NURS201 - May 2013

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Discusses the search process and EBP

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  • It ties you to controlled vocabulary, filters you to the most relevant terms
  • NURS201 - May 2013

    1. 1. Roy Brown, MLISEducation and Research LibrarianTompkins-McCaw Library, VCU LibrariesDatabase Basics:Performing a Good Search
    2. 2. CONFIDENCE IN YOURSEARCHING SKILLS
    3. 3. WHAT MAKES A GOODSEARCH?
    4. 4. WHERE TO TURN WHENYOU NEED INFORMATION
    5. 5. Goals:• Be aware of the process for doing an effective search• Understand the difference between keyword and subjectheading searching• Know how to use Boolean operators & limits• Be able to identify appropriate databases for different informationneeds• Be able to better use PubMed & CINAHL (Friday)Effective Searching = Less Time & Reading
    6. 6. Why do you need to search efficiently?1979 estimated that 2 million articles were published inbiomedical literature annually and increasing. If apractitioner were to attempt to keep up with literatrue byreading 2 articles per day, in 1 year they would fall 55centuries behind. Another way to put it would be that ifphysicians were to read everyting of possible relevance,they would need to read 5500 articles per day....Haynes, R., McKibbon, K., Fitzgerald, D., Guyatt, G., Walker, C., & Sackett, D. (1986). How to keep up with the medical literature: why try tokeep up and how to get started. Annals Of Internal Medicine, 105(1), 149-153.Physically impossible to read everything that is publishedin that literature, which now means attempting to readnearly 90,000 journals per year. Estimated that if youread two articles a day every day, by the end of the yearyou would be over a year behind in your reading.Lawrence, D. (1997). Literature searching and critical appraisal of the literature for the practicing chiropractor. Chiropractic Technique, 9(4),151-156.Since 2005, between 2,000-4,000 completed references areadded each day to PubMed
    7. 7. Levels of EvidenceEvidenceBasedPracticeGuidelinesMeta- Analysis /SystematicReviewCritically Appraised Topics[Evidence Syntheses]Critically Appraised IndividualArticles[Article Synopses]Randomized Control Trials (RCT’s)Cohort Studies / Cross-Sectional StudyCase Controlled Studies/Case ReportsReviewsBackground Information / Expert OpinionFiltered InformationUnfilteredInformationEBP Objective:Clinical Knowledge Bedside
    8. 8. THE SEARCH PROCESSTompkins-McCaw Library for the Health Sciences, VCU Libraries
    9. 9. The Search Process2.5. Evaluatethe Results6. Good Results = Use the Data• Bad = Start Over3. Choose the appropriatedatabase(s) or resource foryour topic4. Perform theSearch1. Problem/ ConstructQuestionImage: http://evidencebasedhealth.blogspot.com/Formulate Your SearchStrategy• Synonyms for Search Terms• Subject Heading vs. Keyword• Boolean Operators & Limits
    10. 10. THE SEARCH PROCESSStep 1: Starts with Problem or Need for Information/Developing a Clear Research QuestionTompkins-McCaw Library for the Health Sciences, VCU Libraries
    11. 11. The Search Process2.5. Evaluatethe Results6. Good Results = Use the Data• Bad = Start Over3. Choose the appropriatedatabase(s) or resource foryour topic4. Perform theSearch1. Problem/ ConstructQuestionImage: http://evidencebasedhealth.blogspot.com/Formulate Your SearchStrategy• Synonyms for Search Terms• Subject Heading vs. Keyword• Boolean Operators & Limits
    12. 12. The Problem……….• Helping a older, femalepatient to deal with thepain or other issues relatedto fibromyalgia• Improve Quality of LifeQuestion - Brings Focus to Search of the LiteratureChronic Pain / Fatigue / Sleep Issues
    13. 13. Formulate Your QuestionQuestionIs therapeutic touch or guidedimagery more effective whentreating a patient withfibromyalgia?P(Problem, Patient,Population,Program)I(Intervention)C(Comparison)O(Outcome)T(Type ofQuestion)T(Type ofStudy)
    14. 14. Type of Question/ Best Type ofStudyType of Question Best Type of StudyTherapyHow to select treatments to offer patients that do more goodthan harm and that are worth the efforts and costs of usingthemRandomized Control Trial (RCT)PreventionHow to prevent a disease or condition RCT/ Cohort Study / Case ControlPrognosisHow to estimate the patients likely clinical course over timeand anticipate likelycomplications of diseaseCohort Study/ Case Control/ Case Series or Case ReportDiagnosisHow to select and interpret diagnostic tests Blind RCT Compared to the Gold Standard(best treatment/test for diagnosis)Etiology/HarmHow to identify causes for disease RCT/ Cohort Study /Case ControlCost analysisEconomic costs of all facets of a intervention or diseasetreatmentEconomic Analysis
    15. 15. PICO & Breaking Search Into ConceptsMain ConceptsBreak Search in Groups/Concepts15Fibromyalgia | Guided Imagery & Therapeutic TouchThese concepts will be used to search the databasesFind Synonyms/ Related Terms for ConceptsDifferent Databases Use Different TermsP(Problem, Patient,Population,Program)I(Intervention)C(Comparison)O(Outcome)T(Type ofQuestion)T(Type ofStudy)Patient withFibromyalgiaFemaleOlder/AgedTherapeuticTouchGuidedImageryAlleviatingthesymptoms ofFibromyalgiaTherapyRCT
    16. 16. What are some alternative terms…• Guided Imagery• Fibromyalgia• Therapeutic Touch
    17. 17. Fibromyalgia TherapeuticTouchGuided Imagery• Fibromyalgia• Chronic FatigueSyndrome• Diffuse MyofascialPain• Fibromyalgia-FibromyostitisSyndrome• Postviral FatigueSyndrome• Therapeutic Touch• Massage• Zone Therapy• Reiki• Guided Imagery• Hypnosis• Directed ReverieTherapy• Imagery(Psychotherapy)Alternative Terms…
    18. 18. Ways to Find Alternative Terms/Background Information• Good Sources:1. Point-of-Care Tools• First Consult• Up to Date2. Government Sites• Medline Plus• PubMed Health3. Controlled Vocab. EntryTerms4. Google Scholar Term/ConceptMining
    19. 19. Google vs. Google Scholar main purpose of is tohunt for text in Webpages Displays results basedon Page Rank Does not really coverinformation contained inlibrary catalogs, officialgovernment documents,phone books, etc.• Indexes the full text ofscholarly literature across anarray of publishing formatsand disciplines• Includes most peer-reviewed online journals ofEurope and Americaslargest scholarly publishers• Tends to put weight oncitation counts whendisplaying search resultsFalagas, M. E., Pitsouni, E. I., Malietzis, G. A., & Pappas, G. (2008). Comparison of PubMed, scopus, web of science, and google scholar: Strengths and weaknesses The FASEB Journal :Official Publication of the Federation of American Societies for Experimental Biology, 22(2), 338-342. doi:10.1096/fj.07-9492LSFVine, #., & Rita. (2006). Google scholar Journal of the Medical Library Association, 94(1), 97–9.Wikipedia contributors.Google search Retrieved, 2012,
    20. 20. THE SEARCH PROCESSStep 2: Formulating Your Search Strategy
    21. 21. The Search Process2.5. Evaluatethe Results6. Good Results = Use the Data• Bad = Start Over3. Choose the appropriatedatabase(s) or resource foryour topic4. Perform theSearch1. Problem/ ConstructQuestionImage: http://evidencebasedhealth.blogspot.com/Formulate Your SearchStrategy• Synonyms for Search Terms• Subject Heading vs. Keyword• Boolean Operators & Limits
    22. 22. KEYWORD SEARCHINGTompkins-McCaw Library for the Health Sciences,VCU Libraries
    23. 23. How to search…Keyword or ControlledVocab/Subject Heading?NeoplasmPressure UlcerContusionMyocardial Infarction Cancer Bed Sores Bruise Heart AttackV.A.P. Ventilator-AssociatedPneumoniaV.B.A.C.  Vaginal Birth After Cesarean
    24. 24. DESCRIBE THEFOLLOWING ITEM
    25. 25. Person 1• Aluminum Can• Coke Can• Can withCondensation• Soda CanPerson 2• Pop Can• Soda Can• Can That is Sweating• Red Aluminum CanPerson 1• Aluminum Can• Coke Can• Can withCondensation• Soda Can• Red CanPerson 2• Pop Can• Soda Can• Can That is Sweating• Red Aluminum CanDescribe This Can ……
    26. 26. Keyword• Also called natural language searching• Search for words or phrases found in title, abstract, orother parts of articles• Keyword searching used for• New terminology• Rare terms• Other terms that have no related subject heading• Spelling variations• Truncation - Train*• Trained, Trainer, Training, etc.• Grouping Using “Guided Imagery”• Use Quotation Marks• Without Quotes – AND Terms TogetherPerspectiveSynonyms
    27. 27. WHERE THEDATABASE SEARCHESFOR KEYWORDSIn the Citation
    28. 28. All searched when searching bykeyword
    29. 29. All Places that are searched whendoing a keyword search in PubMed
    30. 30. SEARCHING WITHSUBJECT HEADINGS/CONTROLLED VOCABULARYMeSH - PubMedCINAHL Headings - CINAHLTompkins-McCaw Library for the HealthSciences,VCU Libraries
    31. 31. Pepsi CokePopSoda SodaPopSubject Headings/ Controlled Vocabulary• Controlled Vocabulary – Thesaurus• Help to return results that directlyapply to subject of the search• Hierarchy – Tree Structure• Broad –Specific• Minor / Major Heading• Major Heading - Focuses your searchresults to returning articles thatspecifically address the topic• PubMed – have stars beside them• CINAHL – Divided into Major & MinorHeadings• Scope Note – Term DefinitionSoftDrink
    32. 32. Examples of HierarchyPubMed CINAHL
    33. 33. May need to move backward in order to moveforward……
    34. 34. Good Choice• Broad• Commonalitiesbetween peopleIssue: Breastfeeding practices ofadolescent mothers in Vietnam.Too Broad10ArticlesTip: Sometimes Need to Back Up to MoveForward
    35. 35. WHERE THEDATABASE SEARCHES FORCONTROLLED VOCABULARY/SUBJECT HEADINGSIn the Citation
    36. 36. Subject Heading Field in CINAHL
    37. 37. Subject heading field in PubMed
    38. 38. BOOLEANOPERATORS/COMBINING TERMSAND, OR, NOTTompkins-McCaw Library for the HealthSciences,VCU Libraries
    39. 39. Boolean Operators - AND• Combines concepts• Relationship• Retrieves records thatcontain BOTH termsenteredSoda Pop WeightGain
    40. 40. Boolean Operators - OR• Combines synonyms orlike concepts• No RelationshipNecessary• Retrieves records thatcontain EITHER termenteredCoke Pepsi
    41. 41. When Searching………..Combining Terms TogetherGroup 1CombineTerms with ORGroup 2Combine Termswith ORAND ANDGroup 3Combine Termswith OR
    42. 42. Fibromyalgia Therapeutic Touch Guided Imagery"Fibromyalgia“[Subject Heading]OR"Fatigue Syndrome,Chronic“[Subject Heading]ORFibromyalgia[Keyword]ORChronic FatigueSyndrome[Keyword]“Therapeutic Touch “[Subject Heading]ORTherapeutic Touch[Keyword]ORMassage[Keyword]"Imagery(Psychotherapy)“[Subject Heading]ORGuided Imagery[Keyword]ORHypnosis[Keyword]Good Search – Combination of SubjectHeadings and KeywordsAND AND
    43. 43. Keep in Mind – Doing A Good SearchBreak Your Search into Concepts –Don’t Marry Early/ Let Them Date!!!!Start Your Search Broad and Then Focus – Don’t PutBlinders on the Horse Too Soon !!Be sure to come up with alternative or relatedterms for your topicAlways search in at least two databases.Use Controlled Vocabulary When PossibleMeSH/CINAHL Headings
    44. 44. WAYS TO INCREASEOR DECREASERESULTSExploding, Subheadings, LimitsTompkins-McCaw Library for theHealth Sciences,VCU Libraries
    45. 45. Explode Option: Increases NumberIncludes Chosen Termand All of those Below itin the treePubMed – DoneAutomaticallyCINAHL – MustChoose to Explode ATerm
    46. 46. Subheadings
    47. 47. Using Limits• Language• Age Group• Time Period/ Date• Gender/Sex• Publication Type• Systematic Reviews• Meta Analysis• Randomized Control Trials• Practice Guidelines• Reviews
    48. 48. Not Finding Enough?Ways to Expand Your ResultsFinding Too Many Articles?Ways to Focus Your Results(Ways to Get More Articles)Try To :• Explode Your Terms• Keyword Searching• Look At Related or CitingArticles(Ways to Get Fewer Articles)Try Using:• Major Concept/Subject• Subheadings• LimitsOther Things to Think About…..
    49. 49. Selecting the Right Resource• Research Guides• Nursing Research Guide• Important Databases• PubMed/Medline (Free)• CINAHL• APA PsycNet/PsychInfo• Cochrane Library• TRIP Database (Free)• National GuidelinesClearinghouse (Free)• PubMed Health (Free)• Medline Plus (Free)http://guides.library.vcu.edu/nursingEvidenceBasedPracticeGuidelinesMeta- Analysis /SystematicReviewCritically AppraisedTopics[Evidence Syntheses]Critically Appraised IndividualArticles[Article Synopses]Randomized Control Trials (RCT’s)Cohort Studies / Cross-Sectional StudyCase Controlled Studies/Case ReportsReviewsBackground Information / Expert OpinionFiltered InformationUnfilteredInformation
    50. 50. Quick Review….1. What is the advantage of using subject headings/controlledvocabulary over keywords when doing a search?3. What is one way you could decrease the number of articlesyou get in a search when using subject headings/controlledvocabulary?2. Will truncation increase or decrease the amount of articlesyou in get in a search?
    51. 51. Break Time…………
    52. 52. If You Need Help……..• Get in touch with Me…..Roy Brown, MLISEducation and Research LibrarianTompkins-McCaw Library, VCU Librariesrebrown2@vcu.edu / Ph. 804-828-1592
    53. 53. Filtered InformationUnfiltered Information

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