The New PubMed: Trick or Treat?

The New PubMed: Trick or Treat?

After a long days work, when looking at the screen,

there it was: PubMed’s new interface, so it seemed,

But one blink – and it had gone…

To come back the following dawn.

The change itself was long announced,

we could play with the new “Advanced”.

Still I postponed and procrastinated,

Pointless: the new PubMed couldn’t wait

any longer, but this Redesign isn’t it for me….

Sure, the front page looks web-2-ish, minimalistic & clean,

which is perfect for the Google-Generation,

the hurry-don’t think-just-slash-i-got-one-publication-

PhD’s, for whom all alterations have been made.

Some people think you just have to wait

& see and get used to it.

but I’m already fed up with it.

I know you all think it is just a Librarian-rant.

Librarians they can stick with the new “Advanced”,

“Advanced” however, is just Limits & Index…

But boy did they make this page look complex!

Sure, the basic researchers seem to be quite pleased.

Busy physicians too, they think it is more easy.

They tell me librarian not to wine:

“Go MEDLINE OVID! we stay with this design.”

This is no new idea, didn’t you know:

I long seek refuge in OVID MEDLINE, although

only for exhaustive searches, that much is true.

So why -having this alternative- am I still feeling blue?

Well, I’m not complaining for myself, but for you.

I don’t speak as a searcher, but as a teacher too.

It is so frustrating that I have to explain to you

that each step you take is now multiplied by two.

NLM says all functionalities are still there.

The problem is you have to find where…

I don’t mind the present front page,

but the so called “Advanced” gives no advantage,

at least not for doctors searching evidence.

I teach them “Googling doesn’t make sense“.

Just choose the most important concepts,

work from the History and search words separately.

Begin to find the MesH-terms, and although it is complex

add textwords too, to find papers not yet indexed.

Combine synonyms with “OR” and concepts with “AND”,

Go to the Clinical Queries and use the appropriate command”..

But now it takes so many steps. It is a BIG FAIL

sometimes. You start at the front page, look at the Details,

mapping is wrong, go to Advanced, scroll, scroll, scroll..

to Mesh, “send to Pubmed”, where am I? out of control,

again on the Start page? Go to Advanced again.

Away with Limit and other boxes! – I don’t need them!

The Index yields a MeSH that doesn’t exist?!

Darn, via automatic mapping the multi-term-word is split

in 3 separate words, complete out of context,

as I see In the Details -so I have to re-enter them,

And where have the Clinical Queries gone?

Right, have to scroll the entire “Advanced” page… Yawn…

While it is true that I’m a “bit” exagerating,

my point is that the new PubMed creation

could have been so much better:

not only the functionality, the route also matters.

The redesign is a missed opportunity,

to build an entire new PubMed you see.

The interface is still quite orthodox.

I want clickable and movable boxes

with MESH in clouds thru which you can “walk”

and Clinical Queries that you can drag and drop

with a mapping tool-you can adjust,***

and savings of your settings, that is  a must.

“But the new PubMed”, you ask me

“what is it: a-trick-or-a-treat?”….

“It looks like a nicely wrapped candy,

but tasting a bit bittersweet?!”

Notes

* These links come from Eagle Dawg-blog: Pubmed: All in the attitude

** doesn’t apply to quick and dirty searches on the front page

*** i.e. allow to split or not

Photo Credits:

• Trick or Treat: (Flickr CC) catchesthelight/2989360212/
• Hand & candy: (Flickr CC) ncollett/1810987271/
• Bittersweet: Flickr (CC) deliciousmonster/2946761628/

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De Ivoren Toren van Thomése

By way of exception I write a Dutch blog post to respond to an article in a Dutch Newspaper ridiculing speakers, writers, chatting and twittering people in a long-winded (3 pages) pompous, “literary” way, saying that they are terrorizing dictators. Although the writer, Thomése, might be right in some respects (all people  want to express their opinion, want to be heard, but nobody listens), his critique just hits the topic superficially. By doing so, the article adds to the already existing misunderstandings regarding social media. I finish my review by expressing the wish that Thomése mastered the art of Tweeting: be social, clear and comprehensive in 140 characters.

Image by PjotrP via Flickr

Bij uitzondering een Nederlands stukje op dit blog. Ik schrijf meestal alleen over medische-wetenschappelijke zaken -in het Engels-, maar in dit geval kon ik het niet laten. Ik kreeg namelijk een aanval van acute, persisterende jeuk toen ik het stuk van Thomése in Het NRC Handelsblad van afgelopen weekend las. Een blog bericht van Jeroen Mirck (“P.F. Thomése is een kleine dictator”) kon mijn jeuk slechts enigzins verlichten.

Het stuk van Thomése in de Opinie & Debat bijlage, heeft als kop: Sprekers, schrijvers, bellers, sms’ers, chatteraars, twitteraars: allemaal kleine dictators. Eerst vallen je ogen op chatteraars en twitteraars (oh het is weer zo’n trendy anti-Twitter story op zijn Volkskrants [1]), maar dan zie je ’sprekers, schrijvers en bellers’ staan en je vraagt je af: “wie blijft er over”?

Het vervelende van dit stuk is dat het dermate ‘literair’ (en quasi-intelligent [1]) is dat je eerst twee-en-een-halve krantenpagina door proza heen moet worstelen voordat er uberhaupt iets over deze groep “Sprekers, schrijvers, bellers, sms’ers, chatteraars, twitteraars” gezegd wordt.

Thomése wijdt ettelijke kolommen aan de introductie, een klassiek verhaal van Sartre (Erostrate uit le Mur), wat kennelijk nodig is om later zijn “kritiek in beeldspraak” te vervatten. Dit -op zich prachtige verhaal [2]- komt erop neer dat de hoofdpersoon, Paul Hilbert, gewoon is van bovenaf (de zesde etage) “neer te kijken” op mensen als waren het mieren. Hierdoor abstraheert hij mensen, ze ontmenselijken. In gedachten doodt hij willekeurige mensen -ja iedereen zou wel eens bepaalde mensen neer willen knallen, inclusief Thomése-. Wanneer Hilbert dit daadwerkelijk doet daalt hij (ook letterlijk) af naar een lager niveau en verliest hij daarbij zijn uitzonderingpositie. Hij wordt mier onder de mieren en wordt vanwege zijn daad opgejaagd tot aan het nederige toilet.

Thomése ziet in elke hedendaagse multimediale burger een Paul Hilbert, die met een killersblik op zijn eigen zesde verdieping “de gebeurtenissen op de voet volgt, zappend en surfend, alles en iedereen verwijderend uit zijn bewustzijn.”

“Er zijn te veel sprekers, te veel schrijvers, te veel bellers, sms’ers, chatters, twitteraars, allemaal kleine dictators, en allemaal willen ze laten weten – wat eigenlijk? Dat ze bestaan, om te beginnen. Hallo met mij even en dan komt het. Te veel mensen laten ongevraagd weten wat ze doen, wat ze willen en zullen (….) Maar waar zijn de lezers, de kijkers, de luisteraars? Wie moet dat allemaal aanhoren, aanschouwen, ondergaan? Zonder luisteraars kan er ook geen onderscheid meer worden gemaakt, is alles even belangrijk geworden. Er is niemand die nog tegenspreekt.”

De voorbeelden die Thomése geeft lijken vooral quotes uit discussielijsten of tweets. Het is een lukrake verzameling van uitspraken als:

“Ik mag hem wel die Scheringa”.
“Ik vind het een glibber”
Einde discussie.

Nietzeggend, inderdaad. Maar om dit nou een terroristisch-dictatoriale uitspraak te noemen die -in het openbaar gangbaar is geworden… pfff.

Een mening over iets hebben en in het openbaar ventileren is iets van alle tijden. De kruidenier van weleer ventileerde ook ongevraagd zijn mening over de heren politici, de economie of anders wel het weer. En iedere klant had ook weer zijn mening. Dat veel mensen niet de kunst verstaan te luisteren is ook niet uniek voor deze tijd.

Aan de andere kant zijn tijden zijn inderdaad veranderd: het is jachtiger, vluchtiger, consumptiever en platter geworden. Maar dat komt niet persé dóór het gebruik van multimedia.

De vergelijking van het multimediale plebs met de terroristische dictator die van 6 hoog alles oplegt loopt eigenlijk mank. Dictator ben je alleen als je mensen tot luisteren kunt dwingen en als anderen daar dus niet aan kunnen ontkomen. Luidruchtige mobiele gesprekken in de tram en stalkende schrijvers zijn uitzonderingen die deze regel bevestigen. Al zijn bellen en praten toch tamelijk pre-21ste eeuw.

Reacties op krantenartikelen, berichten, lijsten en blogs zijn wellicht vaak ontzettend eenzijdig en van een hoog wat-ben-ik-toch-origineel-en-leuk gehalte, maar het mooie is dat je het niet hoeft te lezen. Als multimediale burger (zender en ontvanger) ben je geheel vrij hierin.

En dat geldt zeker voor een nieuwe tool als Twitter. Zoals ik in een recente workshop aangaf: “Twitter is wat je er zelf van maakt.”

Doorzoek je Twitter real life op “Scheringa” of “H1N1″ dan zie je een woud aan allemaal losstaande meningen en uitspraken, meestal erg flauw of gewoon onzin. Ik doorzoek Twitter vrijwel nooit op te algemene termen en zeker niet op “trending topics”.

Veel mensen komen, net als Thomese niet verder dan deze verrekijker-visie op Twitter. Sommigen dalen even af, twitteren wat en zijn dan enorm teleurgesteld: niemand reageert. Wat ze niet begrijpen is dat Twitter een SOCIAAL MEDIUM is. Je moet een netwerk opbouwen van twitteraars die jij  interessant vindt en je moet zelf ook interessant genoeg zijn voor anderen om je te volgen. Althans als je zelf ook gehoord wilt worden.

Twitter kent nauwelijks hierarchie, er zijn geen dictators, dat werkt niet. Om beurten is iedereen schrijver en iedereen publiek, maar zo dat er een wisselwerking is. Ideaal gesproken, niet iedereen verstaat die kunst. [3]

Degene die ik volg zijn mijn menselijk filter voor ruis. Twittert iemand van de mensen die ik volg over ‘Scheringa’ of ‘H1N1′, dan is dat in de meeste gevallen waar, interessant of grappig.

Ik ontken niet dat er niet-luisterende leuteraars zijn. De kunst is om mensen te vinden die je wel boeien. Op dezelfde wijze als dat je vrienden maakt: het moet klikken. Het is allemaal eigen keus, zeker in de nieuwe (sociale) media.

Wat ik mis in Thomése’s stuk is de nuance, het is typisch de blik van iemand op de Eiffeltoren die naar beneden kijkt en enkel mieren ontwaart. Van bovenaf lijkt dat een hopeloos gewirwar en is iedereen eender.

In zijn stuk haalt Thomése Herostratus aan, de provocateur uit de klassieke oudheid die dacht: “ik kan misschien geen tempel bouwen, maar ik kan er wel een in brand steken”. Ik kan niet nalaten een vergelijking te trekken met Thomése, die wel in een ivoren toren woont en uitkijkt over de massa, die sociale media als Twitter niet doorgondt noch beheerst, maar het wel weet af te branden. Helaas verstaat hij niet de kunst dat op zijn Twitters te doen. In 140 leestekens….

1. Bron: http://www.jeroenmirck.nl/2009/10/pf-thomese-is-een-kleine-dictator/
2. Begin jaren 70 behoorden Simone de Beauvoir en Sartre tot mijn favoriete schrijvers.
3. Het is voor mij mogelijk wel wat makkelijker omdat mijn aanwezigheid op Twitter vooral werkgerelateerd is.

Silly Sunday #9: the Apocalypse of the Vocal Bubblewrap.

Tuesday Grand Rounds will be hosted by Gina Rybolt of Code Blog (see announcement).

O dear, a few hours left before the deadline expires …. What to do?

I could submit the post on BlogWorld Expo [SOTB], where I embedded an interview with Gina and Kim.

However, because it is almost Haloween, Gina is all for the super-scary!

What about the Attack of the Flu-Virus Invaders. Pretty Scary if viewed under magnification.

Or what about the next video. I could barely watch it. It is not medical, but it sure looks like eyeballs. Moohaha!

You know, we let Gina choose.

Hattip: @2525 (Francisco van Jole). This is what he said: “De bolletjes van bubblewrap laten knallen? Na het zien van deze gruwelijke film nooit meer”. And I agree, after seeing this *horror film* I will never ever pop a bubble wrap again (2x)

This post is tagged as Friday Foolery post (#9)

How a Flu-Virus Invades your Body: An Animation

I’ve seen “viral invasion, replication and spread” more elaborately and scientifically explained, but nothing comes near a clear visual and audible presentation of what happens on a micro-scale.

Here is a video on a Flu Attack that stirs the imagination.

And one thing or another, those kind of videos get really viral on Twitter and blogs as well.

When seeing the video you at least understand why CDC’s motto is: Cover it!

Although the above video has the tags “swine” and “flu” and alludes to H1N1, it gives no specific information on H1N1 (Swine flu), but could be about any influenza virus. For information on H1N1 go to:

• the CDC H1N1 page: http://www.cdc.gov/h1n1flu/
• Flu.gov: http://www.flu.gov/
• Medline Plus: H1N1/Swineflu
• Highlight Health for some specific articles on H1N1
• Informatie van de Rijksoverheid over Nieuwe Influenza A (H1N1): http://www.grieppandemie.nl/
• An up to date map tracking the progress of H1N1 swine flu at: http://flutracker.rhizalabs.com/

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• “Swine Flu A “National Emergency”?” and related posts (ibloga.blogspot.com)

BlogWorld Expo [SOTB]: Two Additional Videos

Today I learned there were two more videos realted to the BlogWorld Expo, that I shouldn’t withhold you.

First, the ABC News Covered the Medblogger Track At Blog World Expo. Here is an interview with Dr. Val Jones with Dave Lucas of ABC.

The video “Medical Bloggers On ABC News: Empowering Patients With Accurate Information” is summarized as follows at her blog Get Better Health:

….”Dave Lucas is tired of all the false health information that fills his email inbox each day. He’s very relieved that there are physicians, nurses, and patient advocates “swimming against the tide” of pseudoscience and misleading health information online. Today Dave and I discussed how people can find accurate and potentially life-saving health information through peer-reviewed medical blogs, thanks to the health blogger code of ethics (administered by MedPage Today)”.

Another interview was with Paul Levy, President and CEO of Beth Israel Deaconess Medical Center in Boston, and author of Running a Hospital. Paul participated in a panel discussion as part of the Medblogger Track (co-sponsored by Johnson & Johnson and MedPage Today). Because the video is barely audible, I just mention his main statements (highlighted in red in the video shown here at the JNJ Health Channel):

• Paul writes his blogposts without any prior permission or approval process
• It is quicker to fix a mistake on a blog, than it is in traditional media
• Biggest regret is responding to sarcastic or hostile comments in kind instead of staying above the fray

Medical Bloggers On ABC News: Empowering Patients With Accurate Information

BlogWorld Expo [SOTB] & The Status of the Medical Blogosphere

During my stay in Singapore from October 9th-16th there were 2 other great events, one of them  being the Blogworld Expo, the  World largest Conference on Blogging in the Las Vegas Convention Center. As a matter of fact, I would never have the opportunity to go to such a place, because I’m blogging in my spare time and although it has many spin-offs for my work, I would never have the resources and the time to go there. So, it was with a little jealousy and envy that I followed all those cheerful tweets from my colleague medbloggers. They apparently had a lot to talk about, -also outside the context of the meeting. I even understood that Bongi came all the way from South Africa.  And I can’t say the video below eases the pain :

more about “Scenes from Blog World Expo 2009 and …“, posted with vodpod

Image of Kim McAllister

It was the first time during the Blogworld Expo there was a medblogging-track. Thanks to the effort of Kim McAllister of Emergiblog. She posted a kind of a *rant* that there was nothing for medbloggers at two events. Seeing this, one organizer of Blogworld Expo commented: we have a place for you if you want to come. Johnson & Johnson were willing to sponsor, and MedPage Today offered an additional sponsorship. Below is an interview with Kim as well as with another well known blogging nurse, Gina Rybolt of Codeblog. In this interview “the conversation turns to why they blog, how they manage to do it without compromising their patient’s privacy and how they wish marketers and pharma brands would approach them.”

Rohit Bhargava who interviewed both nurses also interviewed the famous medical blogger Kevin Pho of KevinMD about why he blogs, what results he has seen and the future of the medical blogosphere the future of Medical Blogging. He makes clear why it is important for doctors to blog. However, there is one major obstacle for busy physicians, namely: TIME!

Want more information an/or pictures on the medblog-part of the conference, please see:

• KevinMD : Scenes from Blog World Expo 2009 and the future of medical social media.
• Kim of Emergiblog: Many posts, i.e. BlogWorld/New Media Expo – The Exhibited, The Uninhibited! and One For the Medblogger History Books and Baby Got Back….to Blogging! and Post Blog World Post
• Doctor Anonymous, BlogWorld 09: HIPAA & Blogging
• Rob Lamberts (Musings of a Distractible Mind), Medical Bloggers Frolicking at Blogworld
• Ramona Bates (Sututre for a Living), BlogWorld Expo 2009
• Paul Levy, Going virtual @ BlogWorld
• Bongi (Other-things-amanzi) Fabulous Las Vegas
• Kerri (sixuntilme): BlogWorldExpo: Medical Bloggers Make Their Debut.

The opening keynote of the Blogworld Expo was delivered by Richard Jalichandra, CEO of Technorati, showing some highlights from their annual study following the growth and trends in the annual State of the Blogosphere. The report was released over five days. (See Techcruch for presentation and short explanation ; the entire report is available at Technorati)

What I found most interesting:

• In Social Media the content is the conversation.
• There is a rising class of “professional” bloggers.
• But still Hobbyists represent 76% of all bloggers
  (I have some problems with the division in ‘professional bloggers’ and ‘hobbyist’ though, since professional bloggers are those regarded as “earning some money” and hobbyists are regarded as those that don’t. I think there should at least be 3 main groups: those blogging as a profession (earn money), those blogging as an expert (mostly) in their free time (professionally) and those writing about their hobbies, children etc (hobbyists).
• The hobbyists blog for fun and to express themselves
• 15% is part time professional, they blog to supplement their income and to share their expertise
• 9% is self-employed, 4% is corporate (see Figure below)
• Of the professional bloggers 2 thirds are male, 16% are 18-44, are more effluent and educated than the general population and the hobbyist bloggers (hmmm that also pleads against medbloggers not belonging to this group)
• 73% of all bloggers use Twitter vs 14% of the general population (but nr 1 reason is to promote their blog)
• 26% of bloggers who also use Twitter say that the service has eaten into the time they spend updating their traditional blogs – though 65% say it has had no effect.
• on average only .83% of the page views come from Twitter referrals.
• Advise to succeed: be passionate.
• Bloggers believe that politics (57%) and technology/business (44%-20%) are among the fields most impacted by the blogosphere, and that they will continue to be transformed by the blogosphere going forward. Health was only mentioned by 5%.

I wonder where/whether Science/Health/Medbloggers fit in? Are they underrepresented in the study? Or do they belong to a minority anyway? See here a discussion on Twitter (catched with QuoteURL)

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Friday Foolery #8: Dynamic LAIKA Sputnik and Pandora’s box

@fackeldeyfinds on Twitter alerted me to the following video saying: “This one is for you”.

more about “LAIKA on Vimeo“, posted with vodpod

Indeed the video is about Laika Sputnik, but not about me, nor Laika the dog, but about a dynamic font “that can seamlessly use the whole spectrum of its cuts. A font that is able to move between its extremes in real time. An interactive font that is able to respond to its surroundings.”

Apparently Laika has been developed by two Swiss men, Michael Flückiger und Nicolas Kunz, for their bachelor thesis at the Hochschule der Künste Bern.

You can read more on their website http://laikafont.ch/ (see here for English version).

On that website you can also dynamically interact with Laika by moving your mouse (see test-page).

More fun with fonts and letters by Michael Flückiger: “Details Pandoras Box” and Typocraphic Spiderweb. The last is really spectacular.

more about “Details Pandoras Box on Vimeo“, posted with vodpod

more about “Typocraphic Spiderweb on Vimeo“, posted with vodpod

#Cochrane Colloquium 2009: Better Working Relationship between Cochrane and Guideline Developers

Last week I attended the annual Cochrane Colloquium in Singapore. I will summarize some of the meetings.

Here is a summary of an interesting (parallel) special session: Creating a closer working relationship between Cochrane and Guideline Developers. This session was brought together as a partnership between the Guidelines International Network (G-I-N) and The Cochrane Collaboration to look at the current experience of guideline developers and their use of Cochrane reviews (see abstract).

Emma Tavender of the EPOC Australian Satellite, Australia reported on the survey carried out by the UK Cochrane Centre to identify the use of Cochrane reviews in guidelines produced in the UK ) (not attended this presentation) .

Pwee Keng Ho, Ministry of Health, Singapore, is leading the Health Technology Assessment (HTA) and guideline development program of the Singapore Ministry of Health. He spoke about the issues faced as a guideline developer using Cochrane reviews or -in his own words- his task was: “to summarize whether guideline developers like Cochrane Systematic reviews or not” .

Keng Ho presented the results of 3 surveys of different guideline developers. Most surveys had very few respondents: 12-29 if I remember it well.

Each survey had approximately the same questions, but in a different order. On the face of it, the 3 surveys gave the same picture.

Main points:

• some guideline developers are not familiar with Cochrane Systematic Reviews
• others have no access to it.
• of those who are familiar with the Cochrane Reviews and do have access to it, most found the Cochrane reviews useful and reliable. (in one survey half of the respondents were neutral)
• most importantly they actually did use the Cochrane reviews for most of their guidelines.
• these guideline developers also used the Cochrane methodology to make their guidelines (whereas most physicians are not inclined to use the exhaustive search strategies and systematic approach of the Cochrane Collaboration)
• An often heard critique of Guideline developers concerned the non-comprehensive coverage of topics by Cochrane Reviews. However, unlike in Western countries, the Singapore minister of Health mentioned acupuncture and herbs as missing topics (for certain diseases).

This incomplete coverage caused by a not-demand driven choice of subjects was a recurrent topic at this meeting and a main issue recognized by the entire Cochrane Community. Therefore priority setting of Cochrane Systematic reviews is one of the main topics addressed at this Colloquium and in the Cochrane Strategic review.

Kay Dickersin of the US Cochrane Center, USA, reported on the issues raised at the stakeholders meeting held in June 2009 in the US (see here for agenda) on whether systematic reviews can effectively inform guideline development, with a particular focus on areas of controversy and debate.

The Stakeholder summit concentrated on using quality SR’s for guidelines. This is different from effectiveness research, for which the Institute of Medicine (IOM) sets the standards: local and specialist guidelines require a different expertise and approach.

All kinds of people are involved in the development of guidelines, i.e. nurses, consumers, physicians.
Important issues to address, point by point:

• Some may not understand the need to be systematic
• How to get physicians on board: they are not very comfortable with extensive searching and systematic work
• Ongoing education, like how-to workshops, is essential
• What to do if there is no evidence?
• More transparency; handling conflicts of interest
• Guidelines differ, including the rating of the evidence. Almost everyone in the Stakeholders meeting used GRADE to grade the evidence, but not as it was originally described. There were numerous variations on the same theme. One question is whether there should be one system or not.
• Another -recurrent- issue was that Guidelines should be made actionable.

Here are podcasts covering the meeting

Gordon Guyatt, McMaster University, Canada, gave  an outline of the GRADE approach and the purpose of ‘Summary of Findings’ tables, and how both are perceived by Cochrane review authors and guideline developers.

Gordon Guyatt, whose magnificent book ” Users’ Guide to the Medical Literature”  (JAMA-Evidence) lies at my desk, was clearly in favor of adherence to the original Grade-guidelines. Forty organizations have adopted these Grade Guidelines.

Grade stands for “Grading of Recommendations Assessment, Development and Evaluation”  system. It is used for grading evidence when submitting a clinical guidelines article. Six articles in the BMJ are specifically devoted to GRADE (see here for one (full text); and 2 (PubMed)). GRADE not only takes the rigor of the methods  into account, but also the balance between the benefits and the risks, burdens, and costs.

Suppose  a guideline would recommend  to use thrombolysis to treat disease X, because a good quality small RCTs show thrombolysis to be slightly but significantly more effective than heparin in this disease. However by relying on only direct evidence from the RCT’s it isn’t taken into account that observational studies have long shown that thrombolysis enhances the risk of massive bleeding in diseases Y and Z. Clearly the risk of harm is the same in disease X: both benefits and harms should be weighted.
Guyatt gave several other examples illustrating the importance of grading the evidence and the understandable overview presented in the Summary of Findings Table.

Another issue is that guideline makers are distressingly ready to embrace surrogate endpoints instead of outcomes that are more relevant to the patient. For instance it is not very meaningful if angiographic outcomes are improved, but mortality or the recurrence of cardiovascular disease are not.
GRADE takes into account if indirect evidence is used: It downgrades the evidence rating.  Downgrading also occurs in case of low quality RCT’s or the non-trade off of benefits versus harms.

Guyatt pleaded for uniform use of GRADE, and advised everybody to get comfortable with it.

Although I must say that it can feel somewhat uncomfortable to give absolute rates to non-absolute differences. These are really man-made formulas, people agreed upon. On the other hand it is a good thing that it is not only the outcome of the RCT’s with respect to benefits (of sometimes surrogate markers) that count.

A final remark of Guyatt: ” Everybody makes the claim they are following evidence based approach, but you have to learn them what that really means.”
Indeed, many people talk about their findings and/or recommendations being evidence based, because “EBM sells well”, but upon closer examination many reports are hardly worth the name.

A Spooktacular Medlibs Round at Alisha764’s blog

While I was attending the Cochrane Colloquium, Alisha Miles of Alisha’s blog wrote a really spectacular spooktacular Medlib’s Round, the blog carnival of *best* posts in the medical library blogosphere.

The official round comes with a whole bunch of bonus posts. Subjects included range from wikis to toolbar widgets, from unprofessional online content by medical students to H1N1-information, from the MidWest Medical Library Conference to social media (Side Wiki, Google Wave etc). As expected there are also many posts about the PubMed Redesign.

Interested? Please take a look at the spooktacular Medlibs Round here.

It is really incredible that so many posts were submitted in just 2 weeks and Alisha managed to include so many more.

Other good news about the round: we’ve got excellent hosts till April 2010! Really all sorts of *TOP* bloggers: (medical) librarians, a scientist, a physician and a Pubmed-3rd party host:

• Submission: ¤ 10 Nov-2009: Highlight Health
• Submission:  ¤ 05-Dec-2009: Knowledge beyond words
• Submission: ¤ 02-Jan-2010: Dr Shock MD PhD
• Submission: ¤ 06-Feb-2010: Emerging Technologies Librarian
• Submission: ¤ 09-Mar-2010: The Krafty Librarian
• Submission: ¤ 03-Apr-2010: Eagle Dawg Blog

If you would like a host the MedLib’s Round please comment on this post, dm me at twitter or mail me at :

The submission for each round is due the first Saturday of each month. The next round will already be published in about three weeks. Walter Jessen of Highlight Health looks forward to your posts. The main theme of the round will be:

Finding credible health information online

Other blogposts -if relevant to the MedLibs Round- will also be considered.

Submitting is easy (thanks Patricia Anderson):

1. Write (a) blogpost(s) on your blog (or write a guest post on someone else’s blog) as usual.
   
2. Pick the post you like that fits.
   
3. Go to the blogcarnival submission from here, (register or log in),
4. Fill in form to share the permalink of your post.
   
5. The current host selects anthology of best submissions.
   

Friday Foolery #7 Play Doh World, the Safe and Unexpected

Seen at the Loom of Carl Zimmer: using Play Doh, Sophia Tintori and Cassandra Extavour talk about multicellularity and the specialization of reproductive cells.

The video, made by the evolutionary biologist Casey Dunn, is from Creature Cast, a collaborative blog produced by members of the Dunn Lab at Brown University. The Dunn Lab investigates how evolution has produced a diversity of life. On this newly evoluted “Creature Cast” you can find short, original and  good quality posts on zoology in the broad sense often with beautiful photos or videos. You can now subscribe to the CreatureCast video podcast through Brown University at  iTunes U.

more about “CreatureCast Episode 2 on Vimeo“, posted with vodpod

Work provided under a Creative Commons Attribution-Noncommercial-Share Alike license.

Another example of a great post on Creature Cast is the Tale of two holes about why some animals have one hole and others two. Does the single hole in one-holed animals correspond to the mouth or anus of animals with two holes?  Apparently the same sets of genes appear in many different contexts within and across species. In this case there are two distinct modules for mouth and blastopore (the first hole developed in animals during their development) and they can be decoupled. Again there is a terrific photo made by Dunn showing a sea anemone with a single hole for eating, excreting, and shedding eggs and sperm, and an annelid worm with two holes.

This is a Friday Foolery post, thus permit me to show me something completely different: a successful Play-Doh ad-campaign started in Singapore (what a coincidence, the city I left 26 h ago). These ads talk to parents directly, reminding them about the thousand of possible things you can make with the product, but even more so about how safe it is to play with it. (although someone commented: “what if kids eat those pills? Although Play-Doh is non-toxic…)

From: Play Doh Ads Make Crying Out For Help Fun [Weird] (consumerist.com) and A campaign with an edge (uglydoggy.com)

Related articles by Zemanta

• CreatureCast video: multicellularity explained (boingboing.net)
• Play Doh Ads Make Crying Out For Help Fun [Weird] (consumerist.com)

A Personalized Twitter Times: useful to others too.

Yesterday I posted my “Introduction to Medicine 2.0″ presentation on this blog and on Slideshare (where it is currently featured at their homepage).
Looking back I think that half of the participants found the Twitter part (and the way it is interwoven with other Web 2.0 tools) the most interesting, whereas this was the part where the other half was beginning to gaze. Later, Chris said that it should be no surprise that people not used to such a tool as Tweetdeck think: “What the hack is that, all those columns, with @, RT, names and links?” – it seems meaningless and such a waste of time. No matter what you tell them.

Today I received my personalized Twitter Times, which is constructed of blogposts that are most popular (most tweeted about) by my friends -the people whose ideas and interest I share on Twitter-. I find it a really neat overview of -indeed- very interesting posts. Certainly useful when a congress doesn’t allow me to follow tweets: I can read my newspaper late at night instead.

The Twitter Times is useful to other Tweople too, because they can find like-minded people they didn’t know by then.

Furthermore,  it might be useful for absolute beginners who don’t grasp the meaning of Twitter. Such a Twitter Times offers a far better overview and reads much more easily than tweets on Tweetdeck, which barely seem useful without their context.

Perhaps The Twitter Times could convince these skeptics to use Twitter as well. Or would they rather be inclined to say: “Thank you for the trouble, I rather read yours”….

Here is my real life personal ” Twitter Times” (and here is the PDF of Todays Twitter Times)

You can get yours at: http://www.twittertim.es/ (but it takes a few days)

Hattip: Francisco van Jole @2525

Cochrane 2.0 Workshop at the Cochrane Colloquium #CC2009

Today Chris Mavergames and I held a workshop at the Cochrane Colloquium, entitled:  Web 2.0 for Cochrane (see previous post and abstract of the workshop)

First I gave an introduction into Medicine 2.0 and (thus) Web 2.0. Chris, Web Operations Manager and Information Architect of the Cochrane Collaboration, talked more about which Web 2.0 tools were already used by the Cochrane Collaboration and which Web 2.0 might be useful as such.

We had half an hour for discussion which was easily filled. There was no doubt about the usefulness of Web 2.0 for the Cochrane in this group. Therefore, there was ample room for discussing technical aspects, like:

• Can you load your RSS feed of a PubMed search in Reference Manager? (According to Chris you can)
• How can you deal with this lot of information (by following a specific subject, or not too much people – not many updates on a daily basis; you don’t have to follow it all, just pick up the headlines, when you can)
• Are you involved in a Wiki that is successful? (it appears very difficult to involve people)
• What happens if people comment or upload picture on facebook (of the Cochrane collaboration) in an appropriate way (Chris: didn’t happen, but you have to check and remove them)
• How do you follow tweets (we showed Tweetdeck,  hashtags # and #followfridays)
• What is the worst thing that happened to you (regarding web 2.0)? Chris and I thought a long time. Chris: that I revealed something that wasn’t officially public yet (though appeared to be o.k.). Me: spam (but I remove it/don’t approve it).
  Later I remembered two better (worse) examples, like the “Clinical Reader” social misbehaviour, a good example of how “branding” should not be done, and sites that publish top 50 and 100 list of bloggers just to get more traffic to their spam websites

Below is my presentation on Slideshare.

The (awful) green blackgound color indicates I went “live” on the web. As a reminder of what I did, I included some screendumps.

The current workshop was just meant to introduce and discuss Medicine 2.0 and Cochrane 2.0.

I hope we have a vivid discussion Wednesday when the plenary lectures deal with Cochrane 2.0.

The answers to my question on Twitter

1. Why Web 2.0 is useful? (or not)
   
2. Why we need Cochrane 2.0? (or not)

can be found on Visibletweets (temporary) and saved as: Quoteurl.com/sggq0 (permanent selection).

I think it would be good when these points are taken into account during the Cochrane 2.0 plenary discussions.

* possible WIKI (+ links) might appear at http://medicine20.wetpaint.com/page/Cochrane+2.0

<!–[if !mso]> Dia 52

§http://visibletweets.com/#query=%23CC.20%20OR%20%23CC20&animation=2

§Or:
http://www.quoteurl.com/sggq0

This week I will blog from…..

Picture taken by Chris Mavergames http://twitpic.com/kxrnl

Chris and I will facilitate a web 2.0 workshop for the Cochrane (see here, for all workshops see here).
The entire program can be viewed at the Cochrane Colloquium site.

Chris Mavergames, Web Operations Manager and Information Architect of the Cochrane Collaboration will also give a plenary presentation entitled:
“Cochrane for the Twitter generation:
inserting ourselves into the ‘conversation‘”.

The session has the promising title: The Cochrane Library – brave new world?

Here is the introductory text of the session:

The Cochrane Collaboration is not unique in facing a considerable challenge to the way it packages and disseminates healthcare information. The proliferation of communication platforms and social networking sites provides opportunities to reach new audiences, but how far can or should the Collaboration go in embracing these new media? In this session we hear from speakers who are at the heart of the discussions about The Cochrane Library’s future direction, including the Library’s Editor in Chief. We finish the session with reflections on the week’s discussions with respect to the Strategic Review (…)

Request (for the workshop, not the plenary session):
If you ‘re on Twitter, could you please tell the participants of the (small) web 2.0 workshop  your opinion on the following, using the hashtag #CC20.*

1. Why Web 2.0 is useful? (or not)
   
2. Why we need Cochrane 2.0? (or not)
   

An example of such an answer (from @Berci):

#CC20 Web 2.0 opens up the world and eases communication. Cochrane 2.0 is needed bc such an important database should have a modern platform

If you don’t have Twitter you can add your comment here and I will post it for you (if you leave a name).

Thanks for all who have contributed so far.

—–

*this is only for our small-scaled workshop, I propose to use #CC2009 for the conference itself.

Friday Foolery #6 Man-to-Man-Hug

General Etiquette: How To Give A Great Man To Man Hug

Hattip: @precordialthump (Twitter)

more about “How To Give A Great Man To Man Hug (C…“, posted with vodpod