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Liberating the literature

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Medical images on Trip

One great feature on the Premium Trip Database is the huge medical image section.  Below are three examples (click on image to expand):

Measles

Metformin pharmacokinetics

MRI Neck

A great range of images all clearly laid out and accessible with the typical ease you’d expect from Trip.  As we’re starting to say Making evidence easy!

Upgrade today and start taking advantage of how powerful and easy to use Trip is. For further information about the benefits of the premium Trip see this beautiful infographic.  To view the prices and benefits of an individual subscription click here and for institutional subscriptions click here.  If you’re unconvinced email me: jon.brassey@tripdatabase.com to arrange a free trial.

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Peer-review and journals

Richard Smith (who used to edit the BMJ) has just posted on Facebook:

Publishing in journals is a slow, balls aching process that adds no value. Only academics who need the “points” bother. Far better to blog.

Richard has long argued against the peer-review process and here are two blogs, by Richard, for further reading

A connected article, by John Ioannidis, How to Make More Published Research True, makes a number of assertions, two of which are selectively shown below:

  • Currently, many published research findings are false or exaggerated, and an estimated 85% of research resources are wasted.
  • Modifications need to be made in the reward system for science, affecting the exchange rates for currencies (e.g., publications and grants) and purchased academic goods (e.g., promotion and other academic or administrative power) and introducing currencies that are better aligned with translatable and reproducible research.

 I’ve often marveled at the connected worlds of academia and publishers – two worlds that have a symbiotic relationship, one without the other wouldn’t work.  I am on a few online academic paper repositories and I’m always getting emails from people I follow who have published a new article.  I’m staggered by how often they can churn them out.

I then look at the wonderful EvidenceUpdates (a service funded by the BMJ and supplied by HIRU at McMaster). They scan the ‘top’ 120 journals and do an in-house quality assessment (a form of critical appraisal) and those that pass get sent to a network of clinicians who assess the papers for newsworthiness and relevancy to clinical practice.  Amazingly around 95-96% are rejected.  While I’m not suggesting all 95-96% are junk, I suspect the majority are little more than vanity publishing.  Academics wanting another article for their CV and publishers desperate for content to justify the purchase price.

My own world of Q&A frequently shows how poorly aligned academia is with coal-face clinical information need.  It was one of the reasons I got involved in the setting up of DUETs (DUETs publishes treatment uncertainties from patients, carers, clinicians, and from research recommendations, covering a wide variety of health problems.) The idea is to grab ‘real’ questions with a view to improving research procurement.  There is a suspicion that academics pursue their own interests which may not be aligned with clinical need.  So, DUETs allows for the ‘real’ questions to be raised.  Working with James Lind Alliance it can be a powerful combination.

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Flibanserin and blogs

‘Female viagra’: FDA panel backs Flibanserin with safety restriction. 

Whenever I see stories about new drugs published in the newspapers I turn to Trip to see what we’ve got on the topic. It turns out we’ve got relatively little.  The top trial (SNOWDROP trial) concludes:

In naturally postmenopausal women with HSDD, flibanserin, compared with placebo, has been associated with improvement in sexual desire, improvement in the number of SSEs, and reduced distress associated with low sexual desire, and is well tolerated.

But what I like is that the first result in Trip is Astroturfers rule the day: FDA’s flibanserin reviewers were “emotionally blackmailed” by a slick lobbying campaign, a critical examination of the process.  While many do not like the inclusion of blogs (they can easily be removed from the search results) they can offer a critical insight/context which can be missing from journal articles.

As an aside, another thing I enjoyed seeing was that our clinical trial search found 12 trials, all of which are now classed as closed.  I’d not appreciated the power of having registered trials pulled through in to Trip.

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Trip tiles

We’ve been live, as a Freemium service, for a little over two weeks.  In my more pessimistic (pre-launch) moments I was thinking that at this stage I may be having to abandon the whole idea as no-one was purchasing Trip.  However, I’m delighted that this is not the case!  We’re massively ahead of schedule and as such we’re accelerating various upgrades that we’d hoped to do towards the end of 2015.

Even more exciting, we’re thinking of new ideas!

One idea springs from my desire to do something interesting with the Timeline.  The Timeline records your searches and articles viewed on Trip and not much else.  So, one idea is to create something called Trip Tiles!  A fresh tile would be created with every new search and at the top of the tile would be the search terms and underneath would be the articles viewed.  In many ways this is what the timeline currently does.  But I think there’s the potential to link other people’s searches.  So, you might search and find three articles and as part of that process we highlight that 1 or more of the articles has been viewed in someone else’s timeline and offer you the chance to see their tile.

Best illustrate that with one of my legendary attempts at a picture (if we roll out this feature we’ll get them properly designed):

You could go from tile to tile both browsing and looking to see if you’ve missed any useful articles that someone else has already found.  Not only that you can see what search terms they’ve used – again possibly useful.
How we’d implement this would be a challenge, but I’d see that as an interesting challenge not a particularly tough one!  Any feedback on the idea would be appreciated – comments on the blog or via email: jon.brassey@tripdatabase.com

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Clinical Trials in Trip

Clinical trials are a vital element of evidence-based healthcare.  And, increasingly, trial registries are being searched as part of evidence synthesis activities.

As Trip’s main role is to help users find important evidence it’s natural we wanted to include clinical trials in our search index.  The fewer barriers there are to finding evidence the more likely it is to be used.  So, combining clinical trials in our search index makes them easy to find and therefore more likely to be used – simple really!

Trip obtains trials from the American ClinicalTrials.gov website, a site with over 190,000 clinical trials.  The site is a registry and results database of publicly and privately supported clinical studies of human participants conducted around the world.  To be clear, it is a global database as the image below shows (for a search for measles).

As ever one of Trip’s mains strengths is simplicity.  Log in with your Premium account and search, this example is for a search for aspirin and cancer

In the above image the clinical trials are highlighted and you can see that there are three types:

  • Open – trials that are recruiting
  • Closed – trials that are either not yet open or have finished recruiting
  • Unknown – often the trials aren’t updated so clinicaltrials.gov are unsure of the status

If a user clicks on the ‘Open’ clinical trials you get the following:

It really is simple.  Evidence really is simple with Trip.

To access this and the many other benefits of Trip Premium sign-up now via this link (NOTE: Institutional subscriptions are available).  If you’re unsure or you require further details of Trip’s great power see our beautiful infographic. 

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Institutional pricing

Who thought it’d be so complicated to secure a suitable scheme for institutions.

Initially we had intended for institutions to estimate the number of likely users and this has had two unforeseen consequences:

  • Those purchasing the license are uncomfortable guessing. It requires extra work and a bit of guesswork, which leads to the second point…
  • What if they’re wrong – are there consequences?

So, between them it doesn’t work!

The next method I explored was by size of organisation but is that an accurate way to assess size?  Some publishers use full-time equivalent staff while others use full-time equivalent users!  The latter is to ensure students are counted in a universities ‘head count’ – otherwise the majority of users could be unpaying students!

The current favourite is based on the PsychInfo method which is slightly more complex but more flexible.  How we’re planning to adopt it is to have four main types of organisations:

  1. Universities
  2. Hospitals/health centres
  3. Government/public sector
  4. Corporations

Each of these will be divided into 3-4 sizes e.g. very small, small, medium and large.

This approach should be familiar with those involved in purchasing so hopefully it’ll be less problematic.  But what I am keen to stress is, if in doubt, get in touch and discuss AND negotiate..!

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Ten days in and things to do

It’s been a successful launch of the new version of the site.  We’ve had lots of sign-ups to the Premium version and that includes a number of institutions – so, so far so good.  Fortunately, we’ve had no ill-feeling expressed around the move to Freemium, I imagine most users understand the reasons.  We have had lots of feedback which has started a mini-development cycle.  So, things that we’re planning on doing in the near future include:

  • Improved export meta-data. Currently we only include basic data such as title, publication and year.  We’re now planning to extend that to include authors, volume, issue, page numbers and abstract.
  • OpenAthens.  We’re still exploring this but it looks like it’s a route that we need to go down.  The only hesitation is the cost!
  • Institutional pricing.  Even though we planned it and spoke to a number of people I think the way we’ve packaged institutional subscriptions is overly complex and off-putting.  So, we’re working hard to simplify this and we aim to roll out a new approach in the very near future.

If there are any other improvements you’d like to see, feel free to email me: jon.brassey@tripdatabase.com

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The first 24 hours

Its been 24 hours since the new, Freemium, version of Trip went live.  A few things I’ve learnt:

  • People have not been openly hostile about us moving to the new business model, I was expecting some abuse. I got some mild complaints from Twitter – but if that’s the worst of it.
  • People seem happy to pay and we have a number of paying customers.  Before we went live I was trying to think what might be good, bad and terrible and couldn’t actually come up with anything sensible.  However, the response so far has been encouraging.  But, I do need to stop checking the payments system every hour.
  • Institutional interest has exceeded expectations and it’s been really interesting dealing with many of the queries.
  • Internet Explorer (version 8) is not liked by Stripe, our payment system.
  • The system to reset passwords was a bit naughty and refused to send out links to reset the passwords.  Fortunately, that is now fixed!
  • I’m beginning to better understand some of the background functionality that I’d been not really thinking about.
  • I really need to think about VAT when setting up a payments system.

I think the biggest realisation is that, to make this model work, will require significant hard work on my part!  Anyone out there with (a) good sales skills (b) spare time (c) will to work on payments by results??

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The New Trip Database

The new version of the Trip Database is live and to help celebrate we’ve produced a beautiful infographic.

While to many the new site will not look massively different there have been some huge changes.  Perhaps the biggest has been the adoption of the Freemium business model.  What was previously freely available at Trip remains, largely, free but for those who want an enhanced service there is a Premium (paid for) service.  We have adopted this model based on the absolute need for financial security. 

So, what do those purchasing the Premium model get?

More content

  • Approximately an extra 100,000 systematic reviews (including systematic review type content such as HTAs), more than double available via the free Trip.
  • Millions of free full-text articles
  • Ongoing clinical trials database of over 175,000 clinical trials
  • Access to a large medical image database
  • Tens of thousands of clinical videos

More functionality

  • Export of records to reference management software
  • The ability to easily exclude certain content types (e.g. eTextbooks)
  • Trip educational credits
  • Article views, see which articles are most popular for your search

Other things

Another new feature is moving to a more secure site with a new password system (this is for both free and premium users).  This will require users to renew their login/password details but it’s a one-off – so hopefully not too traumatic.

Finally, and mentioned above, is the new Trip Evidence Service. Run by experienced and skilled information experts the Trip Evidence Service can provide various services: formal literature searches, horizon scanning and evidence reviews. Given the varied staff skills the service can also offer bespoke information services.

So, why delay, click here to upgrade to the new Premium Trip today (click here).  NOTE: Institutional subscriptions are available,

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