The TRIP database (Figure 1) grew out of the work of its founders Jon Brassey and Dr Chris Price, trying to answer clinical questions using the principles of evidence-based medicine. As a wide range of websites were used to identify the best available evidence, each website used took at least 5 min to search, and there was a need to respond to the questions in a clinically relevant time, the value was recognised of having just one website to search. Consequently, the first, crude, web-based version of TRIP was launched in 1997. Since then, there have been a number of upgrades to the site and more recently the site has been externally evaluated by a team from the Centre for Evidence-based Medicine (www.cebm.net) led by Professor Paul Glasziou.

Figure 1
figure 1

The TRIP database homepage

Full size image

The TRIP database was a subscription-based service for 4 years, during which time a number of significant improvements were made but when use of the service also dropped off dramatically. Since September 2006, the database has been accessible to all.

Database content

Content on the database is identified in a variety of ways with regular systematic searches of the internet and regular collaboration with clinical answering services, such as the UK National Health Service clinical answering services (www.clinicalanswers.nhs.uk) and Attract (www.attract.wales.nhs.uk) to identify quality resources. TRIP also works with the Department of Family Medicine at Laval University, Quebec, Canada, to help identify and appraise sites in a more systematic manner. A directory of evaluated websites using a validated evaluation instrument is available at http://132.203.128.28/medecine/repertoire/repertoire.asp.

The content of the TRIP database is separated into a number of categories (see Table 1), the divisions being based on Haynes' work on the ‘4S’ approach to current best evidence.1

Table 1 TRIP database categories
Full size table

Searching TRIP

The TRIP database is searched using a prominent search box that will be familiar to all those who regularly search internet sites. The usefulness of the site can be seen by the fact that an example-search I tried on fluoride varnish very rapidly identified the following:

  • Systematic reviews 17

  • Guidelines

North America 4

Other 1

  • Clinical questions 4

In addition to the following Medline articles:

  • Therapy 85

  • Diagnosis 2

  • Systematic reviews 19

  • Prognosis 5

  • Aetiology 6

A similar search of PubMed for fluoride varnish produced 486 hits with 39 suggested to be reviews. In order to improve the PubMed search to identify the higher quality articles, a more detailed search with additional filters would be required. So for the busy clinician, higher quality information is identified more rapidly using TRIP.

A further refinement of the searching process on TRIP is the opportunity to search the specialist sites. Oral health is included as one of the specialist sites (Figure 2) and it searches both the core TRIP content and 11 leading oral health journals (see Table 2).

Figure 2
figure 2

TRIP database — oral health specialist search page

Full size image
Table 2 Dental journals included in the oral health specialist search
Full size table

The TRIP database is produced by TRIP Database Limited, who have been involved for a number of years in health-related knowledge management. Their TRIP database is a very useful resource for the practitioner and one which should be included as one of your favourite sites or bookmarks.