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Dear Ben (and the list)
Abstract:
We must integrate Usability and Accessibility into our approach to
finding evidence on the internet. This
message contains links to some free resources for assessing Usability and
Accessibility.
We couldn't agree more with your comment about using resources that are
easy to use.
Right across all sectors, there’s good evidence that the web resources
that get used are, not surprisingly, the ones that are usable! Sites that have
poor usability don't get used, and ultimately don't survive.
Evidence-based databases, in their efforts to meet concerns about quality
of content, have overlooked this and are still unusable in everyday practice.
Quality information must be accessible and usable as well as reliable.
Good quality health information on the web needs to be:
1 Accessible,
2 Usable AND
3 Reliable (i.e.
robustly Evidence-Based)
Sadly, a site which sacrifices 1 or 2 to maintain standards in area 3
won’t do as well as one that has performs well in 1 and 2 but is lousy in
3.
To see what we mean by Accessibility, Usability and Reliability, please
consult these links:
·
Accessibility:
http://www.minervation.com/accessibility
·
Usability: http://www.minervation.com/usability
·
Reliability:
http://www.minervation.com/reliability
Where to start?
We think that a good first step is, as with EBM, to create a better understanding
of what constitutes good usability and disseminate the skills for assessing it.
To this end, we've developed a suite of appraisal tools, called the
LIDA tool, for assessing these three elements of web sites. We've also provided an automated system
for checking accessibility (i.e. whether web pages meet standards for disabled
access and good coding practice). These resources can be accessed for free from
http://www.minervation.com/validation.
We're currently validating the usability tool and hope to publish the findings
soon. We'd be delighted to receive
feedback from list members who are interested in these issues.
How do we tell good evidence-based resources from bad?
If you ask a web information provider "Is your web content evidence-based",
none of them will say "no", so how can we tell if they're really up
to scratch?
We'd be really interested in hearing people's feedback on these tools,
especially on how to approach this reliability question. We think this needs to address both
process and output.
In many cases, a questionable production process (the proverbial GP chained
to a computer in a basement somewhere) will produce good quality output some of
the time; conversely, an apparently
sound production process could end up creating poor quality information some of
the time.
We think that it needs a combination of validating the production process
and validating the content produced, but we’re not sure of the best way
forward as yet.
What about existing tools?
We felt that none of the existing appraisal approaches we've looked at
(such as PREVNET, DISCERN or the HON code) adequately addresses the issues of
usability and accessibility in enough detail.
Also, existing approaches to usability and accessibility (testing on
real life users) are too impractical for the evaluation of lots of sites and don't
address the quality of content to the extent that we'd expect as EBHC
specialists.
Declaration of Interest
Best regards
Douglas Badenoch and Andre Tomlin
Directors,
Tel: +44 1865 487162
Fax: +44 1865 481482
-----Original Message-----
From: Evidence based health (EBH) [mailto:[log in to unmask]]
On Behalf Of Djulbegovic, Benjamin
Sent:
To: [log in to unmask]
Subject: Re: Google better than MEDLINE?! how about some Bayes??
Martin, in a response to your thought-provoking idea (and to stimulate further
discussion), I am arguing that the approach you illustrated is a classic case
of what is known in decision-making literature on bias as "availability
heuristics" [the probability of recall of information of interest is
judged but the ease with which it can be assessed and not by its relevance or
methodological rigor (="truth")]. Hence, you started your search with
Uptodate (a resource which is better known for its excellent marketing than its
critically-appraised content). This is not a criticism of what you have done- I
do the same- it is just to show that we (i.e. EBM) is a long way from
practicing what we are preaching: using time-consuming search to uncover
reliable evidence is not happening even among us who are strong proponent of
EBM. (For example, I have spent last several years cataloging high-quality
evidence in oncology, and still am using resources such as Uptodate, since my
database is relatively small to answer all my questions, and going routinely to
PubMed is often a grueling exercise). Thus, in reality we are using whatever is
available to us or we call consultants (which may or may not provide us a solid
EBM advice, as we discussed it here several months ago).
would be interested in your further thoughts
ben
Benjamin Djulbegovic, MD,PhD
Professor of Oncology and Medicine
H. Lee Moffitt Cancer Center & Research Institute
at the
Department of Interdisciplinary Oncology
SRB #4, Floor 4, Rm #24031 (Rm# West 31)
Editor: Cancer Treatment Reviews (Evidence-based Oncology Section)
http://www.harcourt-international.com/journals/ctrv/
e-mail:[log in to unmask]
http://www.hsc.usf.edu/~bdjulbeg/
phone:(813)979-7202
fax:(813)979-3071
-----Original Message-----
From: Martin Dawes, Dr. [mailto:[log in to unmask]]
Sent:
Subject: Re: Google better than MEDLINE?! how about some Bayes??
What do you mean by the word "better"?
1. You have a question or several interlinked questions.
2. What is the probability that there is a published answer?
3. If the probability is low that an answer exists which database when
searched would be most likely to exclude an answer existing if your
search is negative.
4. If the probability is high that an answer exists which database
would
be most likely to rule in that an answer exists (and provide the
answer).
So this morning I saw a woman with Sjogrens who was complaining of
gastritis.
Q1. Does sjogren's cause gastritis?
Q2. In a woman with Sjogren's what is the probability that the
gastritis
is caused by Sjogren's?
The pre-search probability of an answer to Q1 and Q2 existing, as
judged
by the resident and I, was moderate. I decided that if the answer to Q1
was not in a text book then the answer to Q2 & Q1 probably is not
going
to exist as the syndrome is not new. I decided on Uptodate as an easy
reference. Q1 answer exists and is positive. Therefore Q2 probably
exists (the post search probability is higher than the pre search
probability) and I will now look on Medline.
A sub process of this approach is "which search terms include or
exclude
an answer existing within certain databases".
Bayesian approaches to searching???
Anyone interested in developing this further??
Martin Dawes
Acknowledging a discussion with Pierre Pluye
-------------------------------------
Chair Family Medicine
H2W 1S4
Tel 514 398 7375 ext 0227
Fax 514 398 4202
-----Original Message-----
From: Evidence based health (EBH)
[mailto:[log in to unmask]] On Behalf Of Djulbegovic,
Benjamin
Sent:
Subject: Re: Google better than MEDLINE?!
Tanya, as strange as it seems to be, but some of my students have been
using Google and anecdotally they were able to locate certain types of
the studies sooner than using MEDLINE (PubMed). I actually wonder if
anyone compared Google with MEDLINE?
thanks for this timely message
best
ben
-----Original Message-----
From: Feddern, Tanya [mailto:[log in to unmask]]
Sent:
Subject: Google better than MEDLINE?!
***cross-posted***
Hello, everyone. I'd like
your thoughts on this. I learned
that
supposedly a
author and journal editor, advocated using Google and Dogpile (instead
of MEDLINE) to find article citations for evidence-based practice.
Obviously, she doesn't know about the powerful features of specialized
literature databases such as the PubMed or Ovid software for searching
MEDLINE. If she did, she
wouldn't be using Google to find evidence for
patient care (nor suggesting this in an invited lecture).
Unfortunately, this idea is probably being picked up by others.
Have any of you heard of other respected faculty telling students and
healthcare professionals to use Google instead of MEDLINE? How did you
address that? Please feel
free to forward this. I will
summarize to
the list(s).
Take care,
Tanya
Tanya Feddern, MLIS, AHIP, MOT, OTR/L
http://www.geocities.com/nqiya/EBMbib.html
http://www.geocities.com/nqiya/index.html
Evidence-Based Medicine Assistant Professor; Reference & Education
Services
Library
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