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Searching the medical literature aug 2010






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    Searching the medical literature aug 2010 Searching the medical literature aug 2010 Presentation Transcript

    • Searching the Medical Literature Robin Featherstone Clinical Medicine Librarian UWO [email_address] http://www.slideshare.net/featherr Selinda Berg Clinical Medicine Librarian Windsor [email_address]
    • Objectives
      • List four categories of information resources
      • Apply selection criteria to identify appropriate information resource
      • List five databases to find primary studies
      • Strategize and execute a systematic, explicit and reproducible search of the biomedical literature
    • Level of Evidence Pyramid Qualitative Studies
    • Systems, Synopses & Summaries Systems Synopses Summaries Few exist Number in the thousands Fewer than 50,000 Textbook-like; integrate clinical evidence with other types of info; directed at clinical practice decisions Summaries of studies and systematic reviews; includes guides or advice from expert clinicians Systematic reviews of articles and guidelines; you assess and make decisions Very easy to use Easy to use May require searching
    • Criteria for Selecting a Resource
      • Soundness of evidence-based approach
      • Comprehensiveness and specificity
      • Ease of use
      • Availability
    • Questions to Ask
      • Bias? Conflict of interest?
      • Evidence grading or ranking applied?
      • Links?
      • Discipline coverage?
      • Consistent and quick to search?
      • Cost?
      • Available in my location?
    • Studies
      • Number in the millions
      • No processing of evidence – must individually assess
      • Require searching large databases
    • Available from Western Libraries (or for free) Find at: www.lib.uwo.ca/programs/undergraduatemedicaleducation/ Systems Synopses Syntheses Studies
      • ACP PIER
      • DynaMed
      • Clinical Evidence
      • UpToDate
      • Micromedex
      • ACP Journal Club
      • InfoPOEMS ( Essential Evidence Plus)
      • DARE (Database of Reviews of Effects)
        • Centre for Reviews and Dissemination
      • Cochrane Database of Systematic Reviews
        • Cochrane Library
      • US National Guidelines Clearinghouse
      • MEDLINE
        • PubMed
        • Ovid
        • Pubget
      • EMBASE
      • SCOPUS
      • Cochrane Controlled Trials Registry (CCTR)
          • Cochrane Library
      • CINAHL
      • PsycINFO
      • Web of Science
      • TRIP Database
    • A Comprehensive Search is...
      • Systematic
      • Explicit
      • Reproducible
    • 7 tasks in a comprehensive search
      • Develop a search statement or question
      • Select a source
      • Choose search terms
      • Run the search
      • Apply practical screens (limits)
      • Apply methodological screens
      • Synthesize the results
    • How questions influence search results Relevancy Retrieval (# of search results) Broad Questions Narrow Questions High = lots of articles Low = very few articles High = directly relevant articles Low = mostly irrelevant articles
    • Sample Search Statements
      • I am looking for articles about osteoarthritis of the knee.
            • 13,886 articles in PubMed
      • I am looking for RCTs on arthroscopic surgery for osteoarthritis of the knee that include placebo surgery as a control.
            • 9 articles in PubMed
      • I am looking for RCTs on arthroscopic surgery conducted in latino females with type 1 diabetes mellitus.
            • 0 articles in PubMed
    • Turn your statement into a strategy
      • Break you question into concepts
      • Identify subject headings for each concept
      • Identify keywords for each concept
      • Tips:
        • Use a “target article” to help identify search terms
        • Use a strategy worksheet to keep track of your terms:
        • http://www.lib.uwo.ca/files/taylor/grad/Search_Strategy_Worksheet.pdf
    • Does hand washing prevent MRSA? in the ICU? Hand washing MRSA ICU Prevention Handwashing [MeSH] Methicillin-Resistant Staphylococcus aureus [MeSH] Intensive care units [MeSH] + Handwash$.mp. Methicillin resistant staphylococcus aureus.mp. Intensive care unit$.mp. Prevent$.mp. Hand wash$.mp. MRSA.mp. ICU.mp. Hand disinfect$.mp. Critical care unit$.mp. Surgical scrub$.mp. Hand clean$.mp.
    • Different databases have different subject headings
      • Tips:
        • Complete a concept map for each database that you search
        • Select subject headings that are the closest match for your concept (remember: systematic, explicit and reproducible)
        • Pay attention to “explode” commands – some databases will search related headings by default, others will not
      Database Subject Headings Medline MeSH EMBASE EMTREE CINAHL CINAHL Headings Cochrane Library MeSH Web of Science N/A Scopus N/A
    • Some key operators in Ovid Note: These are recommended operators for research lit reviews. There are many, many more operators... Use Ovid‘s Help menu to locate them. Or see: http://content.library.utoronto.ca/gerstein/subjectguides/ovidmedline_shortcuts.pdf Operator Command $ Truncation (finds alternate endings) ? Wildcard (finds alternate spellings) .mp. Mapping Alias (tells Ovid to search for your term in the Title, Abstract, Subject Headings, Table of Contents and Key Phrase Identifier fields) – useful for lit. reviews because it is broad () Parentheses control the order of search operations Adj Adjacency operator (can be followed by a number) tells Ovid terms must appear adjacent to one another AND all terms must appear in results OR any terms will appear in results
    • How does patient adherence to medication regimens influence outcomes following surgery for myocardial infarction? Source: Practical Screens:
    • Running your search
    • Running your search(es)
      • Start with your first concept
        • Search for the subject headings first
        • Then search keywords
        • Combine these synonymous searches with OR using your search history
      • Repeat for your second, third, and subsequent concepts
      • Finally, combine large search results set with AND
    • Running your search(es) Search #2 = Search #3 = Search #4 = Search #5 = #1 OR #2 OR #3 OR #4 Search #1 = Concept 1 Search #6 = Search #7 = Search #8 = Search #9 = Concept 2 Search #10 = #6 OR #7 OR #8 OR #9 Search #11 = #5 AND #10 Results
    • Applying practical & methodological screening criteria
    • Screening
      • Two kinds: practical and methodological
      • Why?
        • Use practical screening to identify a broad range of potentially useful studies
        • Use methodological screening to identify the best available studies
    • Practical Screening Criteria – some examples
      • Date of publication
        • only studies conducted between 2005 and 2010
      • Participants of subjects
        • only children 6 to 12 years of age
      • Publication language
        • only materials written in English
      • Research design
        • only clinical trials
    • Methodological Screening Criteria - some questions to ask
      • Is the study’s research design internally & externally valid?
      • Are the data sources used in the study reliable & valid?
      • Are the analytic methods appropriate?
      • Are the results meaningful in practical & statistical terms?*
      • *Fink, A. (2005). Conducting Research Literature Reviews . London: Sage.
    • Applying Screens (or limits)
      • Apply practical screens by using “limits” (may also be called “search options”)
      • Apply methodological screens by reading through the articles
    • Next steps
    • Moving to another source
      • Retain as much of your original strategy as possible
      • Recognize that subject headings will be different (or non-existent)
      • Keep track of your search terms using a new concept map
    • Working with your results
      • Export search results from each database or website into a citation manager (i.e., RefWorks)
      • Remove duplicates
      • Remove inappropriate studies by applying methodological screens
    • Synthesizing the results
    • Look for Patterns
      • What conclusions did these studies reach?
      • Which studies agreed/disagreed with the consensus?
      • Consider using a synthesis matrix:
      • www.ncsu.edu/tutorial_center/writespeak/download/Synthesis.pdf
    • Use your results to...
      • Describe current knowledge about your research topic
      • Support the need for and significance of new research
      • Explain research findings
      • Describe the quality of a body of research*
      • *Fink, A. (2005). Conducting Research Literature Reviews . London: Sage.
    • Recap
      • What is a quality search?
      • Develop a research question that’s ________
      • Which boolean operator do you use to combine synonymous search terms?
      • What screens should you apply to your results?
    • Questions Robin Featherstone Clinical Medicine Librarian UWO [email_address] Selinda Berg Clinical Medicine Librarian Windsor [email_address]