Because quality control is central to the growth of AskTrip, we invest a lot of time in it. I’d like to share a couple of examples where we take a systematic review and ask AskTrip the very clinical question the review set out to answer.

Example 1: A Systematic Review And Meta-Analysis Of Randomized Trials Of Therapeutic Intraarticular Facet Joint Injections In Chronic Axial Spinal Pain

AskTrip question: What is the evidence for intra-articular facet joint injections in treating chronic axial spinal pain?

Using the neutral(ish) ChatGPT 5 we asked it to compare the results:

Both sources agree that intra-articular facet joint injections offer at best short-term pain relief in chronic axial spinal pain, with limited or low-certainty evidence and weak/negative support from guidelines. The systematic review/meta-analysis (ONE) takes a narrow, RCT-only lens and downgrades the evidence to Level IV with low certainty, stressing the absence of robust long-term benefit. The broader narrative and guideline-based synthesis (TWO) reaches a similar conclusion but adds clinical context: short-term improvements are sometimes seen, yet effects are transient, major guidelines (e.g., NICE, BMJ) recommend against routine use, and alternatives such as radiofrequency ablation generally provide more durable relief. Thus, while both sources converge on limited efficacy, ONE emphasizes strict evidence grading, whereas TWO highlights comparative effectiveness, guideline positions, and practical considerations such as imaging and safety.

Example 2: Prophylactic Antibiotics for Upper Gastrointestinal Bleeding in Patients With Cirrhosis: A Systematic Review and Bayesian Meta-Analysis

AskTrip question: In patients with cirrhosis and upper gastrointestinal bleeding, should prophylactic antibiotics be administered to reduce mortality or complications like infection or re-bleeding?

ChatGPT5 comparison:

The 2024 systematic review and Bayesian meta-analysis casts doubt on the mortality benefit of prophylactic antibiotics in cirrhotic patients with upper GI bleeding, showing that shorter or no prophylaxis was likely non-inferior for mortality and rebleeding, though antibiotics did reduce reported infections; overall, it highlights low–moderate quality evidence and questions the current 5–7 day guideline standard. In contrast, the AskTrip answer aligns with NICE and earlier meta-analyses, presenting prophylactic antibiotics as evidence-based standard care that reduces mortality, infections, and rebleeding, particularly in decompensated cirrhosis, and recommending 5–7 days of treatment with ceftriaxone or quinolones depending on resistance. Thus, while the SR emphasises uncertainty and possible overtreatment, the AskTrip answer reflects guideline consensus and stronger claims of clinical benefit.

A really interesting finding, our answer reflects current guideline recommendations, which support prophylactic antibiotics in cirrhotic patients with upper GI bleeding. But a new 2025 systematic review questions the mortality benefit and suggests shorter or no courses may be just as effective. It’s a clear example of how new evidence can challenge established guidelines—and why keeping answers under review is so important.