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Rather than trying to explain the observation by going back, I might suggest a few hypotheses that you might then track prospectively. Hypothesis 1: Some pharma has a new drug they are bringing to market (or whose patent is about to expire) and have launched a publicity blitz (public campaigns, increased detailing to clinicians, strategic release of research data to the media, etc.). Hypothesis 2. Some celebrity has had a recent, well-publicized problem and some of our patients/colleagues are living vicariously through their experience. Hypothesis 3. seasonal variation in exacerbations of health problems Hypothesis 4. Random clustering of searches I am sure there are several other hypotheses. I think each of the ones I mention have some methodologic issues, but I believe would lend well to prospective data collection. For instance, if you (and colleagues, students, etc.) were to keep a close watch on the media and the activities of pharma representatives, and see a new blitz, you could compare the "hits" for that issue and compare it to the "hits" for some other item (for instance, studies on ear wax removal) Good luck! Henry Henry C. Barry, MD, MS Associate Professor Senior Associate Chair Department of Family Practice E-mail: [log in to unmask] B-104B Clinical Center Academic Office:(517) 353-0851 Michigan State University Clinical Office:(517) 353-3050 East Lansing, Michigan 48824 Fax: (517) 355-7700 -----Original Message----- From: Jon Brassey [mailto:[log in to unmask]] Sent: Tuesday, June 11, 2002 5:16 AM To: [log in to unmask] Subject: Medical Trends I run the TRIP Database (www.tripdatabase.com) and have recently had a new piece of software written that monitors what papers people go and view. I've had some interesting results and am trying to make sense of them! Basically, over the last few days the top four articles viewed from the TDB have been on Urinary Incontinence. Two weeks ago the most popular papers tended to be related to Fall Prevention in the Elderly! Has anyone got any ideas how I can figure put these apparent trends? All the best jon