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Lit Reviews for the Health Sciences


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Presentation given at the University of Western Ontario as part of the Graduate Student Workshop series on June 21, 2010.

Published in: Health & Medicine, Technology
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Lit Reviews for the Health Sciences

  1. 1. Literature Reviews for the Health Sciences June 21, 2010 Robin Featherstone Clinical Medicine Librarian [email_address] Presentation available at:
  2. 2. What’s a Research Lit Review? <ul><li>A research literature review is a systematic , explicit and reproducible method for identifying, evaluating, and synthesizing the existing body of completed and recorded work produced by researchers, scholars, and practitioners.* </li></ul><ul><li>* Fink, A. (2005). Conducting Research Literature Reviews . London: Sage. </li></ul>
  3. 3. Why would you have to conduct one? <ul><li>For your thesis </li></ul><ul><li>For your work as a research assistant </li></ul><ul><li>For a funding proposal or grant application </li></ul><ul><li>For your academic work as a faculty member </li></ul><ul><li>For your work as a professional researcher </li></ul>
  4. 4. 7 tasks in the Research Lit Review <ul><li>Selecting research questions </li></ul><ul><li>Selecting your sources </li></ul><ul><li>Choosing search terms </li></ul><ul><li>Running your search </li></ul><ul><li>Applying practical screening criteria </li></ul><ul><li>Applying methodological screening criteria </li></ul><ul><li>Synthesizing the results </li></ul>
  5. 5. Selecting research questions
  6. 6. Why do I need a research question? <ul><li>To guide your review </li></ul><ul><li>To provide you with keywords for your search </li></ul><ul><li>To give your research precision </li></ul>
  7. 7. Scenario <ul><li>You’re applying for a grant to support your research on hygiene in clinical settings. </li></ul><ul><li>Think of some specific questions related to this topic... </li></ul>
  8. 8. Questions <ul><li>Broad: </li></ul><ul><li>What are the best methods of maintaining a clean clinical environment? </li></ul><ul><li>Narrow: </li></ul><ul><li>Does hand washing prevent MRSA in the ICU? </li></ul><ul><li>Very Narrow: </li></ul><ul><li>What are the attitudes of general practitioners in Southern Ontario to the use of hand washing to prevent MRSA? </li></ul>
  9. 9. How questions influence search results Relevancy Retrieval (# of search results) Broad Questions Narrow Questions High = lots of articles Low = very few articles High = directly relevant articles Low = mostly irrelevant articles
  10. 10. Good Question for Literature Review <ul><li>Narrow: </li></ul><ul><li>Does hand washing prevent MRSA in the ICU? </li></ul>
  11. 11. Selecting your sources
  12. 12. Lit reviews depend on data from seven sources <ul><li>Online public bibliographic databases (i.e., MEDLINE) </li></ul><ul><li>Private bibliographic databases (i.e., EMBASE) </li></ul><ul><li>Specialized bibliographic databases (i.e., Cochrane Database of Systematic Reviews) </li></ul><ul><li>Manual or “hand searches” of references lists </li></ul><ul><li>“ Grey literature” - </li></ul><ul><li>Web reports </li></ul><ul><li>Experts </li></ul>
  13. 13. To find databases... <ul><li>Try program pages from the library: </li></ul><ul><li>Consult your colleagues or your librarian: </li></ul><ul><ul><li> </li></ul></ul>
  14. 14. Selecting sources <ul><li>Where are we likely to find articles that answer the question: </li></ul><ul><li>Does hand washing prevent MRSA in the ICU? </li></ul>
  15. 15. Some places to search <ul><li>Bibliographic Databases </li></ul><ul><li>Medicine </li></ul><ul><ul><li>PubMed (or Ovid MEDLINE) </li></ul></ul><ul><ul><li>EMBASE </li></ul></ul><ul><ul><li>Cochrane Library </li></ul></ul><ul><li>Multidisciplinary </li></ul><ul><ul><li>Scopus </li></ul></ul><ul><ul><li>Web of Science </li></ul></ul><ul><li>Nursing and Allied Health </li></ul><ul><ul><li>CINAHL </li></ul></ul><ul><ul><li>Proquest Nursing and Allied Health Source </li></ul></ul><ul><li>Web Sources </li></ul><ul><li>Associations (APHA) </li></ul><ul><li>Organizations (WHO) </li></ul><ul><li>Government ( MOHLTC, Public Health Agency of Canada) </li></ul><ul><li>Other </li></ul><ul><li>“ Grey Literature” </li></ul><ul><ul><li>ProQuest Dissertations & Theses, conference proceedings (i.e., AMA), etc... </li></ul></ul><ul><ul><li>BASE Search Engine </li></ul></ul>
  16. 16. Choosing search terms
  17. 17. Breaking down your question <ul><li>Select your database </li></ul><ul><li>Break you question into concepts </li></ul><ul><li>Identify subject headings for each concept </li></ul><ul><li>Identify keywords for each concept </li></ul><ul><li>Tips: </li></ul><ul><ul><li>Use a “target article” to help identify search terms </li></ul></ul><ul><ul><li>Use a strategy worksheet to keep track of your terms: </li></ul></ul><ul><ul><li> </li></ul></ul>
  18. 18. Why do I have to select a database first? <ul><li>Your database will determine: </li></ul><ul><ul><li>Your subject headings </li></ul></ul><ul><ul><li>Your operators (i.e., truncation symbols) </li></ul></ul>
  19. 19. Different databases have different subject headings <ul><li>Tips: </li></ul><ul><ul><li>Complete a concept map for each database that you search </li></ul></ul><ul><ul><li>Select subject headings that are the closest match for your concept (remember: systematic, explicit and reproducible) </li></ul></ul><ul><ul><li>Pay attention to “explode” commands – some databases will search related headings by default, others will not </li></ul></ul>Database Subject Headings Medline MeSH EMBASE EMTREE CINAHL CINAHL Headings Cochrane Library MeSH Web of Science N/A Scopus N/A
  20. 20. Identifying concepts <ul><li>Which concepts are contained in the question: Does hand washing prevent MRSA in the ICU? </li></ul><ul><li>Hand washing </li></ul><ul><li>MRSA </li></ul><ul><li>ICU </li></ul><ul><li>Prevention </li></ul>
  21. 21. Sample Search Strategy Concept #1 Concept #2 Concept #3 Subject Headings Keywords AND AND OR Hypertension [MeSH]+ Diabetes Mellitus, Type 1 [MeSH]+ Blood Pressure Monitoring, Ambulatory [MeSH] OR OR OR OR Hypertensi$.mp. (Diabetes mellitus adj5 (type 1 OR insulin?dependent OR juvenile?onset OR sudden?onset)).mp. ((blood pressure OR BP) adj2 (monitor$ OR test$) adj5 (home OR self OR ambulatory)).mp. OR ((high OR elevated) adj2 (blood pressure OR BP)).mp. OR OR
  22. 22. Some key operators in Ovid Note: These are recommended operators for research lit reviews. There are many, many more operators... Use Ovid‘s Help menu to locate them. Or see: Operator Command $ Truncation (finds alternate endings) ? Wildcard (finds alternate spellings) .mp. Mapping Alias (tells Ovid to search for your term in the Title, Abstract, Subject Headings, Table of Contents and Key Phrase Identifier fields) – useful for lit. reviews because it is broad () Parentheses control the order of search operations Adj Adjacency operator (can be followed by a number) tells Ovid terms must appear adjacent to one another AND all terms must appear in results OR any terms will appear in results
  23. 23. Does hand washing prevent MRSA in the ICU? Hand washing MRSA ICU Prevention
  24. 24. Running your search
  25. 25. Running your search(es) <ul><li>Start with your first concept </li></ul><ul><ul><li>Search for the subject headings first </li></ul></ul><ul><ul><li>Then search keywords </li></ul></ul><ul><ul><li>Combine these synonymous searches with OR using your search history </li></ul></ul><ul><li>Repeat for your second, third, and subsequent concepts </li></ul><ul><li>Finally, combine large search results set with AND </li></ul>
  26. 26. Running your search(es) Search #2 = Search #3 = Search #4 = Search #5 = #1 OR #2 OR #3 OR #4 Search #1 = Concept 1 Search #6 = Search #7 = Search #8 = Search #9 = Concept 2 Search #10 = #6 OR #7 OR #8 OR #9 Search #11 = #5 AND #10 Results
  27. 27. Search Ovid MEDLINE
  28. 28. Applying practical & methodological screening criteria
  29. 29. Screening <ul><li>Two kinds: practical and methodological </li></ul><ul><li>Why? </li></ul><ul><ul><li>Use practical screening to identify a broad range of potentially useful studies </li></ul></ul><ul><ul><li>Use methodological screening to identify the best available studies </li></ul></ul>
  30. 30. Practical Screening Criteria – some examples <ul><li>Date of publication </li></ul><ul><ul><li>only studies conducted between 2005 and 2010 </li></ul></ul><ul><li>Participants of subjects </li></ul><ul><ul><li>only children 6 to 12 years of age </li></ul></ul><ul><li>Publication language </li></ul><ul><ul><li>only materials written in English </li></ul></ul><ul><li>Research design </li></ul><ul><ul><li>only clinical trials </li></ul></ul>
  31. 31. Methodological Screening Criteria - some questions to ask <ul><li>Is the study’s research design internally & externally valid? </li></ul><ul><li>Are the data sources used in the study reliable & valid? </li></ul><ul><li>Are the analytic methods appropriate? </li></ul><ul><li>Are the results meaningful in practical & statistical terms?* </li></ul><ul><li>*Fink, A. (2005). Conducting Research Literature Reviews . London: Sage. </li></ul>
  32. 32. Applying Screens (or limits) <ul><li>Apply practical screens by using “limits” (may also be called “search options”) </li></ul><ul><li>Apply methodological screens by reading through the articles </li></ul>
  33. 33. Apply Practical Screens <ul><li>Add the following limit to your combined search result set: </li></ul><ul><ul><li>Publication Year: 2000 - Current </li></ul></ul>
  34. 34. Next steps
  35. 35. Moving to another source <ul><li>Retain as much of your original strategy as possible </li></ul><ul><li>Recognize that subject headings will be different (or non-existent) </li></ul><ul><li>Keep track of your search terms using a new concept map </li></ul>
  36. 36. Hand searching and final steps <ul><li>Locate the reference lists for selected articles* </li></ul><ul><li>Identify new articles that have cited your articles* </li></ul><ul><li>Identify key journals and “hand search” their issues </li></ul><ul><li>Test your search strategy by checking to see if a few “target articles” appear in the results </li></ul><ul><li>* Use Web of Science or Scopus </li></ul>
  37. 37. Working with your results <ul><li>Export search results from each database or website into a citation manager (i.e., RefWorks) </li></ul><ul><li>Remove duplicates </li></ul><ul><li>Remove inappropriate studies by applying methodological screens </li></ul>
  38. 38. Synthesizing the results
  39. 39. Look for Patterns <ul><li>What conclusions did these studies reach? </li></ul><ul><li>Which studies agreed/disagreed with the consensus? </li></ul><ul><li>Consider using a synthesis matrix: </li></ul><ul><li> </li></ul>
  40. 40. Use your results to... <ul><li>Describe current knowledge about your research topic </li></ul><ul><li>Support the need for and significance of new research </li></ul><ul><li>Explain research findings </li></ul><ul><li>Describe the quality of a body of research* </li></ul><ul><li>*Fink, A. (2005). Conducting Research Literature Reviews . London: Sage. </li></ul>
  41. 41. Recap <ul><li>Remember... research lit review is: systematic, explicit and reproducible </li></ul><ul><li>Select appropriate research question </li></ul><ul><li>Identify appropriate databases </li></ul><ul><li>Break your question into concepts </li></ul><ul><li>Identify synonyms and subject headings for each concept </li></ul><ul><li>Combine synonym searches with OR </li></ul><ul><li>Combine concept searches with AND </li></ul><ul><li>Apply practical and methodological screens </li></ul><ul><li>Send search results to a citation manager </li></ul><ul><li>Remove duplicates </li></ul><ul><li>Use your lit review to summarize knowledge, assess research and support new research initiatives </li></ul>
  42. 42. Questions Robin Featherstone Clinical Medicine Librarian [email_address]