Embase: Tips and tricks for trainers - Webinar, 27 Nov 2013

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  • Where do you go for tools?What do you like to use when training or presenting on Embase?What have you found useful?
  • The story is essentially that as you move closer to doing a 100% comprehensive literature search – your costs / time investment go up exponentially. Therefore, it’s only worth buying an Embase sub or employing an Embase related /based text mining solution, if the use case requires you to get close to that 100% coverage (PV, systematic reviews, clinical evaluations / investigations, HTA’s etc.)  It’s a framework that we could use more extensively to position Embase and to defend / substantiate pricing. For example , when we are selling Embase, we’re not selling 28 million records, we’re selling the possibility to go from 70/80% retrievability on any particular topic, to (let’s say) 95%. Of course, the only way to get to a 100% is to buy and read every relevant journal there is and visit every conference. Needless to say the solution that would require the most time / investment and would be virtually impossible to do on a regular basis (postmarket surveillance).
  • Impact of increased regulatory pressures in PV continue to drive interest among small & mid Pharma, consultancy agency’s and generic manufacturers. As new ’12 PV standards are being applied, Pharma is being audited. As a consequence they are stepping up their scrutiny on the quality of data and PV service providersEvidence Based Medicine continues to grow and we see an increased number of signups and quotes from the HS domain (Embase being offered in conjunction with Clinical Key). Systematic reviews and spinoffs (HTA’s, Comparative Effectiveness Reviews, Rapid Evidence Advisories) continue to drive the need for Embase in the Academic and Government domain. In the medical devices domain adaption of new ‘safety’ requirements is influenced by a 5-year grace period.
  • Some examples of commonly asked questions. Any other questions at this point?
  • To help you and your users visualize the content in Embase, you can use this diagram. This shows the Embase content, combined with MEDLINE going back to 1960 and with Embase Classic going back to 1947. Embase AIPs. In Process and Conference Abstracts ensure users have the opportunity to review the most recent research as soon as possible. We are looking into adding MEDLINE AiPs and In Process this year.And to look at the overlap in more detail…
  • All of Embase and all of MEDLINE are in Embase.com, with minimum duplication. We choose for Embase record . We will address some questions on this later.the The strategy for searching for Embase ONLY is included. This search will NOT include Medline unique and records which are overlapping Embase/MEDLINE.
  • Let’s take a high level view of what is happening with indexing.Probably like all databases, Embase indexing serves three main roles: to translate (**), expand (**), and focus (**).What is specific to Embase is how we interpret each of these aspects.For example:Under the heading translation, what is special about Embase is the natural language terminology used for indexing, and the very large number of synonyms.expansion stands for the in-depth indexing of drugs, diseases and in fact also medical devices which is derived from the full text of the articleand focus refers to the specific tools that Embase makes available to help you drill down to the articles you need.
  • A few things to focus on:MEDLINE records in Embase: For all these records, we use the MEDLINE indexing, which we map against Emtree in order to ensure that these MEDLINE records are fully retrievable in all searches using Emtree.(**) The details of how we do the mapping are described in the white paper whose URL is shown here.(**) For example, the mapping for MeSH subheadings has to take into account that for some of them there is no equivalent Embase subheading.
  • For example:May I introduce Pierre. Pierre is a clinical liaison librarian, in the Information Services Biomedical Library, Center for Evidence-Based Research. They work with 3 main hospitals.Pierre has many concerns,for example, he instructs users in the use of library resources and management of information and he assists with literature searches on evidence-based practice issues, consulting with staff conducting systematic reviews with regards to search strategies. He serves as the primary library contact for many of the resources used by clinicians. Hisusers are mainly involved in finding information from relevant and reliable sources regarding the effects of different forms of healthcare and they must be thorough when conducting this research and when publishing.His users are preparing articles for publication and they hear more and more that journal editors and referees now stipulate that Embase searches are needed and authors publishing in the field of EBM, who need to follow Cochrane guidelines MUST conduct Embase searches. How can he best incorporate this into their workflow? Some users are still convinced that MEDLINE is enough and some have even asked about Scopus. Let’s have a look at the unique value Embase offers and also how easy it is to search with confidence!
  • The PERFECT DEMO for Embase. Here we show you the answer and now let’s see how Embase helps you to get there quickly and effectively.
  • One of the major steps in conducting a systematic review is a comprehensive literature search. With Embase, all users, regardless of experience may enter the best term or terms to search, even on the Quick Search page. An user with more experience may have more success with knowing which terms to use to retrieve workable results from non-thesaurus options, Google and Scopus shown here for example but what if you do not have this experience, there are no prompts like you see in Embase.
  • Pubmed (Medline) does allow thesaurus searching but here also we notice a difference in the number of results retrieved. Pubmed finds 132 results compared to 8,000 in Embase. We know there is unique content in Embase, the conference abstracts shown here for, but there is also a difference in indexing focus and so Embase indexes more drugs and more deeply.
  • In Medline, this article although present in Medline is not indexed with digoxin and therefore our search for digoxin and antibacterial agents did not find this article. As we know already, it is found in Embase.For those of you who would like to dive into this search in more detail:Antibiotic and digoxin with drug combinationANDCongestive heart failure with drug therapyAND PneumoniaSave this search – remove drug therapy from disease and rerun main searchNow in session results, remove drug comparison from drug sub-searches and note asterix (indicates which searches have been effected by a change to a related search)– now click on result number to update your search strategy.Compare the effectiveness of sitagliptin and saxagliptin in the treatment of type II diabetes mellitus (show this in Emtree)Go to Drug Search and type in sitagliptin and saxagliptin with drug comparison. Go to Emtree and show diabetes mellitus and then go to ‘type 2 diabetes mellitus’. Take this to Disease Search and combine with disease subheading ‘drug therapy’. Combine both searches.Show editing options. NOT [review]/limAdvanced combine on the Session Results: Last search above NOT saxagliptin search, for example #2 NOT #1.Show Emtree to find suitable terms/subject headings and then using Drug Search to add subheadings.
  • Second poll? – what are pain points?What are other examples here to engage audience and find out more about them? List professions? List tools they know and use? As about main tasks?
  • How are you going to start searching for all the synonyms in a non-thesaurus database, such as Scopus? In Embase, we search for our drug, including all the synonyms. We added the drug concept/subheading, ‘adverse drug reaction’ and ‘drug toxicity’ and here we search for a specific relationship with the drug. This is not possible in Scopus.
  • How are you going to start searching for all the synonyms in a non-thesaurus database, such as Scopus? In Embase, we search for our drug, including all the synonyms. We added the drug concept/subheading, ‘adverse drug reaction’ and ‘drug toxicity’ and here we search for a specific relationship with the drug. This is not possible in Scopus.
  • Now we have introduced a scenario and shown some searching in Embase. We can continue to search and ask the audience to prompt us with the next steps...
  • This is where we get started and try to find the best terms for our search for example.POLL
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  • Live in productBACK to slides
  • Starting with Emtree to find suitable terms/subject headings and then using Drug Search to add subheadings. Search saxagliptin with pharmacokinetics and combine with ‘type 2 diabetes mellitus’ with disease subheading ‘drug therapy’.Go back and search for dipeptidyl peptidase IV inhibitors exploded. Copy back to drug search and combine with pharmacokinetics. Combine with previous disease search.Advanced combine on the Session Results: Last search above NOT saxagliptin search, for example #2 NOT #1.
  • Starting with Emtree to find suitable terms/subject headings and then using Disease Search to add subheadings. From Session Results, you can edit in-line by moving your mouse over the search strategy and selecting Edit. Try using /de and :de for exact search and phrase search. Human/de picks up records where human is in the index field and human:de picks up aspects of human. Selecting human from the Advanced Search form searches /de.When looking for exact journal names, such as biochemistry, use /jt. From the Session Results, we may also Copy to Disease Search form and use major focus.Refer to www.trainingdesk.elsevier.com/embase and the Quick User Guide for more guidance
  • Emtree to disease search => depression/exp/dm_dt (= drug therapy)Limits => [child]/lim OR [adolescent]/limEmtree to drug search => serotonin-uptake-inhibitor/exp/dd_dt (via synonym search for SSRI)1 AND 2 AND 3Emtree => suicide/exp4 AND 5Filter => view & select levels of evidence
  • Emtree => hip-prosthesis/expMetal-on-metal (after reviewing Quick search / autocomplete) Avoid relying on metal-on-metal joint prosthesis, introduced 20131 AND 2Filter => select comparative-study, intermethod-comparisonEdit => replace by compar* (compare free text vsEmtree results)Emtree => treatment outcome Filter => view & select levels of evidence
  • Compare the effectiveness of sitagliptin and saxagliptin in the treatment of type II diabetes mellitus (show this in Emtree)Go to Drug Search and type in sitagliptin and saxagliptin with drug comparison. Go to Emtree and show diabetes mellitus and then go to ‘type 2 diabetes mellitus’. Take this to Disease Search and combine with disease subheading ‘drug therapy’. Combine both searches.Show editing options. NOT [review]/limAdvanced combine on the Session Results: Last search above NOT saxagliptin search, for example #2 NOT #1.Quickly show Emtree to find suitable terms/subject headings and then using Drug Search to add subheadings.
  • Now, as you’ll recall, the check tags include a group of study types, such as “major clinical study” and “randomized controlled trial”.Another way of finding study types is to use the Filters at the left hand side of the results page, which I mentioned a few moments ago.(**) All of the study types mentioned here for one particular search are taken from the Emtree facet on “Types of article or study”(**) This is a rich source of terms that you can use to filter your search, and it now includes 10 so-called topic terms shown here, that I described last month in an Embase webinar on Evidence Based Medicine. If you want to follow up on this, you can access those slides via the Embase info site.This definition of topic terms, by the way, mirrors the definitions of similar terms which the NLM uses to index MEDLINE.
  • Find disease management studies for Type II diabetesGo to Emtree and type in diabetes. Once you see the tree, select non-insulin dependant diabetes mellitus. Click on ‘take this to Disease search’. Point out ‘major focus’ option if users would like to limit their search to only records where the disease is of major importance and show on Disease Search form. Shoe quick and advanced limits.You can then add the subheading ‘disease management’. Check filters for drugs and study types.
  • Don’t loose those important searches, register in Embase so you may save your searches or set up email alerts. Registering also means you receive all up to date information such as upcoming webinars.Antibiotic and digoxin with drug combinationANDCongestive heart failure with drug therapyAND PneumoniaSave this search – remove drug therapy from disease and rerun main searchNow in session results, remove drug comparison from drug sub-searches and note asterix (indicates which searches have been effected by a change to a related search)– now click on result number to update your search strategy.Re-use a named search in a new search. For example you may have a group of #limitstrial AND digoxin
  • Antibiotic and digoxin with drug comparisonANDCongestive heart faliure with drug therapyAND PneumoniaSave this search – remove drug therapy from disease and rerun main searchNow in session results, remove drug comparison from drug sub-searches and note asterix (indicates which searches have been effected by a change to a related search)– now click on result number to update your search strategy.Re-use a named search in a new search. For example you may have a group of #limitstrial AND digoxin
  • Embase: Tips and tricks for trainers - Webinar, 27 Nov 2013

    1. 1. Welcome to Embase! What you need to know about Embase… Your presenter: Ann-Marie Roche
    2. 2. Need to know • Webinar control panel: – ‘chat’ or ‘ask a question’ for questions and comments – Option for full screen view • Q&A during and time at end.
    3. 3. CONTENTS • Tools • Why Embase and who uses Embase • Guiding users through… – Initial investigation – Setting up search strategies – Refining, editing and managing search results 3
    4. 4. SUPPORT TOOLS • Customer support and training page • Webinars • Search Guides and white papers • Videos • Revamping Help and Support in Embase • Newsletter registration 4
    5. 5. WEBINARS IN EMBASE Webinar overview 2013 • Intro webinars – once a quarter • Topic webinars – Evidence-Based-Medicine, Adverse Events, Emtree, Tips and Tricks for trainers • 12 webinars in 2014 Webinars in 2014 • Looking for ideas from you from you for NEW webinars • Extending the number of intro webinars to other time-zones and languages • Repeat popular topics from this year and include priorities like Medical Devices 5
    6. 6. NEW VIDEOS CURRENTLY ON WWW.ELSEVIER.COM/ONLINE-TOOLS/EMBASE/CUSTOMER-SUPPORT BUT MOVING TO WWW.ELSEVIER.COM/ONLINE-TOOLS/EMBASE/TRAINING-AND-SUPPORT • Getting started • Designing your search • Refining your search • Managing your search • Setting up and managing email alerts and saved searches 6
    7. 7. NEW SUPPORT IN PRODUCT 7
    8. 8. WHY EMBASE? 8
    9. 9. HOW EMBASE DELIVERS VALUE ...by including literature and information resources in a timely manner ...by reading full-text to identify drugs, diseases, adverse affects, clinical trials, drug trade names etc. ...by enabling advanced search filters to drill down a comprehensive search to a relevant and manageable record set Conference proceedings Scientific Journals In Press (unpublished) Deep indexing using own taxonomy (EMTREE) Very powerful Search Environment ...by allowing users to automate searching and result management We make sure you don’t miss any biomedical literature They only close alternative is reading all the articles Good precision and recall balance Automation and documentation E-mail Alerting API Interoperability 9 9
    10. 10. BEING AS COMPREHENSIBLE AS POSSIBLE SOURCE Efforttools required TEXT MINING EMBASE SCOPUS PUBMED GOOGLE E 0% 50 % 100 % Percentage of relevant articles retrieved 10
    11. 11. WHO BENEFITS FROM USING EMBASE • Systematic reviews of the (biomedical) literature • Health Technology Assessments or rapid advisories • Comparative Effectiveness Reviews • Post-market surveillance and / or clinical evaluations for Medical Devices • Comprehensive „scanning/monitoring‟ literature for drug adverse effects, emerging public health threats, off-label drug use, efficacy, medication errors, drug-drug interactions, abuse and misuse, quality complaints, counterfeiting, inaccurate or inappropriate statements on drugs and devices in data. Common heading could be Pharmacovigilance. • If users have a more „general‟ research need – Scopus for example is a great solution. 11
    12. 12. FAQS • How current is Embase. Does it have AIP and In Process for example? • Where do conference abstracts come from? • Is all of MEDLINE in Embase? Therefore do I NOT need to search both? Check out our Embase/MEDLINE and differences between Emtree/MeSH white paper • Why do I need indexing? 12
    13. 13. Content Emtree: Biomedical thesaurus, over 60k terms 1947 1950 1974 2009 Embase: Fully indexed: Over 8,000 journals, 1974(5.5M not in MEDLINE) MEDLINE: 2,500 journals unique to Embase, mapped to Embase indexing, 1950- (including MEDLINE Classic) Embase Classic: Digitally scanned and re-indexed, 1947-1973 AIP and In Process: Indexing added, from 2009 Conference Abstracts: Indexing added, from 2009 http://www.elsevier.com/online-tools/embase/about
    14. 14. CONTENT [EMBASE/LIM] NOT [MEDLINE]/LIM MEDLINE Embase 5.5m 10m 9m 2000 3000 2500 14
    15. 15. INDEXING 1. TRANSLATE To bring the semantic richness of medical terminology within your grasp: mapping many synonyms to a single (natural language) preferred terminology 2. EXPAND To expose and summarize the information in biomedical articles beyond title and abstract: discovering in-depth data about drugs, diseases and medical devices 3. FOCUS To identify the key concepts hidden within those articles – what they are really about – providing you with a toolkit to find answers beginning with comprehensive searches 15
    16. 16. INDEXING  MEDLINE INDEXING IS MAPPED TO EMTREE TERMS SEE WHITE PAPER: COVERAGE OF MEDLINE ON EMBASE “When MeSH terms are mapped to Emtree, subheadings are mapped to Embase subheadings. Since not all MeSH subheadings have an exact Emtree equivalent, some of them generate Emtree terms rather than subheadings.” 16
    17. 17. CASE STUDY 17
    18. 18. Meet Karol, an information specialist supporting pharmacovigilence. Karol needs to ensure that she is setting up searches across all relevant sources, to track all adverse events for 3 of their products on the market. There is so much info to track and she struggles to be confident when reporting. Let‟s dive in and show her how she may quickly review all side effects for her drugs, saving her time, while being confident that she is not missing anything with Embase‟s current and unique content.
    19. 19. INITIAL INVESTIGATION 32
    20. 20. PLAN YOUR SEARCH 33 33
    21. 21. START SEARCHING FIND THE BEST TERMS FOR YOUR SEARCH AND INCLUDE SYNONYMS AUTOMATICALLY WITH AUTOCOMPLETE IN QUICK SEARCH 34
    22. 22. CHECK FILTERS CLICK ON DISEASE FILTER FOR EXAMPLE, TO SEE WHICH DISEASES ARE REFERENCED WITH JANUVIA, EITHER AS A THERAPEUTIC AREA OR SIDE EFFECT. 35
    23. 23. CHECK ARTICLES FOR SEARCH TERMS Find interesting search terms or drug and disease relationships without having to consult the full text. 36
    24. 24. START BUILDING YOUR SEARCH 37
    25. 25. START WITH EMTREE Search for over 60K terms, including MeSH terms and over 30K drug and chemical terms Click here to search further in an Embase search form, mapping all synonyms Click here to the see the results, exploded 38 38
    26. 26. REVIEW EMTREE TERMS Consider the term’s History Take note of any Synonyms listed Look at the CAS registry number(s) displayed Read the entry provided from Dorland’s dictionary, when available 39
    27. 27. REVIEW QUESTION 1 •Track the efficacy of saxagliptin in treating diabetes type 2 and compare to other dipeptidyl peptidase 4 inhibitors •Investigate the use of subheadings, such as: ‘Pharmacokinetics’, ‘Adverse Drug Reaction’, ‘Drug Toxicity’ •Use explosion to investigate other depeptidyl peptidase 4 inhibitors 40
    28. 28. REVIEW QUESTION 2 Find disease management studies for Type II diabetes •Look for your term in Emtree •Use the disease search form for disease subheadings. •Use major focus to limit your results. 41
    29. 29. REVIEW QUESTION 3 • Evaluate the evidence for suicide risk in children treated for depression with SSRIs • Evaluate the evidence that children treated for depression using serotonin reuptake inhibitors are at increased risk of suicide 42
    30. 30. REVIEW QUESTION 4 • What are the pro’s and con’s for metal-on-metal hip implants vs other types of hip prosthesis? • What are the pro’s and con’s for metal-on-metal hip implants vs other types in different patient groups? 43
    31. 31. BUILD AND COMBINE SEARCHES REFER TO HELP FOR MORE GUIDANCE AND LINKS TO MATERIALS SUCH AS THE QUICK USER GUIDE. • Use single quotes to capture a phrase „diabetes mellitus‟ for example (not with Autocomplete in Quick Search) • Break up your search into individual searches, such as a drug search (in Drug Search form) and a disease search (in Disease Search form) and combine your results in Session Results • Run your cursor over your search to Edit or copy to a Search Form for guided editing. • Truncation and operators, AND, OR, NOT, NEXT, NEAR 44
    32. 32. BUILD AND COMBINE SEARCHES REFER TO HELP FOR MORE GUIDANCE AND LINKS TO MATERIALS SUCH AS THE QUICK USER GUIDE. • Use single quotes to capture a phrase „diabetes mellitus‟ for example (not with Autocomplete in Quick Search) • Break up your search into individual searches, such as a drug search (in Drug Search form) and a disease search (in Disease Search form) and combine your results in Session Results • Run your cursor over your search to Edit or copy to a Search Form for guided editing. • Truncation and operators, AND, OR, NOT, NEXT, NEAR 45
    33. 33. REFINE, EDIT AND MANAGE 46
    34. 34. STUDY TYPES AND TOPIC TERMS • From Emtree facet “Types of article or study” • Include many more terms than check tags • Now include “Topic terms” (from 2011) Topic terms: 10 terms ending with (topic) Topic terms were introduced in 2011 to differentiate between study types, indexed when the article IS the primary report for an RCT (for example), and articles in which that term is only a topic that is discussed. 47
    35. 35. REFINING YOUR SEARCH CHECK OUT OUR TRAINING VIDEOS AT FOR MORE GUIDANCE • Quick and Advanced Limits on Advanced, Drug and Disease Search forms • Major Focus on all advanced forms – major drugs and diseases retrieved • Field limits under Advanced Search box to search in specific fields such as article title, abstract, conference name, drug name etc • Drug and Disease Subheadings to limit to specific concepts such as Adverse Drug Reaction, Drug Comparison and Side Effect. • Filters on Session Results page for specific diseases or study types for example Check out our training videos at www.elsevier.com/onlinetools/embase/customer-support#videos for more guidance. 48
    36. 36. REGISTERING FOR EMAIL ALERTS AND SAVE SEARCHES •Setting up email alerts •Saving your searches •Staying up to date 49 49
    37. 37. SAVING SEARCHES • Save in personal folders or share your saved searches. • Edit sub-searches within your main search strategy and rerun • Re-use a save search - #name in future searches 50
    38. 38. Q&A 51
    39. 39. THANK YOU • Our next intro webinar is Jan 22 2014! • You may review our up to date webinar schedule on our webinar page. • Slides and recording will be sent as well as any further questions? 52

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