleducation.blogspot.com/2008/12/gout-what-we-dont-know.html
    but the opinions of my colleagues, and patient narratives might.

    December 9, 2008
  4. @Anne Marie, @Laika,

    Thank you for your comments. Just one short note about a practical example how a medical question can be answered on Twitter.

    http://jennifersreport.blogspot.com/2008/12/health-20-makes-it-to-twitter.html

    December 9, 2008
  5. For many questions expertise/knowledge is as good as or better than EBM.

    I would like to stress, however, that EBM is not as strict as many people tend to believe. Evidence need not be proof. Furthermore Evidence (how strong or weak it may be) should ALWAYS be integrated with clinical expertise and patient preferences.

    Indeed the enormous lack of evidence can be very frustrating.

    Still, I do not fully agree with your view on the role of crowdsourcing in case of clinical uncertainty.

    Using your example: “the management of gout”.

    I quickly searched TRIP ;) and found a synthesis in Clinical Evidence (you found as well).

    Clinical Evidence concluded that there is no firm proof that any treatment whatsoever ‘works’. This clinical uncertainty is based on many different trials and Systematic Reviews. The lack of evidence is partly due to the lack of effect and partly to poor quality.

    Thus on basis of the evidence I now know that there is no firm evidence that any treatment works very well. That in itself is helpful information.
    What would crowdsourcing add to this? Would the opinion of Y that X is ‘worth wile’ matter more than several non-positive trials? I don’t think so.

    But if there are no data at all, the opinion of Y might matter more.

    And the preferences of patients always do.

    By the way, (perhaps you ‘ve already seen it), I also found a CKS-(former PRODIGY) guideline on gout (for which you have to register: http://cks.library.nhs.uk/gout/view_whole_topic#-291124) and a guideline of the British Society for Rheumatology (http://rheumatology.oxfordjournals.org/cgi/data/kem056a/DC1/1), which are more practical than Clinical Evidence and state very clear on what evidence the recommendations are based. In the CKS guideline evidence is a separate chapter with links to references (http://cks.library.nhs.uk/gout/view_whole_topic#-292374).

    In contrast to Clinical Evidence these EBM-sources are free to use and to download.

    I’ve also looked at TRIPanswers and athough there are more than 20 Q & A’s, these are very specific. I prefer an evidence based overview.

    December 9, 2008
  6. Interesting point to ponder there — Twitter replies are usually there when you haven’t even lifted your finger from the enter key yet — but how would you get that question around the Twitterverse when, say, your question is tied to some sort of urgency?

    December 10, 2008
  7. I’m not from the medical field but they look to be two different things. Twitter is about the 140 characters, spreading links etc, but its strength lies in its simplicity in this area. Perhaps a mash-up incorporating twitter feeds, delicious bookmarks and a wiki might bring some humanity (ie a real network on people on the other end) to what I *think* TRIP is.

    December 10, 2008
  8. I haven’t heard of TripAnswers before, sounds like an interesting site. I’m a huge fan of Twitter, though.

    December 10, 2008
  9. Wow, I’ve heard about Twitter before, but not about TripAnswers. I checked the site out. It really is nice. Thanks for sharing, now I can ask my clinical questions on there.

    January 4, 2009

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