Keeping Up To Date With The Literature In Child Health


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Grand Rounds Presentation at for the Child Health Dept at University of Missouri on August 14, 2009

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Keeping Up To Date With The Literature In Child Health

  1. 1. Keeping Up to Date with the Literature in Child Health Caryn Scoville, MLS J. Otto Lottes Health Sciences Library
  2. 2. “ About 10 years ago, if general internists wanted to keep abreast of the primary clinical literature, they would have needed to read 17 articles daily. Today, with more than 1000 articles indexed daily by MEDLINE, that figure is likely double.” Straus S, Haynes RB. “Managing evidence-based knowledge: the need for reliable, relevant and readable resources.” CMAJ. 180(9):942-945, 2009, doi:10.1503/cmaj.081697.
  3. 3. Push and Pull for information <ul><li>Push </li></ul><ul><ul><li>Update and journal surveillance services </li></ul></ul><ul><ul><li>Top journal Table of Contents </li></ul></ul><ul><ul><li>Alerts: subject, citation, author </li></ul></ul><ul><li>Pull </li></ul><ul><ul><li>Looking up information to answer questions in clinical practice </li></ul></ul>
  4. 4. Update and Journal Surveillance Services <ul><li>Journal Watch </li></ul><ul><li>EvidenceUpdates (formerly BMJ Updates) </li></ul><ul><li>Others </li></ul><ul><ul><li>DynaMed Journal Surveillance </li></ul></ul><ul><ul><li>AAP Policy email alerts </li></ul></ul>
  5. 5. Journal Watch <ul><li>140 physician-editors survey 350 medical journals </li></ul><ul><li>From the publishers of the New England Journal of Medicine </li></ul><ul><li>Email alerts of article summaries and commentaries </li></ul><ul><li>13 specialties </li></ul>
  6. 9. Journal Watch library access <ul><li>Email alerts are free, but access to many full commentaries requires a subscription </li></ul><ul><li>Library subscribes to online access to Journal Watch specialties </li></ul><ul><ul><li>General Medicine </li></ul></ul><ul><ul><li>Pediatrics and Adolescent Medicine </li></ul></ul><ul><ul><li>Emergency Medicine </li></ul></ul><ul><li>Library also has access to print copies </li></ul>
  7. 10. Steps for accessing Journal Watch <ul><li>Register for Journal Watch email alerts at . </li></ul><ul><li>Receive free email alerts. </li></ul><ul><li>To access commentaries that aren’t free, go to library’s subscription of Journal Watch. </li></ul>
  8. 13. Not free Not free Not free N
  9. 20. Physician FirstWatch <ul><li>A Journal Watch alert </li></ul><ul><li>Daily news </li></ul><ul><li>Available via email alert or RSS feed </li></ul>
  10. 23. Evidence Updates <ul><li>From the publishers of BMJ </li></ul><ul><li>Formerly known as BMJ Updates </li></ul><ul><li>Free for now </li></ul><ul><li>User-customized alerts available in email or RSS </li></ul><ul><li>Quality assessed, relevance rated studies, syntheses, synopses and summaries rated with McMaster evidence criteria </li></ul><ul><li>Access at </li></ul>
  11. 24. Evidence Updates – article inclusion process <ul><li>Staff select articles </li></ul><ul><ul><li>170 clinical journals are reviewed </li></ul></ul><ul><ul><li>Studies included that meet strict criteria for scientific merit </li></ul></ul><ul><ul><li>Reduces 50,000 articles per year to 3000 articles (6%) as having adequate methods to support their conclusions for key aspects of clinical care. </li></ul></ul><ul><li>Physicians rate articles </li></ul><ul><ul><li>Articles assessed for relevance and newsworthiness </li></ul></ul><ul><ul><li>Ratings provided by at least 3 practicing physicians for each discipline. </li></ul></ul>
  12. 32. DynaMed Weekly Update <ul><li>Selected from articles considered for inclusion in DynaMed </li></ul><ul><li>Based on the criteria of choosing &quot;articles most likely to change clinical practice&quot;, </li></ul><ul><li>RSS feed and podcast available </li></ul><ul><li>Not customizable by specialty </li></ul><ul><li>Access at </li></ul>
  13. 36. Journals <ul><li>Review journal tables of contents (TOC) </li></ul><ul><li>Which journal TOC to review? </li></ul>
  14. 37. Top journals by impact factor for Pediatrics <ul><li>Journal of the American Academy of Child & Adolescent Psychiatry </li></ul><ul><li>Pediatrics </li></ul><ul><li>Journal of Pediatrics </li></ul><ul><li>Archives of Pediatrics and Adolescent Medicine </li></ul><ul><li>Journal of Child & Adolescent Psychopharmacology </li></ul><ul><li>Pediatric Infectious Disease Journal </li></ul><ul><li>Pediatric Research </li></ul><ul><li>Archives of Disease in Childhood </li></ul><ul><li>Seminars in Perinatology </li></ul><ul><li>Pediatric Allergy & Immunology </li></ul><ul><li>From 2007 Journal Citation Reports </li></ul>
  15. 38. Other journals to consider <ul><li>Pediatrics in Review </li></ul><ul><li>Specialty journals </li></ul><ul><ul><li>Pediatric Pulmonology </li></ul></ul><ul><ul><li>Pediatric Nephrology </li></ul></ul><ul><li>General Medicine </li></ul><ul><ul><li>New England Journal of Medicine </li></ul></ul><ul><ul><li>JAMA </li></ul></ul><ul><ul><li>Lancet </li></ul></ul>
  16. 39. What an RSS feed looks like
  17. 40. Clinical Reader <ul><li>Free for now </li></ul><ul><li>Recent articles from high impact and popular journals under speciality sections </li></ul><ul><li>Access news, podcasts and other multimedia </li></ul><ul><li>Mobile version coming August 2009 </li></ul><ul><li>Access at </li></ul>
  18. 43. ticTOCs <ul><li>Select the journals for which you want to review Table of Contents </li></ul><ul><li>Get RSS feeds of journal Table of Contents delivered to your RSS feed reader </li></ul><ul><li>Access at </li></ul>
  19. 45. *Notes about journal access <ul><li>Library subscribes to journals via various sources, not always publisher site </li></ul><ul><li>Even if library subscribes, we might not have access to the article yet </li></ul><ul><li>Check Journal/Article Finder to check access or FindIt@MU for access </li></ul>
  20. 46. Search alerts <ul><li>Subject alerts: create a search strategy in database like PubMed and have results sent periodically </li></ul><ul><li>Citation alerts: receive alerts when certain articles or authors are cited </li></ul>
  21. 47. PubMed alerts <ul><li>Register for a MyNCBI account. </li></ul><ul><li>Do a search in PubMed. </li></ul><ul><li>Save Search. </li></ul><ul><li>Receive alerts on a periodic basis. </li></ul>
  22. 55. PubMed alert email example
  23. 56. Scopus citation alert <ul><li>What is Scopus? </li></ul><ul><ul><li>Largest bibliographic citation database of research literature </li></ul></ul><ul><ul><li>Good for cited reference searching </li></ul></ul>
  24. 60. 1. Find an article that you’d like to know when it’s cited Changing epidemiology of Clostridium difficile -associated disease in children. Benson L, Song X, Campos J, Singh N. Infect Control Hosp Epidemiol . 2007 Nov;28(11):1233-5. Epub 2007 Aug 27. PMID: 17926272 [PubMed - indexed for MEDLINE] 2. Copy article title into Scopus Cited 4 times
  25. 62. Scopus citation alerts
  26. 64. Alert for new documents by author Alert for when author’s documents are cited
  27. 65. What the heck is RSS anyway? <ul><li>RSS stands for Really Simple Syndication . </li></ul><ul><li>A syndicated news feed in an XML format to which you can subscribe. </li></ul><ul><li>An alternative to email alerts </li></ul><ul><li>See new content when it is available on websites, blogs, search alerts etc.. </li></ul>
  28. 66. How to get RSS feeds <ul><li>Choose and download a RSS feed reader or use a browser compatible with RSS (IE 7 and higher or Firefox). </li></ul><ul><li>Copy and paste the appropriate URL into your RSS feed reader OR Click on the orange RSS icon </li></ul>
  29. 67. What an RSS feed looks like
  30. 72. Internet Explorer Favorites
  31. 75. Using a feed reader <ul><li>Access your feeds from any location </li></ul><ul><li>More flexible than receiving in browser </li></ul><ul><li>Many feed readers </li></ul><ul><li>Google Reader is one example, access at </li></ul><ul><li> /reader </li></ul>
  32. 76. Google Reader
  33. 83. Skyscape mobile alerts <ul><li>Skyscape mobile especially for mobile devices </li></ul><ul><li>Same service in which provides DynaMed via mobile </li></ul><ul><li>Subscribe to pediatric alert </li></ul>
  34. 87. Drinking through a firehose….
  35. 88. Keeping up at the point of care <ul><li>2 questions for every 3 patients seen </li></ul><ul><li>Only 30-36% of questions are answered </li></ul><ul><li>Hersh, W. “Physician Information Needs”. In Information Retrieval: A Health and Biomedical Perspective . pp. 99-107, 2009. </li></ul>
  36. 89. Factors associated with pursuit of answer <ul><li>Urgency </li></ul><ul><li>Answerability – the physician felt an answer was likely to exist </li></ul><ul><li>Generalizability – an answer would help to manage other patients </li></ul><ul><li>Gorman, P. and Helfland M. Information seeking in primary care: how physicians choose which clinical questions to pursue and which to leave unanswered. Medical Decision Making, 15:113-119, 1995. </li></ul>
  37. 90. Barriers to answering clinical questions <ul><li>Attitude </li></ul><ul><li>Environment </li></ul><ul><li>Lack of computer skills </li></ul><ul><li>Lack of resources </li></ul><ul><li>Lack of time </li></ul><ul><li>Ebell, M. How to find answers to clinical questions. American Family Physician, 79:293-296, 2009. </li></ul>
  38. 91. Possible solutions <ul><li>Value your own questions and write them down as they occur </li></ul><ul><li>Respond positively when colleagues ask you questions </li></ul><ul><li>Make computers available where you practice </li></ul><ul><li>Carry a tablet computer, PDA, or smartphone </li></ul>Ebell, M. How to find answers to clinical questions. American Family Physician, 79:293-296, 2009.
  39. 92. More possible solutions <ul><li>Practice searching for answers to become proficient </li></ul><ul><li>Take classes that teach computer skills </li></ul><ul><li>Subscribe to (or become aware of) relevant evidence-based information sources </li></ul><ul><li>Plan adequate time every week or month to review recent literature </li></ul>Ebell, M. How to find answers to clinical questions. American Family Physician, 79:293-296, 2009.
  40. 93. Best bet – point of care resources <ul><li>UpToDate </li></ul><ul><li>DynaMed </li></ul><ul><li>EBM resources page </li></ul>
  41. 96. PDA resources <ul><li>DynaMed </li></ul><ul><li>Clinical Xpert – via Micromedex </li></ul><ul><li>Epocrates – free drug resource </li></ul>
  42. 97. Thank you! <ul><li>Caryn Scoville </li></ul><ul><li>Librarian </li></ul><ul><li>[email_address] </li></ul><ul><li>882-2844 </li></ul>