Trip Database Blog

Trip started as a result of my work in running a responsive clinical question answering service for the National Health Service – many years ago.  I have had the pleasure of running a number of such services (alas, not one for a few years) and have kept these questions and answers within Trip.  Unfortunately, these have been neglected: they are often two years out of date and they look terrible:

Click here to see it on the web in all its glory!

This is a valuable resource, knowledge needs from real clinicians not the typical top-down approach to knowledge.  We’ve got well over 5,000 Q&As

As part of this years developments in Trip I’m keen to see if we can help save/update these Q&As.  So, how might we do this? Here are some thoughts:

• Improve the design – obviously!  But as well as how it looks it might also be functional elements. Currently it’s the Q and then the A – with no structure.  Could we add things like ‘bottom line’?
• Produce a priority list of Q&As to be updated.  This could be based on a number of elements e.g. (1) How popular is the Q&A (2) How old is it (3) We’re hoping to produce a system to find new, related, articles – so if we find some recent evidence that gets a higher weighting than those with none.
• Open it up to the community – wiki-style – to edit and update. We’re going to be doing lots of work around the Trip community in the near future and this will lend itself nicely to a wiki-approach.

I’m really excited by this and if it works well we could, one day, allow users to pose questions and get the crowd to answer.

Thoughts?

We had a lot of interest in our post What’s important for our Rapid Review system? with – at the time of writing – 297 votes.  The breakdown being:

I was surprised by a few results. I wasn’t expecting ‘teams’ to appear so highly and I was expecting ‘citations’ to be higher up.  Further evidence of the benefits of engagement. These will now help us refine our offering.

The general idea being to develop a ‘minimal viable product’ (MVP) to allow testers to try it out and give further insight. Once that’s done we finalise things and release.  I’d like to think we an get the MVP ready by the end of February (March at the latest) and the finished product by the middle of the year…

Not sure why but I thought I’d look at the stats for this blog over the last few years and I’m quite pleased as (a) larger numbers than I was expecting (b) it’s increasing year-on-year!

2016 – 8,172 visitors and 14,316 page views

2017 – 11,577 and 20,641 (a 44% increase in page views from 2016)

2018 – 19,598 and 33,710 (a 63% increase in page views from 2017 and 135% from 2016)

This is the year we build our rapid review system.  In short it’s a step-by-step ‘wizard’ that supports users (either via automation or community support) to rapidly generate evidence reviews. The steps are as follows:

• Question setting/clarification, including the extraction of search terms.
• Search and document selection, including various techniques to unearth articles that may have been missed.
• Data extraction to produce an evidence table.
• Narrative review including a conclusion or clinical bottom line (to be decided).
• Review finalisation. All the above parts pulled together to produce an easy to read rapid review.
• Publication and peer review.

To help us understand where to particularly focus can you select which elements below are really important – please select the 5 most important aspects. If you think we’ve missed something (or have any general comments) please let us know via the ‘Other’ box:

Thank you

I traditionally start the year highlighting the impact of Trip. Unfortunately this relies on Google Analytics and for some reason our Analytics disappeared mid-year and Google cannot tell me why or how this happened.  So, over ten years of data gone.  But, tellingly, we’ve not reinstalled it as I never had the time to spend understanding the data and acting upon it.  It reminds me of the Einstein quote “Many of the things you can count, don’t count. Many of the things you can’t count really count.”.

If we look back at the results for 2017 we improved care, globally, on a massive scale.  This year our usage is more likely to be higher than lower – so our impact grows and grows!

But what are the other highlights:

Clinical Guidelines – the National Guideline Clearinghouse was shut down mid-2018 and so, as a premier source of guidelines, we stepped in and further boosted our guideline coverage. We now have unrivalled guideline coverage and we featured recently in this article: National Guideline Clearinghouse Is No More: Keep Calm and Search On.

Automated evidence synthesis – The main fruit from our Horizon 2020 funded project appeared in mid-2018 – our automated evidence mapping work. It’s great to get it out there and we hope to do further work later on this year. I’ve finally submitted a paper describing it so, fingers crossed, that’ll appear in the near future.  This was a lot of work and it’s sad that the KConnect project has now ended.

Cochrane ‘crisis’ – that hit in September. I’ve long been critical of Cochrane so it was perhaps not as surprising to me as to others. Still, it was unpleasant for many and the implications will take time to be realised.

Trip Evidence Service – I was particularly pleased with the release of the Evidence Service as we started Trip to support reactive – manual – clinical Q&A services we were involved in. I still enjoy undertaking rapid reviews to support clinical care/policy. The evidence service was produced to take advantage of our skills and also support others with a lack of access to the time/skills to do the reviews themselves. But still a little way off my dream of working full-time on Trip!

Snippets – A small improvement but one that I was happy to see!

Academic papers – I’m not a big writer of papers but occasionally get involved and these are the stand out ones:

• Extracting the Population, Intervention, Comparison and Sentiment from Randomized Controlled Trials – part of the automation project.
• Catalogue of bias: observer bias – I’m involved in the CEBM Catalogue of Bias and this paper came from that work (which is ongoing).
• The TRIP database showed most Acute Respiratory Infections questions were already addressed by Cochrane reviews – a paper which helped demonstrate the worth of Trip in supporting research prioritisation.
• Rapid reviews may produce different results to systematic reviews: a meta-epidemiological study – very pleased to get this out and on Christmas Eve!

Business side of things – We’ve had a Freemium business model for a few years now and it really has proved our saving grace.  We have no organisational/government backers so we need to earn everything we spend.  It’s both perilous but also rewarding to be so independent. Last year we significantly increased our institutional subscribers and that’s left us in a pretty good financial position.  This has been supplemented by the Evidence Service and also a number of consultancy pieces of work around evidence and automation.

2019 – Plans for this year

Hopefully, by the end of January, we’ll be rolling out two major developments:

• Mobile app – we’re in the final stages of testing
• Increased full-text coverage – currently, via our linking to PubMedCentral, 38% of all our journal articles link to full-text (for Pro subscribers). We’re working with UnPayWall and that will see coverage increase to 57%. This is a really important addition and we’re delighted.

We’re already working on a more substantial upgrade which will cover:

• Community – creating a system to encourage our users to support each other.
• Rapid review system – using community support and a ‘wizard’ (step-by-step support) to create timely rapid reviews.
• Clinical Q&A – we’re still working on this but it might well end up looking a bit like Quora for health professionals.

Then, who knows about the second-half of the year! I think we’ll do some further work on the automation project but the rest we’ll see how things develop.  If you have any ideas then please get in touch.

Have a great year