Trip Database Blog

Emergency medicine

1. What is the effect of family presence on the efficacy of pediatric trauma resuscitation? BestBETs
2. Guideline Summary: Traumatic brain injury medical treatment guidelines. Colorado Division of Workers’ Compensation
3. Emergency Care Acute Pain Management Manual. National Health and Medical Research Council
4. Guidelines for concussion/mild traumatic brain injury & persistent symptoms: second edition – for adults (18+ years of age). Ontario Neurotrauma Foundation
5. Suspected acute stroke. CKS

Endocrinology

1. Canadian Diabetes Association 2013 clinical practice guidelines for the prevention and management of diabetes in Canada : Diabetes in the elderly. Canadian Diabetes Association
2. Type 2 diabetes – Managing glucose control. CKS
3. Canadian Diabetes Association 2013 clinical practice guidelines for the prevention and management of diabetes in Canada. Canadian Diabetes Association
4. Assessment and Management of Foot Ulcers for People with Diabetes, Second Edition. Registered Nurses’ Association of Ontario
5. Type 2 diabetes – Managing foot problems. CKS

Gastroenterology

1. Neonatal jaundice. Queensland Maternity and Neonatal Clinical Guideline
2. Constipation – adults. CKS
3. Established Crohn’s disease. CKS
4. Constipation in older adults: Stepwise approach to keep things moving. RxFiles
5. Clinical practice guideline: Irritable bowel syndrome in adults: diagnosis and management of irritable bowel syndrome in primary care. RCN

Geriatrics, Infectious diseases and Oncology to follow.

Which articles were viewed most in 2016 for the following topics?

Cardiology

1. Saline versus Heparin for Maintaining Patency of Central Venous Catheters: A Review of Clinical Effectiveness and Safety. CADTH
2. Randomised controlled trial: Presence during cardiopulmonary resuscitation is beneficial to family members in the out-of-hospital setting. EBM
3. Chronic heart failure – End-stage chronic heart failure. CKS
4. Management of patients with stroke: rehabilitation, prevention and management of complications, and discharge planning. SIGN
5. Guidelines on Prevention, Diagnosis and Treatment of Infective Endocarditis. European Society of Cardiology

Critical Care

1. Guideline Summary: Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012., Society of Critical Care Medicine]
2. Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia. Cochrane
3. Intravenous immunoglobulin for treating sepsis, severe sepsis and septic shock. Cochrane
4. An evaluation of the feasibility, cost and value of information of a multicentre randomised controlled trial of intravenous immunoglobulin for sepsis (severe sepsis and septic shock): incorporating a systematic review, meta-analysis and value of information analysis. NIHR HTA
5. Guideline Summary: Traumatic brain injury medical treatment guidelines. Colorado Division of Workers’ Compensation

Dentistry

1. Temporomandibular disorders (TMJ). CKS
2. Dental interventions to prevent caries in children. SIGN
3. Non-Fluoride Caries Preventive Agents. DARE
4. Oral Health: Nursing Assessment and Intervention. Registered Nurses’ Association of Ontario
5. Gingivitis and periodontitis. CKS

Emergency medicine, Endocrinology and Gastroenterology to follow.

Hopefully these changes will be out in very early 2017…

First up, the long-discussed Answer Engine:

Second major update is the smart search (we follow your clicks to suggest closely related articles):

Next up is the better integration of the search suggestions:

Finally, two features here – an enhanced RobotReviewer assessment of bias display and a manual broken links system:

NOTE: ignore the numbers associated with each article, these will be removed after testing!

If you work for the NHS England can you please complete this brief poll below.

This year Health Education England paid for a trial of Trip Pro for all staff in England and as we approach the end of the year we’re discussing what happens next year.  This poll should help inform these discussions. NOTE: To register your vote you need to press the ‘Vote’ button under each of the three questions.

If you have any other comments about access to Trip Pro, perhaps extra features to help support you in the NHS then please let us know via the comments or emailing me: jon.brassey@tripdatabase.com

Also, if you want Trip Pro to continue an email of support, sent to the above email would be very helpful!

A search engine requires a number of key elements to be successful; one of which is the websites/links it sends people to are valid and useful!

The NIHR, a large UK-based research funder and publisher, moved to a new URL structure a while back. Initially, this wasn’t a problem as the old articles (and old URLs) still worked.  But that has recently changed.  We have over 1,000 articles in our index from the NIHR and around 50-60% suddenly became broken. So, we’ve rushed through a fix and everything is fine for now.  But while it was the NIHR this week it might be another publisher the week after.

It’s a constant battle.

In 2011 we introduced an automated system which initially worked very well but over time we’ve come to appreciate that it’s only a partial solution.  So, with our next upgrade (due early January) each article will have a new ‘broken links’ link:

The ‘broken link’ link (underlined in red) will be activated by a user clicking on it. This will then cause our broken link system to be activated and hopefully swift action to correct it.

Trip, trying to improve every day.

We have got a number of developments that we want to get out before the end of the year, the most important being the answer engine.

The answer engine works by interpreting the search terms to infer the question and then using a variety of techniques to find the best answer.  This is then displayed at the top of the results.  An example is shown below:

In this example the user has searched for acne and minocycline and our system has interpreted this as being a question about the efficacy of minocycline in treating acne.  The system then looks for the best answer, in this case a Cochrane Systematic Review, and pulls through the conclusion.

The above is a mock-up and is likely to change somewhat, but it gives you an idea of what it looks like.

Initially, the system will be modest in scope and will be semi-automatic.  Our aim is to harness feedback and then make the appropriate changes.  By the middle of 2017 we hope to dramatically increase the scope and be fully automatic.

We’ve been playing with our clickstream data – this time visualising it.  We’ve taken a single document Comorbidity and dementia: a mixed-method study on improving health care for people with dementia (CoDem) and mapped all the connected articles.  A connection is made if a user clicks on the above article and then, within the same search session, clicks on any other article(s).  We then use these connections to make some beautiful images, an example is below.  The article above is the big ‘blob’ towards the bottom of the image!

In preparation for the release of our answer engine (inferring clinical questions from the search terms and showing the ‘best’ answer) we’ve been analysing search terms. An area of particular interest are searches with a disease/condition and intervention (or similarly complex search). So, the top five search terms in Trip that follow this pattern are:

• children paracetamol ibuprofen temperature
• child cancer sibling parent
• osteoarthritis glucosamine
• pelvic floor strength
• pressure ulcer prevention

I imagine few could have guessed that list!

But to illustrate the answer engine idea, if someone searches for osteoarthritis and glucosamine we’ll show – at the top of the results – this answer:

“Pooled results from studies using a non-Rotta preparation or adequate allocation concealment failed to show benefit in pain and WOMAC function while those studies evaluating the Rotta preparation showed that glucosamine was superior to placebo in the treatment of pain and functional impairment resulting from symptomatic OA.”

Which is taken from this Cochrane systematic review.

The Trip Database is just amazing. I love how it works and the features that it offers. But from my experience, it just doesn’t seem as though it is well-known or is getting the recognition from the scientific community that it deserves. What efforts are being done for marketing the Trip Database?

Sincerely,
Isaac M. E. Dodd
MD Student at Howard University College of Medicine

The above is not an uncommon type of email.  Users find Trip, love it and contemplate that it was perhaps accidental that they found it, that few of their colleagues know about it and that it should be more widely known.

One can rely on word of mouth, which works to an extent as we get hundreds of thousands of searches per month.  But to push on probably requires marketing!  Unfortunately, Trip’s marketing budget has historically been virtually zero.  I say virtually zero as I’m not sure if our various Twitter accounts count as marketing or not.

While marketing is not my strength I’m increasingly drawn to the need to do some!  The main aim being to raise awareness of Trip which will hopefully lead to more subscriptions. Historically, if we had money I’d put it towards product development not marketing.  But this is sort of self-defeating.  So, when confronted with something as vast as marketing – where does one start?

Do we:

• Go down the social media route, embracing Twitter more (for instance)?
• Try and use adverts?  Surely not as I doubt the engagement is there.
• Work with 3rd parties in some mutually beneficial way? They get some product from Trip in return for raised profile of Trip.
• Write more papers about the findings of Trip in peer-reviewed journals?

There we go, my marketing thoughts – completely unsophisticated – in one go.  I can think of variants of the above but nothing much more than that.

Clearly we need some help.  So, with a finite budget, what brings the best return on investment?

HELP!