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Trip Database Blog

Liberating the literature

Update on the new site

While we released the new front-end to the site last year we have been busy rewriting the back-end portion of the site. The back-end being the whole document grabbing, processing and indexing side of things – the brain of the site. I visualise it as a car – the body-work is the front-end and the rest is the back-end!

We have virtually finished the back-end work and are currently building a whole new index consisting of over 5 million documents. We’re processing around 275,000 documents a day. Once that’s in place it’ll hopefully be a quick test and then make things live.

The advantages of the new back-end are numerous, including:

  • A higher level of automation than before
  • Indexing is much quicker
  • A lot of the work is cloud-based/distributed making it more resilient/flexible
  • Modern code means easier to maintain and fix

Most users won’t notice much difference; possibly more up-to-date content

Once we’re happy we can then start to have fun and develop the site. Given the rewrite has taken over 2 years we’re very keen to start to improve the site and we’ve got lots of threads of work, for instance:

  • Guideline and RCT ‘scoring’ system in the short-term and systematic reviews in the longer term
  • Experiment with a 3rd layer of search (the site currently only has specific and sensitive)
    – Title (specific)
    – Abstract
    – Body (sensitive)
  • Experimenting with a machine learning/deep learning search algorithm – this is a project we’ve recently started and will have the initial results mid-summer
  • Improve the Advanced search

Happy days!

LMIC filter

As part of Trip’s work with Ariadne Labs (helping to support the roll-out of Trip Pro across Africa) I ran an online webinar on using Trip. One question related to restricting content to African evidence. While we don’t support that, we do have a filter for LMIC (Low and Middle Income Countries) content. It can be found here on the results page:

The filter is simply looking for various terms in the documents and if they have one of them, it is tagged as being LMIC. Terms used are things such as ‘developing world’, ‘resource poor’, ‘lmic’ as well as the country names of those considered LMIC (by the World Bank).

There are two options:

  • Specific – if the document contains any of the filter terms in the title
  • Sensitive – if the document contains any of the filter terms anywhere in the document

Below is an example search

In the above image, the top 3 results are a standard search for measles, while below the red line shows the top 3 results for measles with the ‘LMIC specific’ filter applied.

It’s a simple system but works well and, pleasingly, the feedback was very positive.

Latest monthly upload

I’ve just uploaded the latest batch of manually curated records, a total of 613 new articles. This number is small, relative to the larger number we automatically grab, but it typically represents the content at the top of the evidence pyramid.

Each month hundreds of sites are visited to explore if they have published any new evidence, if they have this is placed in a spreadsheet before uploading to the site. We record the following bits of data for each record:

  • Publication
  • Title
  • URL
  • Year

When we have finished the monthly collection we upload it to our system and that does the rest. New content is typically available by the next day and often much sooner.

Below is a small sample of the records added this month:

  1. Opioid Treatments for Chronic Pain (AHRQ)
  2. Acute Lymphoblastic Leukemia in Adults (Cancer Care Alberta)
  3. Systematic review of needs for medical devices for ageing populations (WHO)
  4. Addressing Social Determinants of Health and Mitigating Health Disparities Across the Lifespan in Congenital Heart Disease (American Heart Association)
  5. Remote monitoring of patients with COVID-19 (KCE – Belgian Health Care Knowledge Centre)
  6. Pacritinib (Vonjo) – To treat intermediate or high-risk primary or secondary myelofibrosis in adults with low platelets (FDA)
  7. Factors associated with outbreaks of SARS-CoV-2 in nursing homes (HIQA, Ireland)
  8. Paediatric Intensive Care Nutrition (James Lind Alliance Priority Setting Partnerships)
  9. Gout: diagnosis and management (NICE guideline)
  10. Digital smartphone intervention to recognise and manage early warning signs in schizophrenia to prevent relapse: the EMPOWER feasibility cluster RCT (NIHR HTA)
  11. Peanut allergy: peanut-avoidant diet and access to adrenaline injector pens (Prescrire)
  12. Lipoedema – diagnosis, treatment, and experiences (SBU)
  13. Impaired Visual Acuity in Older Adults: Screening (US Preventive Services)
  14. Monkeypox: diagnostic testing (UK Health Security Agency)
  15. Regulation and financing of prenatal screening and diagnostic examinations for fetal anomalies in selected European countries (Austrian Institute for Health Technology Assessment)

The evidence above is a joy to see and represents a small fraction of the total uploaded each and every month.

Having great content is a key element of Trip’s continued success, that’s why we spend so much resource on it!

Synonyms

In 2014 I wrote this:

We have a manual system for handling synonyms in our search. This means that if someone searches for IBS we automatically search for irritable bowel syndrome. I’m currently undertaking a review of these synonyms, a long-winded and problematic process – but well worth doing.

When I say/said a manual list we started the synonyms in Trip by exploring the top used search terms in Trip (I think it was the top 8-10,000 terms) and manually looking through them to see if any might have synonyms. So, when I came across IBS in the list, I would add irritable bowel syndrome. When a user searched on Trip for IBS we would effectively insert the other term, making it IBS OR irritable bowel syndrome. This is a crude but surprisingly effective system and – with the new back-end work finally coming to the end, it’s time to review them again.

This is what I’m looking at:

This might take a while 🙂

Monkeypox

Learning lessons from Covid-19, Trip has started actively adding higher-quality content related to Monkeypox. Trip users are actively searching for information and the information ‘landscape’ is changing rapidly. As such, Trip is accelerating it’s content ‘acquisition’.

A search for monkeypox on Trip currently has these results in the top 5:

If you know of any great resources, please let Trip know via monkeypox@tripdatabase.com.

Making Trip Pro available for health professionals in Africa

Ariadne Labs is a joint center for health systems innovation at Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health. They approached Trip earlier in the year to take part in their Better Evidence initiative and this has resulted in Trip Pro being made available, for free, in 20 schools across 12 countries in Africa.

Searching for evidence to improve care during wartime

In little over 24 hours we’ve made some significant changes to the combat injuries filter. We’ve increased the yield of higher-quality articles from 2,000 to nearly 4,000. In conversation with people it’s become apparent that simply pointing to a large number of results isn’t great – as it suggests the user will have to browse the articles. In actual fact, they are more likely to have a clinical question.

So, we’re going to try to create an evidence table, pre-loaded with possible questions. As with the previous post, this table should be added to as and when people reach out. If you have suggestions, please send them to jon.brassey@tripdatabase.com. And, to be clear, we’re not experts in this domain, hence being very open to help.

TopicCombat setting (higher-quality evidence)Combat setting (all evidence)Any setting (higher-quality evidence)Any setting (all evidence)
Amputation121 results965 results1,613 results13,515 results
Antibiotics504 results4,100 results11,793 results148,176 results
Anxiety702 results2,628 results12,273 results87,007 results
Bullet wounds65 results522 results65 results522 results
Burns572 results2,719 results4,005 results28,571 results
Compartment syndrome174 results963 results947 results14,125 results
First aid93 results266 results402 results1,752 results
PTSD611 results2,979 results3,123 results17,085 results
Tranexamic acid42 results111 results696 results3,226 results
Venous thromboembolism164 results464 results3,192 results14,389 results

Thanks to Tom for highlighting refugee health. The following do not have any combat setting filter, they’re just total topic results:

TopicHigher-quality evidenceAll evidence
PTSD refugees207 results565 results
Refugee health648 results2,782 results
Refugee mental health455 results1,292 results
Unaccompanied minor refugees36 results92 results

Kate has highlighted the wonderful Evidence Aid. They have a number of pertinent evidence collections, including Health of refugees and asylum seekers.

Again, any suggestions via jon.brassey@tripdatabase.com

Search filter for combat injuries

Earlier today I heard on the radio about two British surgeons running online training on military surgical techniques for surgeons/doctors in Ukraine. As Trip is a global repository of some of the best evidence available we thought it might be beneficial to try to bring together some of the best ‘combat’ evidence. To that end we have started work on a search filter. This is our starting list:

  • (shrapnel AND (wound OR injury))
  • military
  • soldier
  • (post-traumatic stress disorder AND (soldier or military))
  • (bomb AND injuries)
  • (bullet AND (wound OR injury))
  • (bomb AND (wound OR injury))

These translates to this search string, which is 20,000 results. If you restrict to ‘evidence based’ content (this search string) it drops to a more manageable 2,000 results. However, this is still too many so it possibly requires more filtering. For instance:

Can you help us improve our offering? I guess this comes in two parts (1) improve the filter to locate more military-related articles, and (2) suggestions for pre-formulated searches (such as the surgery or shrapnel searches above)

Any suggestions please send them to jon.brassey@tripdatabase.com

UPDATE (15:26 on 06/03/2022)

Thanks to Becky I’ve added some additional terms:

  • “armed forces”
  • warfare
  • army
  • navy
  • airforce

This finds extra articles, unfiltered it’s now just over 28,000 results, and just over 2,600 higher quality articles.

UPDATE (11:52 on 07/03/2022)

Thanks to Lina we’ve identified a number of new terms:

  • gunshot
  • firearm
  • blast
  • explosion

This now gives just over 44,000 results, and just over 3,500 for higher-quality content.

Update (14:01 on 07/03/2022)

Thank you to Igor and Tracy we’ve identified some other useful terms:

  • shelling
  • grenade
  • “land mine”
  • landmine
  • artillery

This now gives just over 50,000 total results with nearly 4,000 higher-quality results.

Years covered by Trip

We’ve just been contacted by a doctor undertaking a systematic review and he asked, for writing up the search strategy, how far back do our records go. Unfortunately it is not possible to give a definitive answer!

In part this relates to the recent post Journal coverage in Trip where we highlight the nature of incorporating documents. We typically say that the bulk of our content is from the year 2000 onwards. However, as we grab all the RCTs and systematic reviews in PubMed, those are our earliest records. So, we’ve got some systematic reviews and and RCTs from the 1950s (although the definition of these research types may well have changed since then) and our earliest guideline appears to be from the late 1990s!.

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