In Search Of Evidence Handouts


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In Search Of Evidence Handouts

  1. 1. In Search of Evidence Teresa Hartman, MLS / Associate Professor Head, Education Department, UNMC McGoogan Library of Medicine Quarterly Updates Evidence-Based Practice for Public Health Nurses Session II November 4, 2008 Objectives PICO Question 1 • Demonstrate searching for evidence for PICO For the 4 year old pre-K age group, are question. there fewer injection site complications with giving the immunizations in the thigh • Explain resources available to search for as compared to giving the immunizations evidence related to PICO questions for public in the arm? health nurses in Nebraska, including methods to order articles if not available online. P preschool children, pre-K, 4 years old I injection in thigh • Describe services provided by McGoogan C injection in arm Library and the National Library of Medicine O fewer site complications You could start with a simple text word search in PubMed Question 1:Searching PubMed MeSH = Medical Subject Headings: these are the terms that the over 18 million citations are indexed by in the database. MeSH terms used for Question 1 (access the link on the left hand blue PubMed sidebar, under PubMed Services, and search terms like you do using a dictionary): “Child, preschool”[MeSH] “Injections ”[MeSH] “Vaccination ”[MeSH] “Immunization ”[MeSH] 1
  2. 2. Type in a term you are searching for – example, preschool. To search for MeSH terms, click on the MeSH database link on the left side of PubMed screen. Check the results to see if any of them fit your search. Click on the box Note: PubMed and MeSH tutorials: next to it, then click on Send To, and select Search Box with And. The term will be added automatically to a new box that appears on the next screen. Now, search for your next term – example ‘injections’ After clicking on the box next to Injections, and then the Send to drop down menu and selecting Search Box with And, this is how your screen should look. Click on Search PubMed to run the search. 2
  3. 3. You can also use Clinical Queries to search for evidence. Type in text words – example: preschool injections thigh What other complications than ‘pain’ are you searching for? Question 1: Searching PubMed Clinical Queries – Find Systematic Reviews (access the link on the left hand blue PubMed sidebar, under PubMed Services): Search terms used: preschool injections thigh Located: PMID 17473085 Note – could search by specific types of vaccine injections, like chickenpox, to find out the best method to reduce complications . Also, define “complications”. PICO Question 2 Question 2: Searching PubMed For adults who are 21-50 years old, is there a MeSH terms used: higher incidence of influenza vaccination with those who attend a group education session “Adult”[MeSH] (equals age 19-40) during pre-school and elementary parent- “Health education”[MeSH] teacher conferences as compared to those who did not attend? “Patient acceptance of health care”[MeSH] P adults, aged 21-50 “Influenza vaccines”[MeSH] I attended childhood education session on benefits of flu vaccine Best results were retrieved with this search: C did not attend childhood education sessions quot;Health Educationquot;[Mesh] AND quot;Patient O more adults vaccinated Acceptance of Health Carequot;[Mesh] AND quot;Influenza Vaccinesquot;[Mesh] 3
  4. 4. Question 2: comments PICO Question 3 My questions – are there other public health issues For teenage mothers enrolled in a high school teen that have been shown through established parenting class, are their children more current research that they were changed/improved with immunization guidelines/schedules as through education, during childhood or at other compared to children of teenage mothers who times? (Would seat belt/helmet use be similar?) do not receive the education? Maybe there is research in another area that P teenage mothers could be applied to this question. Example: there I attended high school based parenting class is a lot of research on health care professionals (adults) and their compliance with flu shots C did not attend high school based parenting (possibly related to preparations for pandemic class flu prevention.) O children current on immunizations Question 3: Searching PubMed PICO Question 4 MeSH search used: (quot;Childquot;[Mesh] OR For parents who receive SCHIP benefits and a nurse quot;Child, Preschoolquot;[Mesh] OR provided telephone education intervention, are their quot;Adolescentquot;[Mesh]) AND quot;Pregnancy in children more current with immunization guidelines/schedule as compared to children of Adolescencequot;[Mesh] AND parents who do not receive the education? quot;Parentingquot;[Mesh] immuniz* (←this is a P parents/families receiving SCHIP benefits, state health truncated text word) plans for uninsured children Clicking on Related Articles for the first I nurse provided telephone education/intervention C no nurse provided telephone education/intervention citation retrieves promising citations that O children current on immunizations may lead to further MeSH terms to use when conduct further searches. Question 4: Searching PubMed Tips to improve searches MeSH terms used: First and foremost: Use the expert librarians “Telephone”[MeSH] “Nurse”[MeSH] “State health plans”[MeSH] “Child”[MeSH] at UNMC – we are here to serve you. “Child, preschool”[MeSH] “Adolescent”[MeSH] Email , or call toll-free immuniz* (←this is a truncated text word) 1-866-800-5209 with your search Note: I could not locate a mention in the research of an request. Put our graduate degrees and SCHIP program that used nurse telephone intervention/education (that does not mean it isn’t there – post-graduate education to work for your just that I didn’t find one.). Only successful search was: information needs! (Plus, we can search “State health plans”[MeSH] AND immuniz*, resulted in 33 citations. One citation appeared particularly useful: the CINAHL and Cochrane full-text PMID 15867017 databases for you). 4
  5. 5. Tips to improve searches Tips to improve searches Start with a text word search, using Hone in on the results you need by using synonyms for the terms you are looking Limits: limit to years published, humans, for. Think like an author – what terms do language article is written in, and level of you think they used when writing about research (note – you can limit too much): – Clinical Trials what you are hunting? Identify relevant – Randomized Controlled Trials citations; use the MeSH terms found on – Practice Guideline those citations to create more focused – Meta-Analyses searches – Review Tips to improve searches Tips to improve searches Use the Clinical Queries/Systematic Limit results to free full text and McGoogan Reviews search function to locate Library of Medicine holdings to your “citations for systematic reviews, meta- search by adding this search term: analyses, reviews of clinical trials, evidence-based medicine, consensus AND (free full text[sb] OR loprovuneblib[sb]) development conferences, and guidelines.” Additional Resources You can access tutorials and additional Questions? resources on the blog that has been created for this session: Call the Reference Desk: Evidence Based Public Health •559-6221 Information Resources •866-800-5209 (toll-free) Email: • 5