Healthcare Databases Advanced Search (HDAS) A Training Guide Ron Hudson April 2010 Outreach Training Librarian Croydon Health Library and Resources Service NHS Croydon 12-18 Lennard Road Croydon CR9 2RS Tel: 020 8274 6316 Mob: 07733 300 104 Email: [email_address]
Advanced Search Healthcare Databases - Advanced Searching (HDAS) Created by Jane Tatlow as part of the NLH Search 2.0 Representatives Group. Revised by Ron Hudson NHS Croydon Last updated 30.04.10
Go to the NHS Evidence Homepage www.evidence.nhs.uk
Select “NHS Athens Resources” and then “Healthcare Databases”
Logging on with your NHS Athens identity gives you access to all the healthcare databases purchased nationally for use by the NHS.
For a thorough review of evidence based literature you need to search at least two relevant databases separately. This could be a healthcare database and a database from the Evidence Section, or two healthcare databases. This session looks at searching healthcare databases only.
To construct an effective search strategy you also need to plan your search. Consider if the following would be applicable,
Search terms: Are there other synonyms, alternative spellings or technical/layman terms for the subjects you require?
Which databases will be most appropriate?
Are you interested in a particular patient group, e.g. adults, diabetics, outpatients?
What is the medical intervention e.g. specific drugs, therapies, surgery?
You may also want to consider the original language of articles
What is the publication type e.g. clinical trials, systematic reviews?
Or the period you wish to search, e.g. last five years?
Allied and Complementary Medicine (AMED) 1985- Covers occupational therapy, physiotherapy, rehabilitation, plus alternative and complementary medicine: acupuncture, chiropractic, homeopathy, yoga, hypnosis.
British Nursing Index (BNI) 1985- This UK focused database covers general nursing as well as the specific nursing areas covering A&E, neonatal, breast cancer, theatres and orthopaedics.
Cumulative Index of Nursing & Allied Health (CINAHL) 1981- A US database covering all aspects of nursing and allied health. Subjects covered include optometry, radiologic technology, speech and language pathology, nutrition. Covers journals, theses and pamphlets.
EMBASE 1980- With particular emphasis on European sources, this database covers the whole field of medicine. Drugs, pharmacology and substance abuse are particularly well covered.
Health Business Elite
Contains searchable articles from 480 journals in healthcare administration and other non-clinical aspects of health care institution management.
HMIC Health Management Information Consortium 1979- This compiles data from both the Department of Health Library and Information Services and Kings Fund Information and Library Service.
MEDLINE 1950- This is a large US source of medical information. Other subjects include dentistry, veterinary medicine, medical psychology, genetics, and advanced nursing practice.
PsycINFO 1806- Includes international coverage of literature on psychology and allied fields, including education.
An NHS Athens ID allows you to search the following databases:
For complex and systematic searches it is recommended that you search the databases separately. Each database has it’s own specific index and features. Select a single database – a brief description is provided. Here we have chosen EMBASE. Finally select NEXT
Most of the healthcare databases also index articles, assigning index terms or headings from a controlled thesaurus to each article. We can use these thesaurus terms to search for articles. To find the term used by the database thesaurus for your topic and search for articles assigned with those thesaurus terms, select the Map to Thesaurus box. Then SEARCH.
Thesaurus terms or headings are used to categorise each record within the database. Each article record is assigned headings or terms from a controlled thesaurus (sometimes called an index). Selecting the Map to Thesaurus button will display suitable thesaurus terms for your search term. Select the most appropriate heading. If you are not sure use the link to [scope] to display more information.
Thesaurus - explode Selecting the blue thesaurus term will display the thesaurus “tree” with details of more specific or general terms in the thesaurus. Selecting exploded will search all the narrower terms beneath the selected term in the thesaurus. In this example it will include articles specifically indexed with the thesaurus terms Pregnancy Diabetes and Diabetic Angiopathy. If you do not select exploded the search will only retrieve articles indexed with the more general thesaurus term, and you may miss relevant articles.
Results are displayed in a Search history table that builds up as you enter new terms or phrases. Your search statement is repeated in the Search Term column. The number of articles found for each search is displayed as hits. Clicking on the hit number will display citations for the records found. We need to focus our search a bit more before we display any records. Each new search is labelled with a number. You can use these numbers and search lines to combine different searches.
Type one or more words, or a phrase, into the search box. It is helpful to search different topics separately and combine them later. Choose appropriate search criteria from the menu. Title and Abstract is the default setting. Multiple selections may be made by holding down the CTRL key. Finally select SEARCH .
Typing two or more words will retrieve results that contain all those words in the criteria you selected.
To enter phrases, type your words within double quotes. Your results will only include results that contain this exact phrase in the criteria searched. Some phrase examples are:
“ cognitive behaviour therapy” “heart attack”
You can use the * as a wildcard to search for words with the same beginning. For example therap* will find therap y, therap ist and therap eutic; nurs* will find nurs ing, nurs ed, nurs e
To search for an author use the format “Shirkey BL” or if the initials are unknown, replace initial with the wildcard * eg. “Shirkey *” or “Shirkey B*” . The quotes are essential.
Combine similar topics with OR to retrieve items with either criteria. Here we want to retrieve articles that have been indexed as being about diabetes as well as articles with the term diabetes in the abstract/ title. To combine related thesaurus and keyword searches use OR Select the relevant search lines, choose the appropriate button, here OR, Then select Combine Selected Searches
We can repeat this process for all our terms, for our search on the effectiveness of yoga as exercise for diabetics. Line 1 is the thesaurus or index term search and line 2 is the keyword search.
Having combined related thesaurus and keyword searches, we also need to combine the different topics . Use AND where you want BOTH topics to be present in articles retrieved. In this example we need to use AND between our results for diabetes (thesaurus term or keyword) and yoga (thesaurus term or keyword)
Use the combine function AND to search for results that include both or all terms . AND will reduce the number of articles you retrieve. Usually used to combine different topics, for example,
diabetes AND insulin
“ art therapy” AND “mental health”
Use the combine function OR to search for results that include either term. OR will increase the number of articles retrieved. Usually used with similar topics, synonyms or alternative spellings. Some examples are pediatric OR paediatric stroke OR cva yoga or “tai chi” or pilates
NOT is also available but should be used with caution. For example diabetes NOT adult would exclude clinical trials involving both adults and children, not just those involving adults.
Our combined search has retrieved 87 articles. We could view these citations by selecting the number of hits. We can also use the Limits function available for this database to reduce the number of results further.
Limits are displayed beneath the search box. Use the arrows to open each limit and view options, or Expand all limits . To delete previously set limits, use Clear all limits.
Here we have used the drop down menus in the Date Limits to limit retrieved articles to those dated 2005 to Current. It is possible to select a single year of records by selecting only a From Publication Year.
Here we have expanded the Language Limits . Note that your previously selected date limit is displayed in light blue. If you want articles written only in English, select the English Language box. If you wish to select more than one language choose from the drop down Languages menu (including English) and do not select the single English limit. To select more than one option from a menu hold down the control key on your keyboard when you select options.
Clinical Queries Limit Clinical Queries Limit The Clinical Queries Limit will restrict your results to clinically sound studies. They are only available in EMBASE, MEDLINE and PsycINFO. Nine categories are provided, the emphasis may be: Sensitive : Most articles are relevant but may also retrieve some less relevant ones. Specific : Most articles are relevant but may omit a few. Optimized : a combination that optimizes the trade-off between sensitivity and specificity. These filters are based on the work of R Brian Haynes MD, PhD et al of the Health Information Research Unit HIRU. For more detail see the original web page. http:// hiru.mcmaster.ca /hedges/
Once you have selected your limits, enter the search line you wish to apply limits to in the search box, here 7, and then SEARCH
Using the date and language limits has reduced the number of retrieved articles. To display your results select the blue link to records in the hit column.
Records are normally displayed by publication date. If there are less than 500 records, the sort order can be changed by selecting from the drop down menu, then selecting SORT.
Clipboard: Enables the temporary saving of results from different result sets or databases. The clipboard selections cannot be saved for further sessions. To try clipboard: select results of interest and then “Copy to clipboard”. Clipboard automatically recognises duplicate records and will not add another copy of the same result. The number of results on your clipboard will be displayed. Select “ view your clipboard” to view and output results held in this temporary file.
It is possible to view abstracts in search results using the Show Abstracts option. When the box next to Show Abstracts is selected the short citation will also include abstracts where available.
Some records will include links to the full text content of an article. Selecting the blue supplier link will display the article. You may be prompted to enter your Athens username again – check for an Athens log in request if the article does not appear directly.
There are over 1500 journals available online to NHS staff which are purchased by NHS England. Local health library services have added to this total. This includes many top titles such as JAMA and British Medical Journal.
Your NHS Athens username and password is the key to access these journals and articles.
Direct access to a searchable journal title index is available via My Journals, http:// www.library.nhs.uk/booksandjournals/journals or from the link on the NLH homepage.
NOTE: Full text links also include details about print copies held in local libraries. Where no online or print Full Text link is displayed, your local health library may be able to obtain a photocopy. Details of your local health libraries will be available in the My Library pages of NLH website once you are logged in.
To select results for saving or emailing, click the small box beside the short citation. To see more details about a record, select the record title (in blue). Details provided will depend on the database but might include an abstract, publication type or thesaurus index terms.
You can navigate through the result details using the links above. Clicking on a relevant subject heading will perform a search on that subject heading and return you to the search history.
To return to the results display select Current Search Results from the breadcrumb trail in the header section.
At the bottom of each page of results there is a series of options allowing you to select both the output and display formats for your results.
To save selected article details use the form at the bottom of every results page. You can Export Results in PDF, MS Word or Text output format . To display results use Export results with HTML output format. To email results select PDF, MS Word or Text output format. You can also export selected results into Reference Manager software, using the RIS output format.
To add further limits, do another search, or change databases use the links in the breadcrumb trail, shown above.
Use Current Search Results to return to your short citations of results
Use Search and Limits to return to the search history table
Use Healthcare Databases Advanced Search to change the database you are searching.
It is possible to save searches from the Search History page . Saved searches include all details of the original search including terms, search criteria, databases and limits. Select the appropriate rows and then SAVE SELECTED ROWS
Give your saved search a relevant name and SAVE or SAVE & CREATE ALERT
If you select the ALERT option you will be asked to fill in this simple form including email address and frequency. Complete all parts and then SAVE ALERT.
When you return to searching healthcare databases use the HELLO area to manage your saved searches and alerts. You can also recover any searches if experiencing a technical issue.
Select My Saved Searches to view your saved searches. When you rerun your search, you are offered RUN SEARCH ON CURRENT DATABASE, or RUN SEARCH. NOTE: Each database has a slightly different thesaurus, if you use a different database you are advised to remap terms to thesaurus in your new search. For this reason we usually recommend that you use RUN SEARCH as this will run the search in the same database as the original search.
To do your search again in a different database, use the breadcrumb link Healthcare Databases Advanced Search or Search using different databases.
From here you can now select a new database to search. We have now selected Medline
Selecting a different database from the list will display the following page. It is recommended that you use Continue and re-type or use drag and drop to repeat the search in your new database, re-mapping to the new database thesaurus where relevant. If your previous search includes Thesaurus searches do not Re-execute Search History as thesaurus terms may not exist in the new database.
When searching in a new database, it is recommended that you select Show All, so that all your search steps are visible, instead of only the last 10.
Here we have redone the same search in MEDLINE. Note that we have repeated the same Limits for language and period. It is now possible to combine our EMBASE search (with 58 results) and the Medline Search (with 24 results) and remove duplicate records. Select the appropriate search lines and use REMOVE DUPLICATES
This produces a combined set of results from both databases. You can see that 16 records were duplicated and our unique set has only 66 results. You can view all results, the duplicated results or the unique set by selecting the appropriate hit number.
It is also possible to do a quick search across several databases at once. The full functionality of each database is not available in this type of search. QUICK SEARCH ACROSS DATABASES
To do a quick Advanced Search across all the databases select here, otherwise to search across two or more just select the databases of interest. Then click on NEXT .
Here we have repeated our diabetes search across all databases. Note that only the date limit is available. The mapping box is also unavailable and searches cannot be made of the database thesaurus. You are also automatically informed when the total number of results exceeds 500.
Once you have your optimal search you may select specific references and display, email or save the results you require as explained earlier.
You will still need to critically appraise the articles you have found. There are several tools to help you do this. A link to the following resources is provided at the bottom of the Search Books Journals and Healthcare Databases page.
CASP Critical Appraisal Toolkits from the Public Health Resources Unit
University of Oxford CEBM toolkit
Canadian Centre for Health Evidence – User Guides to the Medical Literature
How to read a paper- Professor Trisha Greenhalgh
Syntax for experts Syntax for Experts: Use the following shortcuts in your searches. For more syntax see the Help Screens As above, words next to each other in same order e.g., cerebrovascular ADJ accident ADJ Terms within the “” are next to each other in the same order Eg., “cerebrovascular accident” “” Words in all fields .af Words in abstract .ab Words in Title e.g. diabetes.ti .ti Field Codes Where n is a number greater than 1. Words within the specified number of words (n) of each other, in any order. ie. The ADJ2 operator finds terms in any order with one word between them. ADJn Word or expression preceding the operator but not the one following it NOT Any of two or more words in any order OR Two or more words in any order. Operator not required unless you are using nested terms . AND number (n) specifies the maximum characters after the word stem, eg., therap*3 will find therapy and therapist but not therapeutic. *n Operators Wildcards Words in title and abstract .ti,ab Unlimited truncation, can be used at the end of a word “stem”. For example pregnan* will find pregnant, pregnancy; p*diatric will find paediatric, pediatric *