Great news if you work for NHS England, you can access Trip Pro for ‘free’. Health Education England has entered into a trial, till the end of 2016. This makes Trip Pro free to all NHS staff in England.
If you work for the NHS in England and are not automatically upgraded to Trip Pro (we use your computers IP address) either contact your library or me: jon.brassey@tripdatabase.com
I’m not sure how many of these ‘the future of Trip’ articles I’ve written over the years, but there have been a few. I like to set out my current thinking of the direction of Trip with some reflections on the past.
Business model – our move to a freemium business model last year (most of the site free but a ‘pro’ section for those willing to pay for extra content and functionality) has been a great success. For years we have been concerned about the financial security of Trip and this new approach has allowed us to diversify our income streams and bring the security we craved!
New Design – It’s been out for a few weeks now and I’m loving it and the reaction. We rolled out a few new features but it was more cleaning up the interface. It was a major piece of work and it’s great that this particular project has finished.
Answer engine – This has been talked about for years and it’ll finally be here shortly. It’ll be a learning system to give answers as well as search results.
As all this has been going on as I’ve been reading the very interesting ‘Business for Punks‘ which is an overview of the rise of the Scottish brewery Brewdog. It’s refreshing and has given me the inspiration to write this post. One big factor in their success has been the relationship with their customers, in effect, being their brand ambassadors – helping promote the business and the brand. To a large extent this happens with Trip. We have lots of fans and a great connection and I can always rely on our registered users to help out when I need advice. But one thing that Brewdog have shown is that you cannot do enough customer/user engagement. So, I’m hoping to reflect on better ways of making the Trip users feel part of Trip.
But another really powerful message is to properly define what you’re trying to do and really focus on making that magical. This is something I’ve been pondering for a while and this book helped crystallize my thinking:
Trip started as a service to my work answering clinical questions for general practitioners in Gwent, South Wales in 1997. Q&A is my passion. When we ask users about Trip we get three main reasons for using the site:
The focus of Trip developments has always been the top reason (Q&A) but I’ve been keen to support the other two. I think this will always be the case. But I do think I may have lost sight of what the Q&A component means. What do I want the site to do, in relation to Q&A? A few alternatives:
or
or
They all amount, roughly, to the same thing. The top one answers it best albeit being a bit wordy (but we can work on that). So, the plans for the next major developments involve supporting clinical question answering! This requires a number of components:
Answer engine – as mentioned above it’ll be rolled out soon. It won’t be perfect but it’s a great start and it’s a learning system so it’ll get better with time.
Search algorithm – we’ve followed the same basic algorithm for years, arranging results based on a mixture of word matching (between search term(s) and documents in the Trip index), year of publication and quality of the publisher. This is fine, to a point, but search has moved on massively and we’ve not moved with the times. So, we will be looking to overhaul this. As part of my work in the KConnect I will be working with information retrieval experts to exploit current ‘best practice’.
Belief – Underlying the changing has to be a belief that we can be the best.
Community – Trip needs to state our aim to be the best and to actually be the best. This will rely on our community of users letting us know when we’re great and when we’re less than great. So, our engagement with users needs to be enhanced – from good to great.
So, Trip’s future:
Trip is involved in the extremely interesting KConnect project, via the EU’s Horizon 2020 funding stream. One output of this has been a nice interface to explore our clickstream data. Clickstream data being a record of how people interact with the site eg search terms used, articles viewed etc.
This gives us a glimpse of clinical uncertainties, ‘hot topics’, useful sites etc. Below are three images to highlight potential uses, but we know there are more. Imagination is the limitation with this data!
Image One – this is a record of searches for breast cancer and a drug. So, which drugs are most popular when used in conjunction with the term breast cancer? In this case, it’s trastuzumab!
Image Two – As we record the date and time of the search we can plot search term popularity. So, you can clearly see a peak of searching for ebola around October last year.
Image Three – for searches which publications have been most visited? Top is PubMed, followed by NHS CRD, then NICE. http://dx.doi…. refers to Cochrane and the final entry to the top five is CADTH.
In the registration process there is a section for ‘Institutions’:
This is optional and can be ignored. But it does serve two purposes, should you not ignore it:
But, to repeat, this can be ignored, it is not essential for your registration.
It’s always an exciting time when we release the new site and this time is no different. In fact, I tend to get more excited, as the site gets better and better. So, what’s new?
A beautiful new design which has been based on a in-depth analysis of user activity on the site. So, similar functions are better grouped together.
Three new extra languages supported in Trip. These allow users to search in their own language and see results in their own language. Feedback has clearly demonstrated that query formulation is the hardest translational activity for non-native English speakers. The ability to search in your own language is a real boost. The new languages are Spanish, Hungarian and Swedish. These sit alongside French, German and Czech. This language support has been made possible by our inclusion in the EU-funded, Horizon 2020, KConnect project.
We’ve also added two new categories of results:
We have also created a filter for articles on Overdiagnosis. Once you’ve searched you just click the button and we return documents on overdiagnosis and overtreatment.
We have noticed, from our analysis of site usage, that the ability to refine initial search results by clinical area is really popular. So, we’ve promoted it to make it more prominent. It’s another way to refine your results so it now sits alongside ‘refine by evidence type’.
Other highlights include:
Finally, mobile is increasingly important way of users accessing Trip and as part of the redesign we have significantly enhanced our mobile offering.
The following guest blog has been provided by our friends at Quertle. Like Trip, Quertle is a small independent organization. To help us both thrive and stay independent we are exploring ways to support each other and highlighting each other’s products seems like a nice first step! So, on with the guest blog….
When you need to find evidence-based information, you know Trip is the tool of choice. But, there are many times when you need broader information.
Like most people, you probably have been frustrated by PubMed, Google Scholar, and even the expensive paid search engines. That is because traditional search engines work to find anything that might possibly be relevant, leaving it to you to weed through long lists of results to find what you need. How many times have you looked past page 1 or 2 of the results? Instead you start narrowing down your search to get more relevant results. As a consequence, more often than not, you end up eliminating some of the most critical documents you were looking for. In fact, up to 30% of R&D budgets are wasted on rediscovering existing information.
Fortunately, there is now a quantum leap in search technology. Quetzal® Search and Communication is powered by Quantum Logic Linguistics™. “Sure,” you say, while rolling your eyes, “another search engine.” But, just watch this short video clip to see just one example of how different search can, and should, be. Then, just imagine:
Interested? Try Quetzal or contact Quertle for more information. Quetzal is available via subscription, or as a custom deployment within your organization. And, for being a fan of Trip, please use Coupon Code 6Cwy4ZW&c-3-1 when you register for Quetzal Advanced (monthly subscription) to receive one free month of access.
I was looking at a post from Cochrane Canada on Facebook relating to a free answer they’re making available from the Cochrane Clinical Answers. The question they were supplying an answer to was “In people with people with epilepsy and depression, how do antidepressants affect outcomes?”.
So, I thought I’d see how the Trip Answer Engine answered it (our still under development project). There is still work to do on the algorithm and currently it’s on a standalone site – so it looks poor. But the functionality is there. So, to answer the question we went to the test interface:
We then press search and the result comes back:
So, how does this compare to the real answer:
Call me biased but our answer appears pretty good.
A massive advantage of our system is that it’ll always be as up to date as the published literature (it generates answers from the literature in Trip) and will answer loads more questions than any other resource – when we launch we’ll probably be able to answer 100,000+ questions.
Below is the new homepage for Trip. I’ve blurred it, a bit, to retain some mystery. The homepage has changed considerably the results page less so.
I’m still hopeful to get a test version by the end of February and then – hopefully – a full release by mid-March.
Click on image to enlarge it!
In 2011 I posted:
“An answer engine. For commercial reasons I have to be vague on this for now (something I’m not comfortable with) but it’ll take shape over 2012.“
I have revisited the idea many times in the last five years, always trying to solve the same problem: a search engine doesn’t answer questions, it gives you 10-20 results to articles that may answer your question. I borrowed the term ‘answer engine’ from Steve Wozniak (co-founder of Apple) who used it in relation to the release of Siri. He said people want and need an answer engine.
Until recently the problem has been scalability – how to extract the answers from the great content held in Trip. But, due to my involvement in various machine learning initiatives, the missing link(s) has been found and we’re busy developing an ‘answer engine’. Our initiative works on a number of connected problems areas:
We have made great strides in all three areas. So much so we are currently working on the second iteration of our answer engine. For the test it has two search boxes based on PICO. The first box (P) represents the disease and the second box is the (I) intervention of interest. To illustrate what it does is using the P of ‘sore throat’ and I of ‘antibiotics’ – the answer engine returned:
“Antibiotics appear to have no benefit in treating acute laryngitis. Erythromycin could reduce voice disturbance at one week and cough at two weeks when measured subjectively. We consider that these outcomes are not relevant in clinical practice. The implications for practice are that prescribing antibiotics should not be done in the first instance as they will not objectively improve symptoms.“
The above is a great answer. But we can’t rely on a single test so we’ve been extensively testing it and the current version gets the following results:
So virtually a 50% success rate, which impressed me! But the biggest reason for the partial passes is our system not pulling through the answer (a relatively simple fix) and the biggest reasons for the failures was the inability to exclude additional terms which confused the answer (again, this should be a relatively simple fix).
Our system should be great for a number of reasons:
This is brilliant, it really is…!
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