ACP J Club. 2002 Jul-Aug;137:A15. doi:10.7326/ACPJC-2002-137-1-A15
TRIP (Turning Research into Practice) aims to offer health care professionals a complete and updated list of online resources useful for evidence-based practice. TRIP is a database of Internet links to information resources selected because they offer free access to high-quality content. The TRIP Web site does not report the criteria used to determine whether the information is high quality. The database includes 29 000 links to items in nearly 70 sources that are updated and expanded monthly but not critically appraised by TRIP. Access to TRIP is free of charge, but users are required to register.
TRIP is easy to use, with a simple Web-page design that provides quick downloads even with slow Internet connections. TRIP organizes the links in its database into clinical areas (e.g., cancer, cardiovascular, pregnancy and childbirth, and mental health) and features a self-directed learning area that offers online continuing medical education based on systematic reviews. A user-friendly search engine is also available on the site. The user can enter a word or phrase (searched exactly as typed) or a simple Boolean expression into a query box. The search is limited to the title of the link or to the title and text that were captured in the database when the hit was first identified by TRIP (this text could include the executive summary of a guideline or the abstract of a manuscript). A helpful troubleshooting guide to improve searching is a click away. Users can store their search terms to be run periodically and can have the results e-mailed.
The search results are organized into color-coded categories. The categories include evidence-based resources (including links to ACP Journal Club and Evidence-Based Medicine and links to databanks of critically appraised topics); query-answering services (mainly the Ask TRIP to Rapidly Alleviate Confused Thoughts [ATTRACT] service, www.attract.wales.nhs.uk); peer-reviewed journals (including the journals published by the BMJ Publishing Group, JAMA, Annals of Internal Medicine, and The New England Journal of Medicine); guidelines; electronic textbooks (including the Merck Manual and emedicine.com); and links to the Clinical Queries feature of PubMed (www.pubmed.gov). Within each of these categories, the links are listed by date of publication and include the name of the host Web site.
To evaluate TRIP, we completed a series of searches using questions that arose during our clinical practice. A search that used the simple Boolean expression “diabetes AND smoking” and that was restricted to “titles” identified 6 hits: 5 articles in peer-reviewed journals and 1 guideline from the American Diabetes Association Practice Recommendations. When we completed the search using “titles and text,” it took longer, and most of the 387 resulting hits were not relevant.
A search for “vitamin E” in “titles” led to 19 hits. The results included critically appraised topics of several randomized trials of vitamin E and 3 Cochrane reviews. The hits also included ATTRACT’s answer to a question about the effectiveness of vitamin E in dementia. The peer-reviewed journal hits included abstracts to 3 important clinical trials. The electronic textbook hits offered links to narrative reviews of vitamin E toxicity and deficiency.
Unfortunately, the search engine does not enhance the search terms entered by users who type in synonyms or medical subject headings. We found that searching by title and text yielded too many irrelevant hits, but this finding may represent our lack of experience with the search engine. Performance of quick searches on specific topics using TRIP can be hit or miss because success is dependent on the content of the database. We feel that the inclusion of textbooks delays the search and provides information of limited validity and clinical usefulness.
TRIP offers a friendly interface and quick access to the evidence (particularly if the search is limited to titles) with user-friendly organization of search results. We recommend this resource for those seeking preappraised evidence, reviews, and guidelines. Those seeking the original studies may be better off using the Clinical Queries and Related Articles functions in PubMed.
Victor M. Montori, MD, MSc
Rochester, Minnesota, USA
Jon O. Ebbert, MD
Rochester, Minnesota, USA
Methods/Quality of Information: 1 star
Clinical Usefulness: 3 of 5 stars
The TRIP database can be found at www.tripdatabase.com.