Trip Database Blog

I really enjoy it when we can fund a bit of R&D and one such project is starting to bear fruit. The overall aim of the project is to develop a ‘brain’ underlying Trip that can better deliver evidence to users. This can help in a large number of our areas of interest.

This sub-project is based on the notion of document similarity; in other words if you have a document, which other documents are similar.  A clear use case is one where you find a document that is really interesting, which other ones are most similar to it? Typically you’d keep scrolling through the results. If you have a similarity measure, it automatically finds them for you!

But there are many other uses. For instance we can take clinical questions, classify them as documents (I’m using the term document quite broadly – essentially it’s a distinct amount of text) and see what documents are most similar. Why search when the system can do it automatically?

We can also use this intelligence to keep people up to date with the latest evidence. If we know a user likes document A, we can scan new evidence to see those that are similar enough and alert the user to these.

It’s still early days and we’re still developing things (we’re using a variety of techniques including machine learning) but initial results are promising. Below is a list of text documents we uploaded and ‘asked’ the system to arrange them by similarity:

Most dissimilar
– Prostate-Specific Antigen-Based Screening for Prostate Cancer: Evidence Report and Systematic Review for the US Preventive Services Task Force
– The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification independently predicts wound healing in diabetic foot ulcers

– Docetaxel Versus Surveillance After Radical Prostatectomy for High-risk Prostate Cancer: Results from the Prospective Randomised, Open-label Phase 3 Scandinavian Prostate Cancer Group 12 Trial
Disordered Eating Behaviors Are Not Increased by an Intervention to Improve Diet Quality but Are Associated With Poorer Glycemic Control Among Youth With Type 1 Diabetes

– Decreasing Seroprevalence of Measles Antibodies after Vaccination – Possible Gap in Measles Protection in Adults in the Czech Republic
– The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification independently predicts wound healing in diabetic foot ulcers

Most similar
– Results of Prostate Cancer Screening in a Unique Cohort at 19yr of Follow-up
– Prostate cancer screening with prostate-specific antigen (PSA) test: a systematic review and meta-analysis

– Prostate cancer screening with prostate-specific antigen (PSA) test: a systematic review and meta-analysis
– Prostate-Specific Antigen-Based Screening for Prostate Cancer: Evidence Report and Systematic Review for the US Preventive Services Task Force

– Results of Prostate Cancer Screening in a Unique Cohort at 19yr of Follow-up
– Prostate-Specific Antigen-Based Screening for Prostate Cancer: Evidence Report and Systematic Review for the US Preventive Services Task Force

So far, so good!

We’re currently doing our monthly update highlighting new content and when doing these, some topics stand out; no idea why.  This month there have been a few on screen time in children:

• A systematic review of the association between screen time and sleep in school-aged children and adolescents – PROSPERO
• Screen-based activities and children and young people’s mental health and psychosocial wellbeing: a systematic map of reviews – EPPI Centre
• Digital media: Promoting healthy screen use in school-aged children and adolescents – Canadian Paediatric Society

The top entry, from PROSPERO, is a systematic review protocol exploring the association of screen time and sleep. The second (EPPI Centre) is an ‘evidence map’, while the final entry (CPS) is a clinical guideline.

I was interested to see that the guideline has a distinct section on sleep and if you dig deeper through the documents you seen overlap in a number of places.  Is this good or bad? I suspect that for the producers of the reviews there are ‘logical’ reasons for the content of their product. But I can only think, from a decision makers position, it’s unhelpful.  I’m not sure what the answer is, well not entirely.  Throw in to the mix all the other publications on the topic (see this Trip search as an example) and it could be seen as a mess!

At Trip we’re focused on supporting decision makers to take evidence-based/informed decisions. So, is the answer to, somehow, extract the actionable messages from these very long documents? Sounds reasonable to me, but it opens up additional issues – such as who are the stakeholders, what are their decisions and what do they need to make them!?

As seems so often the response – it’s something to ponder (is this a bit like saying ‘more research needed’)!

In a nutshell it’s a system to support Trip users to obtain answers to their clinical questions. It’s not designed to replace Trip, more like compliment it. You may not have been able to fuller answer your question, be stuck on the meaning of a passage, the nuance of a paper or the meaning of a statistical test.  We’ve developed this powerful solution to harness the wonderfulness of the Trip Community (over 100,000 registered users).

The steps are as follows:

• If you can’t find the answer in Trip you record your question via the ‘Ask a question’ link.
• We send it to members of the Trip community who we feel are best placed to answer it. For instance, you may have a question on heart failure – we’d email it to users with an interest in heart failure and/or cardiology.
• It is anticipated/hoped that at least one of those emailed will answer your question.
• Quality is important and users will be able to upvote an answer (if they like it) or downvote it if they don’t! People answering the questions will be encouraged to reference their answers.

By contributing to this service as a member of the Trip community you’ll be sharing your knowledge to support healthcare around the globe and creating a system that you too may use if you find yourself struggling for an answer.

The Q&A system falls within our new Trip Learning Environment (Triple) a concept whereby users share and learn – in a non-critical manner – from each other. The Q&A is the first system we’re introducing but others will follow afterwards.

The system is a beta as we’re wanting people to test it to see that it works well and highlight any problems (a beta signifies a non-finished, test version of a feature). This should not be onerous, we simply want you to join up to the system and have an explore. It would be great if you asked a question or responded to a question should you know the answer. The test will be over a month or so and we are not anticipating lots of activity – just enough for people to get a feel for it.

Email me via jon.brassey@tripdatabase.com if you’re wanting to help test it.

Trip’s main focus is on answering the clinical questions of health professionals. Searching Trip is great – but not perfect. Our community Q&A is there if you can’t find the answer you want/need.

The concept is simple, a user posts a question and we send it to the health professionals – registered on Trip – who we feel are best placed to be able to answer them.  Hopefully one or more will respond.

We’ve previously asked our users about this idea and the vast majority were highly supportive and gave us excellent feedback – which we’ve incorporated into the design of the service.  So, the next step is to test the system we’ve built.

Please let us know if you’re interested in testing the system. Time commitments is up to you and should be minimal. You can ask questions, answer questions or simply observe the system working. Testing should start within a week or two.

If you’re interested please email me jon.brassey@tripdatabase.com