Prosthetics & Orthotics: Searching for
Evidence
La Trobe University Library
Latrobe.edu.au/library
The Research Question
• You cannot conduct an effective search without a well
formulated question.
• Think about the conce...
Levels of Evidence
La Trobe University Library 3
Developing a search strategy: PICO
1. Break the research question down into concepts:
• Population
• Intervention
• Compar...
PICO example
Population/
Problem
Intervention Comparision Outcome Research
Design
Elderly
people
with
stroke
Ankle-foot
or...
Useful search tips
• Spelling variations: paediatric or pediatric
• Terminology: stroke or “cerebral vascular accident” or...
Linking terms: BOOLEAN operators
• AND - retrieves records containing both of
two terms:
– Back pain AND exercise
• OR - r...
Example of a completed PICO map
La Trobe University Library 8
Population/
Problem
Intervention Comparison Outcome Research...
Databases
• Electronic Indexes that help you identify journal
articles in your research area
• NO single database indexes ...
Types of databases
• Citation databases:
Entries have the citation, subject headings and often an abstract,
sometimes they...
Accessing Prosthetic & Orthotic databases
• On Campus:
– Library Web Page
> Databases
> Subject Area - Health Sciences
> P...
Systematic Searching
• Systematic searches are a combination of using
the terminology of the database (Subject
Headings) c...
Systematic searching: Why use both methods?
Controlled Vocabulary (Subject Searching) Keyword Searching
MEDLINE, Embase, C...
Database aids:
Controlled vocabulary & scope notes
• Subject Headings (Controlled vocabulary or Thesauri): used
to overcom...
Use limits to refine your search
For example:
• Clinical Queries
• Time frame
• Language, gender, age, population
• Public...
Decreasing results
Too many results?
• Apply limits
• Use keywords which are more specific
• Ask for help with finding sub...
Increasing results
Not enough results?
• Try another keyword(s)
• Use broader search term(s)
• Remove the least important ...
Search results – finding the full text!
• Some databases will have the Full Text Finder icon or pdf link
• If not, search ...
Cochrane Library
• To access a variety of search options, click on Search, Search Manager or
Medical Terms (MeSH) to be di...
• Click on the ‘Show conditions’ tab to browse information on the
management of a patient
• Under ‘Treatment’ click on ‘Ev...
Google Scholar - scholar.google.com/
• Search scholarly literature for articles, theses, books,
abstracts, professional so...
Useful library guides
• Prosthetics & Orthotics
• Critical Appraisal
• EndNote
• Grey Literature for Health Sciences
• Sys...
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  • Prosthetics & Orthotics: Searching for Evidence

    1. 1. Prosthetics & Orthotics: Searching for Evidence La Trobe University Library Latrobe.edu.au/library
    2. 2. The Research Question • You cannot conduct an effective search without a well formulated question. • Think about the concepts within your research question • Identify and list the keywords and their synonyms that identify the concepts • Consider the ‘level of evidence’ to be sought – the research methodologies that will help eliminate bias La Trobe University Library 2
    3. 3. Levels of Evidence La Trobe University Library 3
    4. 4. Developing a search strategy: PICO 1. Break the research question down into concepts: • Population • Intervention • Comparison Intervention • Outcome • Research / Study design - - Consider adding another column for the Research Design ie. which study type will give the highest level of evidence to answer the question 2. Identify for each facet: • Synonyms • Spelling variants • Subject headings La Trobe University Library 4
    5. 5. PICO example Population/ Problem Intervention Comparision Outcome Research Design Elderly people with stroke Ankle-foot orthoses None Gait If applicable: which study type will give the highest level of evidence to answer the question? La Trobe University Library “What is the effect of ankle-foot orthoses on gait in elderly people following stroke?” Note: The PICO formula doesn’t always apply and that all elements don’t always need to be present. It is a useful way to structure and focus your question – makes it easier to identify search concepts
    6. 6. Useful search tips • Spelling variations: paediatric or pediatric • Terminology: stroke or “cerebral vascular accident” or . . . . . • Truncation * : rehabilitat* will find rehabilitate/s, rehabilitated or rehabilitation • Wildcard(? or #): depending on the database a wildcard can be either ? or # symbol eg. e.g.randomi?ed will return randomized and randomised • Phrase searching “….” eg. “ankle foot orthoses” • Check the database online help for further information La Trobe University Library 6
    7. 7. Linking terms: BOOLEAN operators • AND - retrieves records containing both of two terms: – Back pain AND exercise • OR - retrieves records containing any of the terms (OR retrieves more records): – Back pain OR back ache La Trobe University Library 7
    8. 8. Example of a completed PICO map La Trobe University Library 8 Population/ Problem Intervention Comparison Outcome Research Design (if applicable) Stroke OR “cerebrovascular accident*” OR CVA “Ankle-foot ortho*” OR AFO* n/a gait OR walk Therapy AND O R
    9. 9. Databases • Electronic Indexes that help you identify journal articles in your research area • NO single database indexes every journal possible in a subject area - only those that match their selection criteria • Efficient, effective and less biased searching therefore requires multiple database searching La Trobe University Library 9
    10. 10. Types of databases • Citation databases: Entries have the citation, subject headings and often an abstract, sometimes they link to full text. Examples: CINAHL, Embase, MEDLINE • Full Text databases: Entries have the citation and abstract and in most cases the full text of an article. Examples: Health & Medical Complete (Proquest), Informit Health • Pre-appraised evidence databases: – The Cochrane Library is a multi-database resource which varies in output e.g. the Cochrane Database for Systematic Reviews contains complete systematic reviews – BMJ Best Practice incorporates Clinical Evidence which summarises the current state of knowledge and uncertainty about the prevention and treatment of clinical conditions, based on thorough searches and appraisal of the literature. La Trobe University Library 10
    11. 11. Accessing Prosthetic & Orthotic databases • On Campus: – Library Web Page > Databases > Subject Area - Health Sciences > Prosthetics & Orthotics • Off Campus: authentication as a La Trobe University student required: – University username and password La Trobe University Library 11
    12. 12. Systematic Searching • Systematic searches are a combination of using the terminology of the database (Subject Headings) combined with free text or keyword searching (alternate terms encountered in the literature). • While there may be some overlap, you will also find many different articles when using both ways of searching for the same concept. • Comprehensive systematic searching requires subject heading and keyword searching! La Trobe University Library 12
    13. 13. Systematic searching: Why use both methods? Controlled Vocabulary (Subject Searching) Keyword Searching MEDLINE, Embase, CINAHL (amongst others) are indexed by subject experts who assign a subject heading (or ‘tag’) that best describes the article. These subject headings are from a fixed list of terms that are arranged in a hierarchical structure that show the relationships between terms. This allows searching at various levels of specificity. Words not taken from a specific list. Can use words that you would normally use when searching. Need to account for variations for spelling, terminology & clinical descriptions. More efficient & precise way of searching where you retrieve only those records which list the subject heading for your concept. Broader way of searching where you will retrieve records which mention your keywords but may or may not be specifically about your concept. Searches only the subject field. Searches words used by the author in other fields such as the title or abstract. Provides consistency in the description of the content of the articles. Useful for searching for a specific term or phrase when there is not an appropriate subject heading. Do not need to think of synonyms for your topic. Useful for searching topics that use new concepts or terminology (subject headings take a while to be developed) 13
    14. 14. Database aids: Controlled vocabulary & scope notes • Subject Headings (Controlled vocabulary or Thesauri): used to overcome differences in individual authors’ use of terminology. e.g. back pain (CINAHL and MEDLINE), backache (Embase) – Click on the Subject Heading, scroll down to the ‘used for’. Provides ideas for other keywords to use! • Scope note: describes how the term is used in the database, the “scope” of the term; the history of the indexing • ‘Exploding’ a term: results will include the ‘exploded’ term (eg. orthotic devices) plus the conceptually narrower terms in the tree (eg. braces) La Trobe University Library 14
    15. 15. Use limits to refine your search For example: • Clinical Queries • Time frame • Language, gender, age, population • Publication types – CINAHL e.g. clinical-trial; masters-thesis; research; review; systematic-review – MEDLINE - e.g. controlled clinical trial; meta analysis; randomised controlled trial; review literature; review, academic; review La Trobe University Library 15
    16. 16. Decreasing results Too many results? • Apply limits • Use keywords which are more specific • Ask for help with finding subject headings. • Search for keywords in particular fields like abstract or title. La Trobe University Library 16
    17. 17. Increasing results Not enough results? • Try another keyword(s) • Use broader search term(s) • Remove the least important concept • Consider possible variants of terms and use truncation or wildcard • Remove a date limit or any other limits you have selected • Try another database La Trobe University Library 17
    18. 18. Search results – finding the full text! • Some databases will have the Full Text Finder icon or pdf link • If not, search by the title of the journal via the Journal tab on the library home page and follow the links to the full text: – sometimes the article may only be in print copy in the Library • If not held by the Library, request the article via Document Delivery Services La Trobe University Library 18
    19. 19. Cochrane Library • To access a variety of search options, click on Search, Search Manager or Medical Terms (MeSH) to be directed to the appropriate search tab. • Further information at: latrobe.libguides.com/healthdatabases > Cochrane La Trobe University Library 19
    20. 20. • Click on the ‘Show conditions’ tab to browse information on the management of a patient • Under ‘Treatment’ click on ‘Evidence’ to view information from BMJ Clinical Evidence (systematic reviews of key clinical questions) BMJ Best Practice
    21. 21. Google Scholar - scholar.google.com/ • Search scholarly literature for articles, theses, books, abstracts, professional societies, online repositories, universities and other web sites across the world of scholarly research. • You can access items held in the Library through Google Scholar. See instructions. La Trobe University Library 21
    22. 22. Useful library guides • Prosthetics & Orthotics • Critical Appraisal • EndNote • Grey Literature for Health Sciences • Systematic Reviews • Health Databases La Trobe University Library 22

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