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Lecture to Medical Student on Feb 20, 2008 …

Lecture to Medical Student on Feb 20, 2008
EBM - How to Search - Basic

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    • 1.  
    • 2. 實證醫學 5 – 查 網路文獻搜尋 2008 Feb. 20 基隆長庚.楊宗翰醫師 實證醫學中心 風濕過敏免疫科
    • 3. Five Steps
      • Ask
      • Acquire (Search)
      • Appraise
      • Apply
      • Audit
    • 4.
    • 5. Ask / 問
      • 精確( specific )的問題
        • 可以 被回答 (answerable)
        • 可以 被搜尋 (searchable)
      • P
      • I
      • C
      • O
    • 6. Appraise
      • Appraised by yourself …
        • Time consuming
        • Original articles
      • Appraised by authorized specialists
        • Systems, Synopses, Synthesis
        • Review articles (narrative, systematic, EBM review)
          • topic or article review
      Dave Sackett
    • 7. Acquire / 查
      • 選擇資料庫
        • What
      • 建構檢索策略
        • How
      • Question
      • Database selection
      • Search strategy
    • 8. Step 1 - Question
      • 那種問題?
        • Foreground or Background
      • 那類問題?
        • Frequency (incidence or prevalence)
        • Diagnosis
        • Harm (etiology or risk factors)
        • Prognosis (natural history)
        • Treatment (intervention)
      • 最佳解決方案(研究方法)!
    • 9. Current Best Evidence
    • 10.  
    • 11. Step 2 – Select Database
      • Which & Why?
        • Contents
        • How to search?
        • Results of search?
    • 12.  
    • 13. The “5S” levels of organization of evidence from health care research – by R Brain Haynes, 2006 Systems Summaries Synopses Syntheses Studies Original journals articles 原始研究文獻 Pre-filtered Secondary Computerized decision support 實證臨床資訊決策系統 Evidence based textbooks 針對某臨床主題統整各類證據以形成之概述 Evidence based journal abstracts 對單篇研究及 SR 做摘要性評估之文章 Systematic reviews 系統性評論 Primary
    • 14. Contents
      • Type of Content
        • Original
        • Review
          • EBM review (topic or article)
          • narrative review
      • Primary or Secondary
    • 15. citation
    • 16.  
    • 17.  
    • 18.  
    • 19.  
    • 20. EBM article review based on case (Critical Appraisal Topics, CATs)
    • 21. EBM topic review
    • 22.  
    • 23.  
    • 24. Contents
      • Original articles
        • Medline (citation)
        • Core clinical journals (full text)
      • EBM reviews
        • Article reviews (Synopses)
        • Systematic reviews …
        • Guidelines
      • Reviews
        • Textbooks
        • Review articles
      • 定期更新,資料來源
      • Cochrane library
      • EBM synopses (Article review)
      • Clinical Evidences, ACP PIER, DynaMed, InfoPOEMs, First Consult, Clin-eguide (Topic review)
      • Uptodate
      • [email_address]
    • 25. Step 2 – Select Database
      • Which & Why?
        • Contents
        • How to search?
        • Results of search?
    • 26.  
    • 27.  
    • 28.  
    • 29.  
    • 30. EBM article review based on case (Critical Appraisal Topics, CATs)
    • 31.  
    • 32.  
    • 33.  
    • 34.  
    • 35.  
    • 36.  
    • 37. 30+ 個選擇
    • 38. Acquire - Which & Why?
      • Contents (original, EBM review, review)
      • How to search?
        • Keywords OR thesaurus/MeSH
          • Synonymy/acronym;
          • Query interpretation (heart attack cancer)
        • Search strategy
          • Boolean logics (AND/OR/NOT/NEAR)
          • Categories & filters (quality & publication types)
        • Search refinements
          • Diagnosis, Differential diagnosis, etiology, pathogenesis, prognosis, signs, symptoms, treatment
          • Population, disease entity (hypertension – pregnancy, portal, pulmonary, renal…)
      • Results of search?
        • Numbers of results – sensitive or specific
        • The order of results – time (current), relevant (best?), clinically appropriate (definition?)
    • 39. http://ebm.twbbs.org/
    • 40. 推薦 4 組 10 個 http://ebm.twbbs.org/ http://10.26.52.233/
    • 41. Acquire / 查
      • 選擇資料庫
        • What
      • 建構檢索策略
        • How
      • Question
      • Database selection
      • Search strategy
    • 42. Current Best Evidence
    • 43.
      • 決定 Keywords
        • 縮寫
          • AMI, BPH, CAP , CAD
          • DM , IDA , MM , SLE
        • 中文 > 英文
          • 漢英字典(非醫學 & 醫學)
        • Results from searches
          • Medline, Google, …
      Step 3.1 - Keywords
    • 44.  
    • 45. Keywords or Index Terms
      • keywords
        • truncation ($/*; Salmonell* or child$)
      • indexed terms
        • MeSH (Medline/Pubmed)
        • CINAHL Index Terms (CINAHL)
        • EMTAGs (EMBASE)
      • automatic term mapping (ATM)
    • 46.  
    • 47. Keywords or Index Terms
      • Definition
        • Neoplasms
          • cancer, carcinoma, tumor
        • myositis
          • inclusion body myositis
      • Relevance (focus or explode)
    • 48.  
    • 49. 1 2 3 2 1 3
    • 50. MeSH ...
      • Most human beings on the planet who are not librarians don't know anything about how to search with MeSH.
        • John Sack, the director of HighWire Press.
      NEJM 2005;354:1:4-7
    • 51. 教育部國語辭典
      • 三隻小豬
      • 打炮
    • 52.  
    • 53. Step 3.2 - Hedges
      • 1 concept or keyword a line (an entry)
      • P & I more important, use C & O to narrow down results
      • OR & AND
      • NEAR, ADJ …
      • ! NOT
    • 54. Step 3.3 - Filters
      • 最佳解決方案
      • Quality filters & Limit
        • clinical query
        • methodology (publication type) filters
        • x English, full text, review
    • 55. Current Best Evidence
    • 56. Filters - limit
      • therapy, diagnosis, prognosis, etiology, qualitative studies
      • review, clinical prediction guides, costs, economics
      • sensitivity, specificity, optimized
    • 57.  
    • 58. Acquire / 查
      • Question
      • Database selection
        • What
        • Content > Search > Result
      • Search strategy
        • How
        • Keywords + MeSH > Hedges > Filters
    • 59. Current Best Evidence
    • 60.  
    • 61.  
    • 62. Databases
      • Background questions
        • Reviews
          • Uptodate, MD Consult (Textbooks, Clinics)
          • Ovid (Books@Ovid, Journals@Ovid)
      • Foreground questions
        • First Consult, Clin-eguide (Ovid), ACP PIER, Dynamed, InfoPOEMs
        • Guidelines, or EBM-style review or CATs, Bandolier
        • Hand searches PubMed (clinical queries, methodological filters)
    • 63. http://ebm.twbbs.org/
    • 64. Slide & Handout … On the web …