Search Basic I

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Lecture to Medical Student on Feb 20, 2008
EBM - How to Search - Basic

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  • Search Basic I

    1. 2. 實證醫學 5 – 查 網路文獻搜尋 2008 Feb. 20 基隆長庚.楊宗翰醫師 實證醫學中心 風濕過敏免疫科
    2. 3. Five Steps <ul><li>Ask </li></ul><ul><li>Acquire (Search) </li></ul><ul><li>Appraise </li></ul><ul><li>Apply </li></ul><ul><li>Audit </li></ul><ul><li>問 </li></ul><ul><li>查 </li></ul><ul><li>讀 </li></ul><ul><li>用 </li></ul><ul><li>審 </li></ul>
    3. 4.
    4. 5. Ask / 問 <ul><li>精確( specific )的問題 </li></ul><ul><ul><li>可以 被回答 (answerable) </li></ul></ul><ul><ul><li>可以 被搜尋 (searchable) </li></ul></ul><ul><li>P </li></ul><ul><li>I </li></ul><ul><li>C </li></ul><ul><li>O </li></ul>
    5. 6. Appraise <ul><li>Appraised by yourself … </li></ul><ul><ul><li>Time consuming </li></ul></ul><ul><ul><li>Original articles </li></ul></ul><ul><li>Appraised by authorized specialists </li></ul><ul><ul><li>Systems, Synopses, Synthesis </li></ul></ul><ul><ul><li>Review articles (narrative, systematic, EBM review) </li></ul></ul><ul><ul><ul><li>topic or article review </li></ul></ul></ul>Dave Sackett
    6. 7. Acquire / 查 <ul><li>選擇資料庫 </li></ul><ul><ul><li>What </li></ul></ul><ul><li>建構檢索策略 </li></ul><ul><ul><li>How </li></ul></ul><ul><li>Question </li></ul><ul><li>Database selection </li></ul><ul><li>Search strategy </li></ul>
    7. 8. Step 1 - Question <ul><li>那種問題? </li></ul><ul><ul><li>Foreground or Background </li></ul></ul><ul><li>那類問題? </li></ul><ul><ul><li>Frequency (incidence or prevalence) </li></ul></ul><ul><ul><li>Diagnosis </li></ul></ul><ul><ul><li>Harm (etiology or risk factors) </li></ul></ul><ul><ul><li>Prognosis (natural history) </li></ul></ul><ul><ul><li>Treatment (intervention) </li></ul></ul><ul><li>最佳解決方案(研究方法)! </li></ul>
    8. 9. Current Best Evidence
    9. 11. Step 2 – Select Database <ul><li>Which & Why? </li></ul><ul><ul><li>Contents </li></ul></ul><ul><ul><li>How to search? </li></ul></ul><ul><ul><li>Results of search? </li></ul></ul>
    10. 13. The “5S” levels of organization of evidence from health care research – by R Brain Haynes, 2006 Systems Summaries Synopses Syntheses Studies Original journals articles 原始研究文獻 Pre-filtered Secondary Computerized decision support 實證臨床資訊決策系統 Evidence based textbooks 針對某臨床主題統整各類證據以形成之概述 Evidence based journal abstracts 對單篇研究及 SR 做摘要性評估之文章 Systematic reviews 系統性評論 Primary
    11. 14. Contents <ul><li>Type of Content </li></ul><ul><ul><li>Original </li></ul></ul><ul><ul><li>Review </li></ul></ul><ul><ul><ul><li>EBM review (topic or article) </li></ul></ul></ul><ul><ul><ul><li>narrative review </li></ul></ul></ul><ul><li>Primary or Secondary </li></ul>
    12. 15. citation
    13. 20. EBM article review based on case (Critical Appraisal Topics, CATs)
    14. 21. EBM topic review
    15. 24. Contents <ul><li>Original articles </li></ul><ul><ul><li>Medline (citation) </li></ul></ul><ul><ul><li>Core clinical journals (full text) </li></ul></ul><ul><li>EBM reviews </li></ul><ul><ul><li>Article reviews (Synopses) </li></ul></ul><ul><ul><li>Systematic reviews … </li></ul></ul><ul><ul><li>Guidelines </li></ul></ul><ul><li>Reviews </li></ul><ul><ul><li>Textbooks </li></ul></ul><ul><ul><li>Review articles </li></ul></ul><ul><li>定期更新,資料來源 </li></ul><ul><li>Cochrane library </li></ul><ul><li>EBM synopses (Article review) </li></ul><ul><li>Clinical Evidences, ACP PIER, DynaMed, InfoPOEMs, First Consult, Clin-eguide (Topic review) </li></ul><ul><li>Uptodate </li></ul><ul><li>[email_address] </li></ul>
    16. 25. Step 2 – Select Database <ul><li>Which & Why? </li></ul><ul><ul><li>Contents </li></ul></ul><ul><ul><li>How to search? </li></ul></ul><ul><ul><li>Results of search? </li></ul></ul>
    17. 30. EBM article review based on case (Critical Appraisal Topics, CATs)
    18. 37. 30+ 個選擇
    19. 38. Acquire - Which & Why? <ul><li>Contents (original, EBM review, review) </li></ul><ul><li>How to search? </li></ul><ul><ul><li>Keywords OR thesaurus/MeSH </li></ul></ul><ul><ul><ul><li>Synonymy/acronym; </li></ul></ul></ul><ul><ul><ul><li>Query interpretation (heart attack cancer) </li></ul></ul></ul><ul><ul><li>Search strategy </li></ul></ul><ul><ul><ul><li>Boolean logics (AND/OR/NOT/NEAR) </li></ul></ul></ul><ul><ul><ul><li>Categories & filters (quality & publication types) </li></ul></ul></ul><ul><ul><li>Search refinements </li></ul></ul><ul><ul><ul><li>Diagnosis, Differential diagnosis, etiology, pathogenesis, prognosis, signs, symptoms, treatment </li></ul></ul></ul><ul><ul><ul><li>Population, disease entity (hypertension – pregnancy, portal, pulmonary, renal…) </li></ul></ul></ul><ul><li>Results of search? </li></ul><ul><ul><li>Numbers of results – sensitive or specific </li></ul></ul><ul><ul><li>The order of results – time (current), relevant (best?), clinically appropriate (definition?) </li></ul></ul>
    20. 39. http://ebm.twbbs.org/
    21. 40. 推薦 4 組 10 個 http://ebm.twbbs.org/ http://10.26.52.233/
    22. 41. Acquire / 查 <ul><li>選擇資料庫 </li></ul><ul><ul><li>What </li></ul></ul><ul><li>建構檢索策略 </li></ul><ul><ul><li>How </li></ul></ul><ul><li>Question </li></ul><ul><li>Database selection </li></ul><ul><li>Search strategy </li></ul>
    23. 42. Current Best Evidence
    24. 43. <ul><li>決定 Keywords </li></ul><ul><ul><li>縮寫 </li></ul></ul><ul><ul><ul><li>AMI, BPH, CAP , CAD </li></ul></ul></ul><ul><ul><ul><li>DM , IDA , MM , SLE </li></ul></ul></ul><ul><ul><li>中文 > 英文 </li></ul></ul><ul><ul><ul><li>漢英字典(非醫學 & 醫學) </li></ul></ul></ul><ul><ul><li>Results from searches </li></ul></ul><ul><ul><ul><li>Medline, Google, … </li></ul></ul></ul>Step 3.1 - Keywords
    25. 45. Keywords or Index Terms <ul><li>keywords </li></ul><ul><ul><li>truncation ($/*; Salmonell* or child$) </li></ul></ul><ul><li>indexed terms </li></ul><ul><ul><li>MeSH (Medline/Pubmed) </li></ul></ul><ul><ul><li>CINAHL Index Terms (CINAHL) </li></ul></ul><ul><ul><li>EMTAGs (EMBASE) </li></ul></ul><ul><li>automatic term mapping (ATM) </li></ul>
    26. 47. Keywords or Index Terms <ul><li>Definition </li></ul><ul><ul><li>Neoplasms </li></ul></ul><ul><ul><ul><li>cancer, carcinoma, tumor </li></ul></ul></ul><ul><ul><li>myositis </li></ul></ul><ul><ul><ul><li>inclusion body myositis </li></ul></ul></ul><ul><li>Relevance (focus or explode) </li></ul>
    27. 49. 1 2 3 2 1 3
    28. 50. MeSH ... <ul><li>Most human beings on the planet who are not librarians don't know anything about how to search with MeSH. </li></ul><ul><ul><li>John Sack, the director of HighWire Press. </li></ul></ul>NEJM 2005;354:1:4-7
    29. 51. 教育部國語辭典 <ul><li>三隻小豬 </li></ul><ul><li>打炮 </li></ul>
    30. 53. Step 3.2 - Hedges <ul><li>1 concept or keyword a line (an entry) </li></ul><ul><li>P & I more important, use C & O to narrow down results </li></ul><ul><li>OR & AND </li></ul><ul><li>NEAR, ADJ … </li></ul><ul><li>! NOT </li></ul>
    31. 54. Step 3.3 - Filters <ul><li>最佳解決方案 </li></ul><ul><li>Quality filters & Limit </li></ul><ul><ul><li>clinical query </li></ul></ul><ul><ul><li>methodology (publication type) filters </li></ul></ul><ul><ul><li>x English, full text, review </li></ul></ul>
    32. 55. Current Best Evidence
    33. 56. Filters - limit <ul><li>therapy, diagnosis, prognosis, etiology, qualitative studies </li></ul><ul><li>review, clinical prediction guides, costs, economics </li></ul><ul><li>sensitivity, specificity, optimized </li></ul>
    34. 58. Acquire / 查 <ul><li>Question </li></ul><ul><li>Database selection </li></ul><ul><ul><li>What </li></ul></ul><ul><ul><li>Content > Search > Result </li></ul></ul><ul><li>Search strategy </li></ul><ul><ul><li>How </li></ul></ul><ul><ul><li>Keywords + MeSH > Hedges > Filters </li></ul></ul>
    35. 59. Current Best Evidence
    36. 62. Databases <ul><li>Background questions </li></ul><ul><ul><li>Reviews </li></ul></ul><ul><ul><ul><li>Uptodate, MD Consult (Textbooks, Clinics) </li></ul></ul></ul><ul><ul><ul><li>Ovid (Books@Ovid, Journals@Ovid) </li></ul></ul></ul><ul><li>Foreground questions </li></ul><ul><ul><li>First Consult, Clin-eguide (Ovid), ACP PIER, Dynamed, InfoPOEMs </li></ul></ul><ul><ul><li>Guidelines, or EBM-style review or CATs, Bandolier </li></ul></ul><ul><ul><li>Hand searches PubMed (clinical queries, methodological filters) </li></ul></ul>
    37. 63. http://ebm.twbbs.org/
    38. 64. Slide & Handout … On the web …

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