Giant microbes!

Are you looking for a gift for that special clinician?

Check out Giant Microbes! For the librarians among us there are even bookworms on offer.

NLH Document of the week

Taken from the National Library for Health "Document of the week"

Librarian support decreased the length of hospital stay.

Case control study looking at the effect of librarian support on patient care.
This case-control study found that during residents' morning report, where case discussion was taking place, supported by a librarian-guided, computerized literature search, the length of hospital stay for patients was reduced. The researchers concluded that "Morning report, in association with a computerized literature search guided by the librarians, was an effective means for introducing evidence-based medicine into patient care practices."
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Citation:Decreased hospital length of stay associated with presentation of cases at morning report with librarian supportDE Banks, R Shi, DF Timm, KA Christopher, DC Duggar, M Comegys, J McLartyJournal of the Medical Library Association, 2007, 95(4), pp371-373

I've just printed off & read this article through, using the CASP Critical Appraisal Checklist for Case-Control studies.

The study asked the question of whether a combination of Morning Report + librarian-provided literature search results altered length of stay, hospital charges (it's a US-based study) or readmission rates. Over 8 months, 105 patients were presented at Morning Report, and these were apparently random, as the doctors involved were given no directions over which patients to select. The comparisons were drawn from the hospital register of almost 20,000 patients admitted over the past 5yrs and 7months, and were matched by ICD9 diagnoses, age & secondary diagnoses. The results of the study show that the median length of stay was 2days in those patients presented at Morning Report (p=0.0238). The authors appear to have taken into account issues of selection bias, and the problems with matching all patients.

I've been thinking a bit more about this, and it is hard to tell which aspect of the intervention made the real difference - was it the extra interest from Morning Report, the literature search, or both? And were the cases presented naturally more interesting/complicated cases? If they were more complex conditions that stimulated interest, you'd expect more time to spent on the patient, possibly more diagnostic tests, and interventions. I suppose it all balances out, but it made me think about which clinical questions make it to the Clinical Librarian.

It's a eally interesting study, as we're always looking for ways that CLs make an impact on patient care, and it can be hard to define what it is we do. Often we're using anecdotal evidence to make a case for our necessity, and this article provides the kind of evidence that people should be listening to. What do you think?

Deep web

I have only just got around to sorting out my bag of delights from the EAHIL workshop in Krakow, in September.

One presentation that particularly gripped me was all about Deep Web - the places Google doesn't reach! From this, I found a number of useful sites, some of which I'd heard of before, but none of which I'd made anywhere near enough use of.

Here's a quick rundown:

Images

www.picsearch.com - a database for finding images, seems more useful than Google Image Search

http://friskr.com - ditto the above

Meta search engines

www.dogpile.com - searches across Google, Yahoo, MSN and Ask all at once

http://clusty.com - A clustered search engine - it clusters the results it brings back by categories

www.mamma.com - similar to the above

Health meta search engines

www.medic8.com - can also browse index as well as search this one

www.webmd.com - health search engine

www.mammahealth.com - same stable as Mamma, but health related - seems very good indeed -try out the aspirin search!

Database search engines

www.completeplanet.com - searches for databases on a topic, and has a browse-able index

www.geniusfind.com - another index of databases categorised by topic.

I'll be adding all of these to my favourites & giving them a go in a real life search very soon.

The blogosphere

I've been doing a little bit of handholding with a friend setting up her RSS feeds, and in return, she's been sending me links to some really good resources she's found.

I'll be perusing this list of medical library blogs this afternoon, and will be logging myself in to add this blog!

I'll also be having a look at the wealth of medicine-related RSS feeds on Medworm to see if there's anything I should add to my own feeds. This is a search engine of RSS feeds, so it may be something I add into my protocol for searches on new and emerging clinical techniques. There's also Libworm too!

As I also do a lot of current awareness (is the right term anymore? I have heard it's outmoded) work, I am going to try saving some of my PubMed searches as RSS feeds. I'm told it automatically updates the search everytime you log into your aggregator, which sounds interesting. I can't believe I hadn't investigated it before now - I've really taken my eye off the ball!

How to use web 2.0 in your library by Phil Bradley is a book that's been sitting on my desk unread for months. I need to schedule myself a catch-up on all this new stuff!

New version of TRIP

I'm really quite excited about the new version of TRIP being launched. I use the database for almost every search I do, often as a scoping search, sometimes after having already searched the primary biomedical databases & Cochrane Library.

Here's what John Brassey has been saying on the TRIP blog:

• Much improved search algorithm, more relevant results at the top and less 'noise'.
• 26 specialist search engines. 26 today and more in the near future. These specialist search engines allow users to simultaneously search the core TRIP content plus the top 10-15 journals specific to that area. I see it as a bridge between users having to go from TRIP to the full, difficult to use Medline.
• New content, we've added a load of web 2.0 content, wikis, podcasts and webcasts.
• A trial of linking to UK-approved education. Today the UK but if the trial works we'll introduce education from around the world.
• A new category 'More' to house the new content.
• Ability to arrange results by relevance or by year.
• We've removed the big google ads banner.

There's more, but those are the main improvements.

I think I'll be using TRIP even more in future!