DENT4104 Searching Medical Databases for Evidence
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This document provides an overview of searching medical databases for evidence-based resources. It discusses guidelines for searching specialist medical databases to identify high-quality peer-reviewed literature. Students learn to develop effective search strategies using keywords, synonyms, Boolean operators and other search techniques. Examples are provided for searching PubMed and other databases, as well as for tracking citations through tools like Web of Science and Scopus. Homework involves practicing a search strategy and setting up workspaces to organize search results.
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DENT4104 Searching Medical Databases for Evidence
- 1. Searching Medical Databases for Evidence. DENT 4104 Searching Medical Databases for Evidence. DENT 4104 Lucia Ravi & Haleh Rajabis Librarians Medical & Dental Library Lucia Ravi & Haleh Rajabis Librarians Medical & Dental Library
- 2. Outcomes Students will be able to: • Search a range of specialist medical databases • Select resources and filter for different levels of medical evidence to identify high quality peer-reviewed literature • Develop an effective search strategy • Track article citations
- 3. Guidelines and Protocols Resources that aim to provide an overview of diagnosis, prevention and treatment of a specific conditions to be readily used by clinicians. • Some claim to be evidence based (look for references) • Some are editorial based (professional backgrounds) Guidelines: suggest current best practice but encourage further investigation by practioners of range of evidence given. Protocols: Generally promoted as the core treatment method. Sometimes listed as Point of Care resource.
- 8. Activity • In groups of 4, go to one of the four resources for Evidence Based Guidelines and look up “Gingivitis” • Go the Resources for Answering Clinical Questions, UWA Resources Tab • BMJ Best Practice • ETG Complete • UptoDate • ClinicalKey
- 10. Dentistry and Medical Databases
- 11. Dentistry and Medical Databases
- 12. Dentistry and Medical Databases IN
- 13. Searching strategy basics Example research question •Does brushing with fluoride toothpaste pose a risk to very young children?
- 14. concept 1 concept 2 concept 3 Key concepts brushing with fluoride toothpaste Risk of young children Keywords Synonyms Also related terms and variant spellings Does brushing with fluoride toothpaste pose a risk to very young children? Search string strategy:
- 15. concept 1 concept 2 concept 3 Key concepts brushing with fluoride toothpaste Risk of young children Keywords Fluoride toothpaste Risk/s children Synonyms Also related terms and variant spellings Teeth brushing Danger/s Toddlers Babies Does brushing with fluoride toothpaste pose a risk to very young children? Search string strategy:
- 16. Boolean search techniques • Use AND to combine concepts (toothpaste AND fluoride) • Decreases number of results • Use OR to combine synonyms (child OR toddler) • Increases number of results • Use NOT for subsets eg. (fluoride NOT Austral*) • Truncation – usually the * will truncate words to their root • eg. Australi* will find australia, australian, etc • Quotation marks – used for searching a phrase eg “tooth disease” • Question mark – often used as a wildcard symbol, eg. behavio?r • Brackets (nesting) – used to join synonyms (tooth OR teeth)
- 17. concept 1 concept 2 concept 3 Key concepts brushing with fluoride toothpaste Risk of young children Keywords Fluoride toothpaste Risk/s children Synonyms Also related terms and variant spellings Teeth brushing Danger/s Toddlers Babies Does brushing with fluoride toothpaste pose a risk to very young children? Search string strategy: “fluoride toothpaste” AND (child* OR toddler*) AND (risk OR danger*)
- 18. Activity • Break down the research question you have been given • Identify the key concepts • Identify synonyms • Build a search string applying booleans • AND, OR, “##”, (###), ?, *
- 19. Medline or PubMed? • See http://www.nlm.nih.gov/pubs/factsheets/dif_med_pub.html for a summary of the differences. PubMed is free, larger, and has greater currency. • MedLine are all those items that have been selected for inclusion and indexed using MeSH terms. Greater control over search strategy in the Ovid interface.
- 20. PubMed search
- 21. Medline search Build up your search concepts one at a time to make full use of MeSH terms and how you construct your search. Set up a Workspace login to save queries and items
- 22. 1. Find Article 2. Search references in original article 3. Search articles that cite original article 4. Search references listed in the citing article forwards backwards Citation searching
- 23. Citation searching in Web of Science & Scopus
- 24. Homework • Search for your chosen reference from Activity 1 in either WoS or Scopus • Has it been cited – how many times? • What can you find out about the research community? • Organise your Research • Set up a personal workspace in Ovid • Save items to a project folder (will send to Endnote) • Save a one of your searches in your workspace
- 25. Be selective There is plenty of quality information available Evaluate and be critical Develop criteria for inclusion and discard the rubbish
- 26. For Further Assistance medref-lib@uwa.edu.au (08) 6457 7570 Please book an appointment for longer queries. Haleh Rajabi Lucia RaviKaren Jones
Editor's Notes
- Guidelines and Protocols come in a range of different forms - there are some database products we provide that specialise in providing these such as BMJ Best Practice and UptoDate.. Some claim to be based on a comprehensive analysis of the evidence and demonstrate this, some are put together by expert panels linked to medical associations and their evidence may be more selective. Sometimes they are highly structured database resources such as the BMJ Best Practice and UptoDate, sometimes they are found within larger databases that collate a range of information from single studies through to systematic reviews and guideline summaries. Sometimes they are referred to as Guidelines, sometimes as protocols and sometimes as First Consults. They often include information produced for patients to understand their condition.
- For instance BMJ Best Practice provides a highly structured organisation of summary information related to a specific condition.
- Here is an example of UpToDate’s Guidelines page on Cleft Palates – similarly it summarises under key headings such as etiology, diagnosis and management. Most guideline summaries should have a references tab, where you can critically consider the sources used.
- Many of the specialist Clinical Practice guideline resources are organised around key topics or areas of medical practice but can aslo manage simple searches of a specific condition.
- Then you have resources such as Clinical Key that search across a broader spectrum of guideline sources and also pull in from a wider range of other sources resources… in this search for instance there are 9 guidelines and a 3 first consults found but also a large number of citations pulled in from Medline as well as bookchapters, images and other full text articles. Note that you can also filter by article type to hone in on these, you would certainly be interested in focussing in on systematic reviews for instance on your research topic. Go to live demonstration, show a number of the Systematic Reviews are coming from Cochrane.. and being indexed within Medline but that it is also bringing in systematic reviews from a wide range of other organisation.. Medline is one of the largest and databases collating medical information from a wide range of sources and indexing it with specialist medical terms which is why the second part of this workshop will focus on it. However back to our purpose.. To look at Guidelines and in this case First Consults (closely aligned to protocols). Clinical Key has identified 9 guidelines related to our topic in some way.. Of these you will notice they are coming from a range of specialist journals and professional organisations. First one looks very on topic and when you go into a guideline you will notice similarly to other guidelines the structuring and organisation of summary information about the condition. The First Consult in particular appears to be like a more traditional guideline.. Covering epidemiology, screening, prevention, diagnosis and treatment. Under resources you will find the summary of evidence used to inform this guideline. ??Follow lead from Cranofacial Journal, takes to Pubmed (associated with Medline) and out to journal site where payment option given.. What do you do if faced with this? Go back to OneSearch.
- Spend some time investigating one and then share in your group? Q: How well does it provide an overview of the topics associated with diagnosis, prevention and treatment etc of this condition? Q: How easy is it to investigate the reference sources or evidence used to develop these summaries, do they appear reliable? Record one of the references of interest to you? (all look at one area, such as Management or treatment approach) Q: How might you use these guidelines to support your own research? Any observation on the use of a resources such as Clinical Key rather than others?
- As indicated by this Online Evidence based resources list (in ACQ)– different resources have different strengths in terms of the types of resources they bring together and how broad they are. One of the broadest databases for collating of medical research and journal articles is Medline/PubMed (you may have found much of the information bringing you back to these). With it’s origins in the US National Library of Medicine is has a strong US focus. Embase is also very broad in its scope of biomedical research literature but it has a greater emphasis on European locations. This is why any systematic review must consider these two databases as primary sources. Both MEDLINE and EMBASE are provided here at UWA through the OVID database platform. We selected this platform because of the very controlled way it allows us to build a search strategy using highly developed medical indexing terms…. And so this is what we will be trialling today. Other more specialist databases exist such as Cochrane and JBI Connect (from the Joanna Briggs institute) – as we saw these focus on systematic reviews and guidelines developed through their research collaborations using specific methodologies they have developed.
- Databases such as TRIP and OvidMD are interesting because of the way they help you to visualise the level of evidence of results returned (example of TRIP and OvidMD). Then you have more limited but specialist databases such as CINAHAL focussed on Community and Allied Health, AUSTHealth focused on Australian research bodies and DOSS the specialist Dental database (these can be linked to from the Dentistry Libguide). Medline and Pubmed do give you more capacity to do this. Can you save and export some results to and Endnote Library? Can you add the access date and a label for the level of evidence?
- Databases such as TRIP and OvidMD are interesting because of the way they help you to visualise the level of evidence of results returned (example of TRIP and OvidMD). Then you have more limited but specialist databases such as CINAHAL focussed on Community and Allied Health (not as relevant to Dentistry), AUSTHealth focused on Australian research bodies and DOSS the specialist Dental and Oral Science database (this can be linked to from the Dentistry Libguide). ?
- A broad database such as Medline or EMBASE – that has a well defined and developed list of medical terms that can be searched at a granular level and into which items have been indexed can be a lot more powerful and exact in returning results on the specific conditions, treatments etc that you are searching for. For this reason we are going to look at the skills required to develop effective search strategies that break down your search question and how you can apply them within a database such as Medline and powerful interface such as OVID.
- Moving on from what was covered in the lecture we will work out a search strategy for this example question then search Medline/PubMed,
- Going back to basics, it is always important – especially when trying to research a very specific medical intervention – to spend time thinking about and breaking down your research question to develop research terms and parameters (or limits). This requires you to first break down your research question into the core distinct concepts and then thinking about related terms or synonyms that might be used in different databases or turn up as keywords or free text searches.. What are some other terms we could use for this research question? Work with the students to create a search strategies for this topic for use in Medline or Pubmed, ToothpasteAND fluoride risk AND young children risk Brushingchildren OR risk factors Teeth caretoddlers OR “fluoride toothpaste” AND (child* OR toddler*) AND risk
- Work with the students to create a search strategies for this topic for use in Medline or Pubmed, DOSS and ToothpasteAND fluoride risk AND young children risk Brushingchildren OR risk factors Teeth caretoddlers OR “fluoride toothpaste” AND (child* OR toddler*) AND risk
- Boolean search techniques – such as truncation, phrase searching, nesting – can increase accuracy of search results
- Work with the students to create a search strategies for this topic for use in Medline or Pubmed, You don’t need to necessarily try all of the search terms you have developed. Can sometimes be better to start with less but have a bank of possible terms to try. ToothpasteAND fluoride risk AND young children risk Brushingchildren OR risk factors Teeth caretoddlers OR “fluoride toothpaste” AND (child* OR toddler*) AND risk
- Medline (1960) represents a much more highly selected range of medical journals as selected by the US National Library of Medicine which have been catalogued using MeSH – Medical subject headings. PubMed (1996) as well as Medline contains in process and ahead of print citations, out of scope articles (from within Medline journals), some full-text OA journals, Book citations from NCBI As such you will get more results in Pubmed but unlikely to be as relevant to biomedical science as those just in MedLine. Pubmed is easier to search. MeSH – a thirteen level hierarchy of medical terms (27,883 descriptors + 87,000 entry terms) Medical Subject Terms Includes Supplementary Concept Records (SRC)– contain specific examples of chemicals, diseases and drug protocols. HM – Heading map field, used to identify the most specific descriptor class (SRC’s are related to descriptors in the HM) Perhaps change image to Venn diagram. . (you might have used a different one in the past) which is much simpler to use.
- Use the advanced search. Box 1 – fluoride toothpaste*, box 2 – risk. Use the filters on the left (will need to show additional filters). Select Languages, Ages and Article Types. When they appear on the left of the screen, click Customize or custom range to select the right ones. Select Systematic Reviews from Article type, from ages select Infant: birth-23 months and Preschool Child: 2-5 years. Deselect all others. Once they are displayed on the left, you then need to select them again (when they turn blue) for the limit to be applied. Additional filters in the same category are OR (broaden the search), using a different category are AND (narrow the search = less results).
- Explain what they are looking at: * Building up of subject terms ..mp symbol for key word searchng In indexing or mapping the terms to subjects came up with flurosis – discovered as a specific MeSH indexing term used to describe impacts of too much fluoride in children’s teeth. Can add these in as separate terms and then I have the capacity to decide how to join them together and fluidity with choices – especially if I log in.. Search six brings concept 1 “fluoride toothpaste and risk factors” together Search 7 combines this with items specifically indexed with the subject term flurosis Search 9 brings together this specific topic with more general terms of toothbrushing and toothpastes.. At each try you should be looking over your results to see if they are matching your search interests or deviating from them. Search 10 brings together additional limits to search 9 – age groups and to review articles only. Go through and demonstrate this search in Medline.. Search strategy (turn off map term to subject heading): #1: fluoride toothpaste* , #2 risk* , #3 1 AND 2 #4 3 limited to birth to 23 months & 2-5yrs (in additional limits) #5 4 limited to systematic reviews (under publication type) Use the reference list of the systematic review to locate single studies. Demonstrate identification of reviews. The login details can be found belowURL: http://ovidsp.ovid.com/username: uwatrainpassword: training
- How you can use citations to expand your search
- Article: Dental fluorosis decline after changes to supplement and toothpaste regimens DOSS, Medline, Web of Science, Scopus and Google Scholar all have citation searching capability. Web of Science and Scopus tend to have the best coverage, however. Note that you will probably get slightly different results in each of these databases as they only give results for the journals they index.
- Use your checklist to discard articles that don’t meet the criteria. Where is the checklist…