1. Medical Oncology Updates
Presentation by Mary Hill
Library Manager
The Christie NHS Foundation Trust
Another example of working with non-library colleagues – this is a current awareness bulletin . So what is new?

2. Putting it into context
Cancer specialist hospital with strong research focus
A lot of research fellows & one suggested they wanted something
more aware of most recent publications
on a weekly basis
with easy access to full text of the articles
comments on the articles
articles provided by research fellows
The something had quite a few criteria but what was attractive was that it was coming from a medical oncologist who very much wanted to be involved. It wasn’t something for the library to do, it was a collaborative project.

3. Something like this …
Weekly
So what does something look like?

4. Easy access with comment
Most recent
Easy access with comment
When you click on the individual record you get something like this (which is slightly cut down)
We can see it is current – this was from the 4th June post
And we have the easy links including for people outside the Trust as we send this to a Yorkshire Trust. This example has a comment supplied as a related editorial. However, the original idea was that this should be our research fellows comments

5. How it works … or not What should happen
Each week a group of medics provide a set of records
This is done by Monday
Librarian to add citation and full text links
Comments to be added to papers to add value
What happens
Mainly one medic and a librarian working their socks off
Usually but crying babies can be an issue
Normally works!
Not as envisaged
Truth moment – is it as we envisaged , various medic input, weekly, easy links and with comments
Well the reality is partially there but with room for improvement. So the group of medics are still be recruited. We now have 2 plus the odd suggestion for an inclusion, it is weekly, with easy links and does have comments adding value but not as envisaged.

6. Finding the material
These are normally added as ‘before print’ or within 2 weeks of publication
Mainly these publications – NEJM, JAMA, JAMA Oncology, JCO, Lancet, Lancet Oncology, Annals of Oncology
Add citations from NICE cancer drugs bulletins with UKMi comments
NICE Technology assessments & relevant Cochrane
Videos of talks from our Grand Rounds
Not the normal literature search by any means because of the currency. Use RSS feeds from websites and Browzine, along with daily drug information updates from NICE
The list of publications is based on those suggested by the clinical fellow – we could go looking at impact factors to scope this maybe more widely. Also if I hear that there has been a major cancer drug breakthrough on the news I try to source that and add it.
Many of the links from NICE come with information from the UK national medicines information which often alert you to editorials or have extra comments which are incorporated into the the update
We also add relevant NICE technology assessments and Cochrane systematic reviews
We have started to add publicly available video broadcasts from relevant Grand Rounds at the Christie

7. Issues Whose doing it? Structure Scope Gathering the evidence
Is it sustainable?
Improving situation
Structure
set format
taxonomy of tags
Issues
Who? At the moment a labour of love although we now have somebody I can send out a link to who will assess if it is OK and put it in the right format and send back for me to post. I have had somebody suggest a paper but I had to do all the work! Currently not sustainable. It is made particularly difficult as the clinical fellow is no longer at the Trust but he is fully committed to his project. I am pull a face positive that it is sustainable
Structure: the format is OK. We have set subheadings where relevant and we are beginning to bullet the methods/results but it would be good to say to have this even more defined e.g. always start the results with n=….. The taxonomy is rather like trying to herd cats. In principal we love a fixed list of terms, in reality, I have clean up weeks where it completely goes haywire. At one point all drugs were being added. You can image the size of the list of tags. This is an ongoing project
Is it effective? Trying to do a before and after study but that is proving difficult. I have discovered don’t ask a doctor to do an online survey and expect any results. I have managed some survey success but it is nowhere near enough to provide any form of evidence. We are working on this!
Scope. The medical director is keen for us to do a clinical and surgical one. Presently, we do not particularly broadcast this and its distriubtion is limited even within our Trust to clinical medical oncology fellows, some F2s and MidYorkshire Trust. We do tweet and that gets a wider audience but we are ready to go wider
Gathering the evidence
survey failure
testing effectiveness properly
Scope
adding clinical oncology

8. Is it used?
These are the results after about 3 hours after publishing. Mainly UK audience but pleased to note we have had to click outs to articles
Overall figures

9. Has it made a difference?
From our slightly successful survey with 16 responses!..
It covers patient care, career progression, research and education

10. Where are we now? Phase 1 trial – small study, is it safe?
Phase 2 trial – proof of concept and dose finding
Phase 3 trial – ready for a larger trial
31 issues and nobody has suffered too many ill effects – some tearing out of hair and rather late nights but we’re still in for the long haul. It’s safe
- thumbs up

11. Summary and way forward
Need to make it sustainable and involve more clinical fellows
Need to standardise tags and information on methods and results
Look at how to add comments from consultants
Basic critical appraisal of research?
Measure effectiveness

12. Would I do it again?
Yes

13. @christielibrary @TheChristieSoO
Any questions?
@christielibrary @TheChristieSoO
Mary