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Searching the Literature:
     the Beginning
          Mary Shah, MLS
  Horblit Health Sciences Library
         Danbury Hospital
    Mary.shah@danhosp.org
Search Strategy
Plan your search at first and the process
       will be much more effective.


1. Focus on what you are seeking
   and think about which resources
   would best have the answer.
2. Break down the query in basic
   terms.
3. Choose the research method.
4. Search each point separately.
5. Combine these subjects with
   AND, OR, NOT (these are Boolean
   Operators).
6. Focus your search with limits.
PICO
PICO can be used to help break down your
  question
• Patient or Population: How would I
  describe a group of patients similar to
  mine?
• Intervention: Which main intervention,
  prognosis, or exposure am I considering?
• Comparison: What is the main alternative
  to compare with the intervention?
• Outcome: What can I hope to accomplish,
  measure, improve or affect?
Where to search?
 • Basic Reference = Search engine
   like Google
 • Background or Introduction =
   textbook
 • Research Article = database like
   CINAHL or Pub Med
 • Practice = Cochrane, DynaMed,
   Nursing Reference Center
Choosing the Evidence
                         Meta‐analyses
Higher Quality                                    Percentage
                                                      of the
                      Systematic reviews
                                                   literature

                  Randomized controlled trials

                         Cohort studies

                      Case‐control studies

                  Case series and case reports

                 Animal and laboratory research
What does this mean?
Evidence‐based practice is
  the systemic application
   of scientific findings to
   clinical practice and
       decision making.

Tools already exist to rate
  the quality of study and
   its ability to inform the
    scientific community.
Boolean? Halloween meat?

      George Boole brought together philosophy and
      math by inventing a logic that worked well with
      computers: the answer is either true or false.


      For your search, this means you can combine two
      search terms using the connectors: AND, OR,
      NOT.
Combining search terms
         AND
Another possibility
           OR


          Fall*


 cancer         Patient
Another possibility
          NOT


          Fall*


 cancer       Patient
Truncation?! Are we going
      someplace w/ an elephant?
• Truncation is a short-cut to
  include all the possibilities:
fall*= fall, falls, falling, fallen, and
  so forth…

• Wildcards fill in for variations:
Reali?e = realize, realise
Not just for dialogue any more
Quotation marks force the database to look for
 that specific combination of words.



In CINAHL:
• Practice Guideline without quotes: 90,812
  results
• Practice Guideline with quotes: 3,656 results
10 Minutes
If you’re taking more than ten
minutes to find what you need,
stop and contact us.
You are the health professional
and we are the information
specialists.
Fax, phone or email—it’s not
interrupting, it’s our job.
Horblit Health Sciences Library
Amanda Pomeroy, MLS
203-739-7279
amanda.pomeroy@danhosp.org


Mary Shah, MLS
203-739-7035
mary.shah@danhosp.org

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Search the literature: the beginning

  • 1. Searching the Literature: the Beginning Mary Shah, MLS Horblit Health Sciences Library Danbury Hospital Mary.shah@danhosp.org
  • 2. Search Strategy Plan your search at first and the process will be much more effective. 1. Focus on what you are seeking and think about which resources would best have the answer. 2. Break down the query in basic terms. 3. Choose the research method. 4. Search each point separately. 5. Combine these subjects with AND, OR, NOT (these are Boolean Operators). 6. Focus your search with limits.
  • 3. PICO PICO can be used to help break down your question • Patient or Population: How would I describe a group of patients similar to mine? • Intervention: Which main intervention, prognosis, or exposure am I considering? • Comparison: What is the main alternative to compare with the intervention? • Outcome: What can I hope to accomplish, measure, improve or affect?
  • 4. Where to search? • Basic Reference = Search engine like Google • Background or Introduction = textbook • Research Article = database like CINAHL or Pub Med • Practice = Cochrane, DynaMed, Nursing Reference Center
  • 5. Choosing the Evidence Meta‐analyses Higher Quality Percentage of the Systematic reviews literature Randomized controlled trials Cohort studies Case‐control studies Case series and case reports Animal and laboratory research
  • 6. What does this mean? Evidence‐based practice is the systemic application of scientific findings to clinical practice and decision making. Tools already exist to rate the quality of study and its ability to inform the scientific community.
  • 7. Boolean? Halloween meat? George Boole brought together philosophy and math by inventing a logic that worked well with computers: the answer is either true or false. For your search, this means you can combine two search terms using the connectors: AND, OR, NOT.
  • 9. Another possibility OR Fall* cancer Patient
  • 10. Another possibility NOT Fall* cancer Patient
  • 11. Truncation?! Are we going someplace w/ an elephant? • Truncation is a short-cut to include all the possibilities: fall*= fall, falls, falling, fallen, and so forth… • Wildcards fill in for variations: Reali?e = realize, realise
  • 12. Not just for dialogue any more Quotation marks force the database to look for that specific combination of words. In CINAHL: • Practice Guideline without quotes: 90,812 results • Practice Guideline with quotes: 3,656 results
  • 13. 10 Minutes If you’re taking more than ten minutes to find what you need, stop and contact us. You are the health professional and we are the information specialists. Fax, phone or email—it’s not interrupting, it’s our job.
  • 14. Horblit Health Sciences Library Amanda Pomeroy, MLS 203-739-7279 amanda.pomeroy@danhosp.org Mary Shah, MLS 203-739-7035 mary.shah@danhosp.org

Editor's Notes

  1. In preschool aged children, is an electrolyte, flavored drink more effective at reducing dehydration than water alone? P=preschool aged children, I=electrolyte, flavored drink, C=water, O=reduced dehydration. Is there a disparity in treatment offered between people with insurance and those without insurance in the emergency department? P=people in ED, I=with insurance, C=without insurance, O=treatment disparity
  2. Meta-analysis = statistical technique for combining results of independent studies. Aims for complete coverage of all relevant studies, looks for heterogeneity, and examines robustness of main findings. Systemic reviews =identifies all relevant published and unpublished evidence, selects studies for inclusion, synthesizes findings in unbiased manner, interprets findings and presents impartial summary. Randomized controlled trials =With clinical studies, patients are divided into the experimental group and the control (one that doesn’t receive the treatment) group. This should remove selection bias. All should be equal at baseline. Co-hort Studies= identifies two groups (or co-horts) of patients, one received exposure of interest and the other didn’t, and following them in the future to outcome. Case-control studies =Identifies patient who have outcome of interest (cases) and control patients who don’t, and look back to see if they had exposure of interest. Case reports & series = Report on a single or group of patients with an outcome of interest.
  3. The search results using the word AND are shown by the grey triangle in the middle. It shows where all three circles overlap. These are the articles that include all three words: Cancer, patient, and fall (and its variations: falls, falling and so forth because we used truncation in the form of the *). Using the word AND narrows the search results.
  4. The word OR will find the articles that include at least ONE of the three words: Cancer, patient, fall (and its variations: falls, falling and so forth because we used a wild card in the form of the *). All contents of all three circles are your results. Using the word OR expands the search results.
  5. The word NOT will find the articles that include at least ONE of the three words: Cancer, patient, fall (and its variations: falls, falling and so forth because we used a wild card in the form of the *). For example: Fall* AND Patient NOT Cancer—excludes the oncology floor. The results are specific, not generic.
  6. When you put the words in quotes, the search results will include only what you asked. It will not include practice guideline s if you don’t ask for it. Your search is only as smart as you make it.
  7. Thanks!