Nested Knowledge: Bridging the knowledge gap in the age of COVID-19

Nested Knowledge: Bridging the knowledge gap in the age of COVID-19
Parvathy Hariharan

Doctors are experts at working based on incomplete information. Medical decision-making depends on correlating the patient’s narrative and symptoms with the physical exam and laboratory results and coming to a diagnosis.  Clinicians even ask about subtle symptoms that we are unaware of, an experience that most of us have had. For a known well-characterized disease, such as the seasonal flu, this system works well. The treatment strategy is clear: what diagnostic tests to administer, how long the results take, what drugs to take, and what to avoid. However, for an unknown new disease, such as COVID-19, a host of novel questions also arise that cannot be adjudicated based on experience: Does the pathogen react differently across age groups? Do strains in different geographical areas react differently? Are some populations more vulnerable than others? The answers are buried deep in scientific research that may be lost in the thousands of opinion pieces flying around about COVID-19. The novel literature is effectively a disorganized haystack with many needles that experts then need to compile, curate, classify, and compare before updating the doctor. The doctor’s job has just become that much harder, not to mention the ease and timeliness of patient care.

In the wake of COVID-19 pandemic, the scientific community has thrown open its doors to information.  The New York Times and The Atlantic have opened up their articles on the pandemic beyond paywalls. The Cochrane Collab scientific community has removed restrictions on their library temporarily and collated all related information in one page with information for healthcare workers, researchers, and policy experts. The journals Nature and Science, along with several others, have set up an exclusive Coronavirus page for research exclusively focusing on the pathogen. Many disease-specific journals are actively accelerating rapid publication and open access of research on the novel coronavirus.

Ironically, abundance of information is not always connected to rapid medical decisions. The plethora of data that is pouring in needs to be compared and analyzed. Medical professionals need to make calculated decisions on the best drugs to provide to patients with diabetics, asthma, cancer, immunosuppression, and heart-failure. They need to know the rates of various potential complications and mortality in these subpopulations and then make an informed choice with updated information at this moment. The latest data can now save a life, literally.

More than ever, Nested Knowledge is committed to providing researchers that information. As a medical publishing platform that curates several thousands of studies in a dynamic visual interface using machine-learning technologies, we are actively working on an updated coronavirus nest, organized by study type and topic with full information on outcomes, interventions, and transmission rates. We expected to publish this information online this week, for free, to enable access to novel research that goes beyond just gathering by tagging each article with its key content and organizing articles by their topics and messages.  A living systematic review with all available information on the topic, identified and categorized to simplify the work of those who are putting their lives on the line for us, so that they can work with the complete information available out there.