Ebpsearching Handouts

  • 1,591 views
Uploaded on

 

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Be the first to comment
    Be the first to like this
No Downloads

Views

Total Views
1,591
On Slideshare
0
From Embeds
0
Number of Embeds
0

Actions

Shares
Downloads
36
Comments
0
Likes
0

Embeds 0

No embeds

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
    No notes for slide

Transcript

  • 1. Finding Evidence Based Clinical Information in the Cochrane Library and PubMed EAHIL Continuing Education Course Helsinki June 24th. 2008. Hilde Strømme, Ullevaal University Hospital, Medical Library
  • 2. Program
    • Introduction about questions
    • Demonstration: PubMed Clinical Queries and PubMed MeSH database
    • Hands-on exercises in PubMed
    • Demonstration: The Cochrane Library
    • Hands-on exercises in The Cochrane Library
  • 3. The 5 steps in Evidence Based Practice
    • Ask a question
    • Find information/evidence to answer question
    • Critically appraise the information/evidence
    • Integrate appraised evidence with own clinical expertise and patient’s preferences
    • Evaluate
  • 4. Examples of Questions
    • Is the Cage Questionnaire a good tool to diagnose alcoholism?
    • Is acupuncture effective for smoking cessation?
    • Can pressure relieving mattresses prevent pressure ulcers?
    • Can measels-mumps-rubella vaccine (MMR) cause autism?
    • In primary nocturnal enuresis in children, do alarm systems compared with pharmacological therapies produce fewer wet beds in the short term and the long term?
    • Will the quality of literature searches performed by health personnel improve if they have guidance from a librarian?
  • 5. PICO: The components of a clinical question Outcome Comparison Intervention or Exposure Population Patient Problem What happens? What is the outcome? What do we compare the intervention with? Not always necessary. What do we do to them? What are they exposed to? Who are the patients? What is the problem? O C I P
  • 6. In primary nocturnal enuresis in children, do alarm systems compared with pharmacological therapies produce fewer wet beds in the short term and the long term? Nocturnal enuresis in children Alarm systems Fewer wet beds Pharmacological therapies Outcome Comparison Intervention or Exposure Population Patient Problem O C I P
  • 7. PICO and Search Terms Pharmalogical therapies Alarm systems Nocturnal enuresis in children antidiuretic agents desmopressin imipramine alarm* nocturnal enuresis bedwetting nighttime urinary incontinence O C I P OR AND
  • 8. Can measels-mumps-rubella vaccine (MMR vaccine) cause autism? Children Autism MMR vaccine (No vaccine) Outcome Comparison Intervention or Exposure Population Patient Problem O C I P
  • 9. PICO and Search Terms Autism MMR vaccine Children Autism Autistic disorder Kanner’s Syndrome (Asperger Sydrome) Measles-Mumps-Rubella Vaccine MMR Vaccine Mumps Measles Rubella Vaccine Virivac Pluserix Priorix Trimovax Triviraten Berna O C I P OR AND
  • 10. Evidence Pyramid Systematic review RCT Cohort Studies Case Control Studies Cross Sectional Studies Case Series Case Report Ideas, Editorials, Opinions Animal research In vitro (’test tube’) research
  • 11. Systematic Review vs. Review Article
    • Systematic Review
      • Identify, compare and summarize ALL relevant studies
        • As close to objective as we get
    • Review Article
      • Compare and summarize SOME relevant studies
        • May be biased
  • 12. Relevant databases Resources/Databases Study design Question Qualitative Studies Randomised Controlled Trial Controlled Trial Cohort Case Control Cohort Case Control Case Series Cohort Cross Sectional
    • Cinahl
    • Medline (and others)
    Experience
    • Cochrane Database of Systematic Reviews, HTA og DARE (in The Cochrane Library), Clinical Evidence, Joanna Briggs, PEDro
    • CENTRAL (in The Cochrane Library)
    • Medline, EMBASE (and others)
    Effects (Therapy, prevention)
    • For questions about adverse effects:
    • DARE + HTA (in The Cochrane Library)
    • For other etiology questions:
    • Medline, EMBASE (and others)
    Etiology
    • DARE + HTA (in The Cochrane Library)
    • Medline, EMBASE (and others)
    Prognosis
    • DARE + HTA (in The Cochrane Library)
    • Medline, EMBASE (and others)
    Diagnosis
  • 13. Other relevant databases
    • DynaMed
    • UpToDate
    • Cinahl
    • British Nursing Index
    • PsycINFO
    • AMED
    • SveMed+
    • … ..
  • 14. Clinical Queries in PubMed Use Clinical Queries to limit your search to the appropriate study design Or to find systematic reviews
  • 15.
    • A search filter is added to your subject search, based on the type of question (therapy, diagnosis etc.)
    • The search filter is based on MeSH headings and text words describing the study design
    • Choose between
      • broad and sensitive search (sensitivity)
      • narrow and specific search (specificity)
    Clinical Queries – what happens behind the scenes? Lena Nordheim, 2007
  • 16.  
  • 17.  
  • 18.  
  • 19. Build your MeSH-search by sending MeSH-terms to the Search Box and then click Search PubMed
  • 20.  
  • 21. MeSH or text words?
    • Using MeSH search will produce relevant hits, but you risk loosing some
    • The best is a combination of MeSH terms and text words. Reasons:
      • The newest references have no MeSH yet
      • Indexing with MeSH is done by humans, humans make mistakes
  • 22. Hands-On Exercises!
    • PICO forms:
      • Identify the different components of the question
      • Decide what type of question it is
      • Find search terms and write them in the appropriate boxes of the form
  • 23. Hands-On Exercises!
    • PubMed Clinical Queries
      • Use the search terms to search PubMed Clinical Queries
      • Try both text words and MeSH database
      • Look at the results – are the results relevant?
  • 24. The Cochrane Library
    • The Cochrane Database of Systematic Reviews (CDSR or Cochrane Reviews)
    • Database of Abstracts of Reviews of Effects (DARE or Other Reviews)
    • Health Technology Assessment Database (HTA or Technology Assessments)
    • Cochrane Central Register of Controlled Trials (CENTRAL og Clinical Trials)
  • 25. Search tips
    • Phrases: Words that belong together: use NEXT or quotation marks
      • common NEXT cold
      • ” common cold”
    • Beware: When you use qoutation marks, truncation will not work
    • Use NEAR for words that should occur close to each other (within 6 words)
      • wound* NEAR infect*
  • 26. More search tips
    • Truncation: infect* = infection, infections, infectious etc. *natal = prenatal, postnatal, perinatal etc.
    • Masking: hyp*tension = hypotension, hypertension
  • 27. Even more search tips
    • Always use Advanced Search
    • Make sure to search for ALL relevant synonyms
      • Tip: Use MeSH database in PubMed to find synonyms
    • Search in ”Title, Abstract or Keywords”
      • Will probably produce the most relevant hits
  • 28. MeSH search – Be careful!
    • If you ONLY use MeSH search:
      • You will not get the newest Cochrane reviews
      • In Clinical Trials you will only get Medline-references
    • Solutions:
      • Combination of MeSH search and text-word search
      • Include the MeSH-term as one of your text-words
  • 29. Use Advanced Search to search for all synonyms Title, Abstract or Keywords will probably produce the most relevant hits.
  • 30. Combine Searches in Search History
  • 31. Hands-On Exercises!
    • PICO forms:
      • Identify the different components of the question
      • Decide what type of question it is
      • Find search terms and write them in the appropriate boxes of the form – use MeSH database in PubMed to find synonyms!
  • 32. Hands-On Exercises!
    • The Cochrane Library
      • Use Advanced Search to search for all relevant synonyms
      • Look at the results
        • Are there any relevant systematic reviews in Cochrane Reviews, Other Reviews or Technology Assessments?
        • Are there any relevant RCTs in Clinical Trials?
      • Exercises 4-8 are suitable for The Cochrane Library