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Liberating the literature

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Medical images on Trip

Trip’s image search is unique and based on a database of millions of images.  As with all things at Trip it’s designed to be easy to use and still deliver great results.  Access to our images is a ‘Pro’ feature and to see other benefits of ‘Pro’ visit our upgrade page.

Below are four examples of screengrabs for a given search.  For each example you can see the search term used and a sample of the images returned:

xray clavicle  Hip arthoplasty AlopeciaCT stroke

 

Would you share your knowledge?

Trip’s primary aim is to answer the clinical questions of health professionals.  We’re pretty good, answering over 70% of them.  But what about the remaining 30%?

If you don’t know the answer to a question it’s hard, but if you know the answer it’s easy – it stands to reason.  So, what if Trip allowed users to ask questions they have not been able to answer and forward them to people we think may be able to answer it?

So, a general/family practitioner may have a question on heart failure.  We could allow the user to record their question and we would forward it to people on Trip with an interest in cardiology/heart failure.  One imagines, if the user knows the answer, it’ll only take a short amount of time to post a reply.

The above all makes sense but relies on Trip users sharing their knowledge.  So, an open question – would you? Please let us know via the ‘Sharing Knowledge’ poll below!

The impact of Trip, first quarter 2016

The main purpose of Trip is to improve patient care.  Our approach to achieve this is to support health professionals to answer their clinical questions using the best available evidence. While we’re not perfect we’re pretty good (there’s always room for improvement).  Previous studies have shown that if we look at 1,000 searches of Trip this is how they may break down:

  • 1000 searches of which 79.1% are from users who manage patients or are patients themselves = 791 searches
  • Of these 791 searches, 72.9% relate to patient care = 576.6
  • Of these 576.6 searches, 70.7% help improve patient care = 407.7

So, around 40.8% of searches of Trip result in improved patient care (a whopping 70.7% of the times clinicians come to Trip to get answers to support their care, they get an answer).  While the figures should be taken highly sceptically (we’re written why they may overestimate and underestimate impact) they offer us a reasonable figure to base our impact measurement. Therefore, to approximate the impact of Trip we multiple the number of searches of Trip by 40.77%.

For January-March 2016 we were searched approximately 713,000 times.  Therefore, Trip positively impacted on care around 290,700 times.  The equates to around:

  • 97,000 per month
  • 22,360 per week
  • 3,194 per day

Those figures have got to be seen positively, but why be content with 3,194 per day, why not 50,000 per day?  With the forthcoming changes to Trip (improved search results, answer engine, better content management) this should surely be our goal.

KConnect

I’m just back from a meeting of KConnect, an EU funded consortium bringing together academia, SMEs and care providers with a view to improving health care.  This is the 3rd meeting in two months and thankfully this one was in London (the others being in Luxembourg and Vienna).

There was lots of exciting developments and the following apply to Trip:

Answer engine.  The answer engine is a system designed to infer questions from a users search terms and pull through the best answer (as well as the usual search results). We have a proof of concept model, which is great. However, there are a few issues with it.  A few conversations with consortia members and it looks like that will be fixed fairly easily.  With the prototype I estimate we got between 50-60% right and with the new tweaks, when they’re rolled should see that rise to over 80%.

The answer engine relies on being able to match search queries to articles.  That needs us to accurately reduce document titles down to medical concepts.  We should now be able to do this more accurately, more quickly and it’ll give us lots more flexibility with how we display the results.

Search log analysis.  I typically refer to this as clickstream data, but search log analysis appears the favoured term.  A new feature that we’ll be rolling out relates to search refinement and this will manifest itself in two ways:

  • During search.  We currently have a drop-down list of suggestions, supplied via PubMed.  However, it’s very ‘dry’ and never feels particularly ‘human’.  By using real-life data from Trip we’re confident that our system will be more real for our users.
  • Post-search.  Users typically only search using 1-2 terms.  This system can be used to suggest additional terms to bring the user closer to the results they need.

Below is a list of query suggestions based on a search for hypertension:

  • 976 hypertension pulmonary
  • 715 hypertension arterial
  • 694 hypertension treatment
  • 572 hypertension pregnancy
  • 439 hypertension diabetes
  • 401 hypertension stroke
  • 248 hypertension exercise

So, if you’ve search for hypertension we might show the above and say, something like ‘are you interested in hypertension pulmonary, hypertension arterial etc.  A user clicking on a search phrase will see the search automatically undertaken.

This should be rolled out shortly and we’ll test it to ensure it actually improves things!

Algorithm changes. Already planned from my visit to Vienna but further refinement of the specification which will see us trying multiple tweaks – in isolation and in combination – to try to ensure an optimal new search algorithm.

There are a few other bits and bobs that significantly affect Trip’s future development – but these are outside of KConnect and therefore can wait for another post.  But, rest assured, these changes are all ambitious and doable!

Institutions and Trip

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:

  1. Better links to full-text.  If you are at an institution that subscribes to journals we can use something called a link resolver to link from Trip directly to your institutions full-text (as opposed to the PubMed abstract.  This is a powerful feature but does require a link resolver.  To find out if your institution has one – ask in the library.
  2. Premium membership. If the institution purchases a premium account it can be used to connect users to the premium content/features.

But, to repeat, this can be ignored, it is not essential for your registration.

New site, released today

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:

  • Regulatory guidance which includes NICE, IQWiG, SMC and new content to Trip – FDA and EMA drug evaluations.
  • Ongoing systematic review, via PROSPERO.

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:

  • Renaming of ‘Trip Premium’ to ‘Trip Pro’
  • Simplified the functionality around each article e.g. tweet this, starring etc.
  • Functions such as search history, login are all consistent and grouped together.
  • A further simplification has been the different evidence types.  This has meant that patient information is now included in the main search leaving the ‘Pro’ content of Videos and Images available from just above the search results.
  • Creation of an explorer function (again located at the top of the search results) which was previously called the search safety net.  At the time of typing this is still being copied over to the new site so won’t be live till later today/tomorrow!

Finally, mobile is increasingly important way of users accessing Trip and as part of the redesign we have significantly enhanced our mobile offering.

Quetzal®

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 technologyQuetzal® 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:

  • Being able to answer questions (such as what genes are relevant to diabetes), seeing the papers, and having a list of those genes;
  • Finding relevant documents not only from PubMed, but also NIH Grants, Toxline, AHRQ Treatment Protocols, Patent Grants and Applications, and much more, including full-text searching;
  • Having free access to over 10 million PDFs with a single click;
  • and much more.

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.

Answer engine, an example

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.

A sneak preview of the New Trip

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!

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