Trip Database Blog

Liberating the literature



Automating PICO and searching

I have the great honour of being part of the KConnect consortia, recipients of an EU Horizon 2020 innovation grant. Trip is involved in a number of great projects within KConnect and I plan to blog about them all over the course of the year.  The first to feature is enhancing our PICO interface.

Asking questions may seem straight forward but it can be difficult so by helping users understand the key elements of their questions it typically gives the questions better structure.  PICO stands for:

  • P = Population (eg what condition the user has)
  • I = Intervention (eg a drug, diagnostic test)
  • C = Comparison (eg an alternate drug or test)
  • O = Outcome (eg mortality, QoL)

Take these two, real question:

  • How can you safely treat constipation in pregnancy?
  • In diabetes would an AIIRA benefit over an ACE? 

In the top Q, the P = pregnancy and the O = constipation.  Alternatively the population could be pregnancy and constipation.

The second Q is more complicated but the P = diabetes, I = AIIRA and C = ACE inhibitors

You’ll note that questions don’t need all four elements; it’s a flexible concept!  Irrespective of the number of PICO elements it can be really useful in helping users think about the key elements of the question they may have.

From user feedback I hear time and time again that the PICO interface is great and really helps health professionals think through their questions.

KConnect is helping us improve it still further!  We will simply allow users to type our their question in full and press search.  We will automatically attempt to identify the PICO elements and then pass those elements to our search.  By highlighting the suggested PICO elements it will teach users by experience what the PICO elements are as well as speeding up the question answering process.

A further minor step – which might be really interesting – is to record the full question and the articles the user subsequently clicked on.  It’s not quite the same as a full answer, but a ‘half way house’.

We’ve a good few months of work on this using, various techniques: machine learning, semantic annotation, hard work.

I’ll keep you posted.

Creating a Q&A environment in Trip

For those of you who’ve followed this blog for a while will see that I’m always revisiting the answer engine concept, most recently two months ago. A month before that I mentioned it in the context of a a Journal of Clinical Q&A

This all stems from my belief that Trip is a wonderful tool to answer clinical questions but a also belief that it could be even better!  After all, it was the reason I started it in the first place – to help me answer clinical questions via the ATTRACT Q&A serviceSurveys have shown that many clinicians agree, with over 70% of questions, supporting clinical care, are helped by using Trip.

Recapping briefly on the answer engine and the Journal of Clinical Q&A:

  • The answer engine will try to predict questions from the search terms and insert an answer above the search results.  Users will get an answer in one click.
  • Journal of Clinical Q&A is a journal idea – radically different from any other journal.  It will be a structured answer to a clinical question, posted on the site (and helping populate the answer engine) which will be peer-reviewed and given a citation.

So far, fairly radical and fairly good.

Now, another variable to consider – the PICO search system.  In the forthcoming upgrade we’ll be enhancing this feature in the premium version.  It will be more guided than the existing version and it could work like this:

  1. Users types in their full-text question.
  2. Users then select the PICO elements from the question.
  3. Users view relevant results.
  4. Users are given the option to write up an answer. If they write up the answer we will show them the articles they’ve looked at and they can indicate which were useful (and thereby form the reference list).
  5. They can choose to keep it private or share it – feeding the answer engine.

Another powerful component for a Q&A environment, what could go wrong (I ask tentatively!)?

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