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Published on November 26th, 2009 | by Daniel Jolley

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gasexchange — How it Works

Traditional online communities, like discussion forums, do not work well for sharing up to date and evidence based knowledge. Useful information is quickly lost among off-topic discussion, arguments or other lesser-quality posts — the signal to noise ratio is just far too low!

Add to this the difficulty in assessing the authority of users’ posts and the time to wade through pages of disorganised information to find what may be relevant, and it’s obvious that the traditional discussion forum is a broken tool. A discussion forum will only ever be that — a place for discussion — not a solution for organising and keeping up-to-date with rapidly changing medical knowledge.

The internet has so far failed to provide the medical community with better access to collected knowledge and experience. The greatest achievement to date has been searchable online archives of journal publications.

But we need a solution to the problem of information overload. Our ability to stay informed and knowledgeable will not only become more important with each passing year, but critically, will also become a much more difficult task. Our focus on ever narrowing specialisation risks that we loose sight of what we can learn from other domain areas; both within medicine and outside.

As we focus by necessity on a smaller number of very high quality trials and publications, we also risk devaluing and loosing the knowledge that cannot be captured and shared this way: expert opinions, anaesthetist experiences after decades of practice, ideas and observations from other domains.

gasexchange is founded on two simple yet powerful features that address these problems: applying real-time peer-review to a greater range of information, and organisation using tags. We apply these features to a question and answer model as a framework for capturing collective knowledge — though, as you’ll quickly discover when using gasexchange, ‘questions’ and ‘answers’ can cover many different kinds of information.

Real-time Peer Review

gasexchange uses a community voting system giving every user the ability to vote up or down the questions and answers on the site. If a user reads a question that they think is interesting, clearly worded and useful to others in the community then an up vote may be awarded. Similarly a clear, accurate and helpful ‘answer’ may also be voted up.

The votes that a question receives determine where it appears in the gasexchange system, and the votes that answers receive determine the order in which they are shown. Thus you can always be confident of finding the most interesting, accurate and highly rated information quickly, even if you only have a few stolen moments between cases to browse the site.

Just as in real life, voting has an effect on a user’s reputation. Up votes increase the reputation of the user posting the question or answer, and down votes reduce the reputation by a small amount. A user’s reputation is both displayed alongside their username, allowing other users to see how the community judges their level of ‘authority’, and also confers increasing responsibilities and powers on users as their reputation grows.

Organisation using Tags

The depth and breadth of anaesthesia and intensive care knowledge is huge. Attempts to force artificial organisational systems on this, though often necessary, all create trade-offs. When we categorise a question asking about the ‘best regional technique providing analgesia after knee surgery’, we need to make a judgement as to whether this is most appropriate for the ‘regional’ category, the ‘orthopedic’ category, or the ‘analgesia’ category.

To avoid this problem and allow for a more flexible and organic method of organisation, gasexchange uses a system of ‘tags’. A tag is just like a label that you would use in the real world to categorise an item – and just like in the real world an item can have more than one tag. Our question above could be tagged ‘regional’, ‘orthopedics’, ‘analgesia’ and even ‘acute-pain’ and ‘post-op’, depending on what the user asking the question considers appropriate.

Because other users with sufficient reputation can ‘re-tag’ questions, the community can further refine the organisation as needed.

Community Driven

The glue that binds these features together is the gasexchange community itself. Not only is the community the source of questions and answers, but through peer-review, reputation, organisation, self-editing and other features that encourage positive community behaviour while discouraging the bad, the community drives and directs the very future of gasexchange.

The knowledge captured and shared through the site then becomes a snapshot of what is considered important by a huge body of professionals from throughout the world.

More information explaining the many features of gasexchange can be found in our Frequently Asked Questions or by watching one of our screencasts. Although different from how many online communities have traditionally worked, you will quickly discover how natural and intuitive the gasexchange system is — have a look and get started today!

[ Image “Morning Meeting at the Fish Market in Vietnam” © Lucas Jans  http://www.flickr.com/photos/21077715@N00/1732947890 ].

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About the Author

is an Australian consultant anaesthetist/anesthesiologist, with interests in anaesthesia education, obstetric and paediatric anaesthesia, and the practice of anaesthesia in remote and under-resourced environments. Daniel trained in Sydney, Darwin and Melbourne, and has worked in Sydney, Melbourne, Darwin, Fiji and Mongolia. He is one of the founders of gasexchange.com along with Brad O'Connor.


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