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Developing the idea searching the literature, adam library
- 1. Papworth Hospital NHSF t Tust oundaion r Developing the idea: literature searching Adam Tocock Clinical Outreach Librarian Adam.Tocock@papworth.nhs.uk Julie Aikens E-Resources Librarian julie.aikens@papworth.nhs.uk In collaboration with Research Skills Course
- 2. Sources and strategies for finding evidence Internet NHS Evidence Resources Reviews Cochrane Library Medline and other databases Research Skills Course
- 3. Internet Quality – Transparency – Authority – Privacy – Currency – Accountability – Accessibility Gateways Research Skills Course
- 4. NHS Evidence Resources Databases Journals www.evidence.nhs.uk Research Skills Course
- 7. Reviews Help to formulate or develop ideas Sheer volume of literature Types of review Where to find reviews Research Skills Course
- 8. Cochrane Library Cochrane Database of Systematic Reviews (CDSR) Database of Abstracts of Reviews of Effects (DARE or Other Reviews) Cochrane Central Register of Controlled Trials (CENTRAL) www.thecochranelibrary.com Research Skills Course
- 10. Healthcare databases Research Skills Course
- 11. Sources of evidence Citation MEDLINE PsycInfo Registers indexes Evidence- based Research Councils Reference Databases Research lists Contact with researchers/ practitioners SOURCES OPACs Handsearching Grey literature Conference Pharmaceutical Databases proceedings industry Direct Internet Published Indexes contact copies Research Skills Course
- 12. Finding the evidence Key factors: Search strategy Database structure Research Skills Course
- 13. Search strategy: formulating an answerable question Use your own words Descriptors or keywords Parameters Research Skills Course
- 14. Focusing the question Health services research often uses PATIENT- INTERVENTION-COMPARISON-OUTCOME (PICO) Problem or patient group? Intervention? Comparable interventions? Outcomes of interest? Research Skills Course
- 15. PICO in practice In men aged over 70 with non-metastatic prostate cancer, does radical prostatectomy, as compared with watchful waiting, prevent the spread of disease or increase survival time? Research Skills Course
- 16. PICO in practice Component Description Example Patient A description of your A man aged over 70 patient including their with non-metastatic clinical condition prostate cancer Intervention What are you Radical prostatectomy considering doing? Comparison What the alternatives Watchful waiting would be Outcomes The events that you Occurrence of are trying to prevent metastases, overall (or bring about) survival time Research Skills Course
- 17. Database structure: MEDLINE TI Title AU Author(s) AD Address SO Journal Details PY Publication Year LA Language of Article CP Country of Publication AB Abstract MESH Medical Subject Headings (Thesaurus terms / Descriptors) Research Skills Course
- 18. Live search Search techniques Thesaurus terms Mapping Boolean operators Search filters Research Skills Course
- 19. Sensitive search strategy design Thesaurus terms e.g. MESH, Emtree and Free text searching = High recall Research Skills Course
- 20. 10 tips for searching Define a focused question Identify and use appropriate resources Search one database at a time Use free text and thesaurus searching Search for one concept at a time Research Skills Course
- 21. 10 tips for searching Always ‘explode’ your term Know how to use AND / OR Be cautious about limiting searches Evaluate results and re-visit strategy Attend a training course Research Skills Course
Editor's Notes
- 1 1 1 Introductions Outline – a slideshow that gives an overview of how to search the literature Then an exercise where we will ask you to formulate search strategy in your groups Then Julie will perform a search based on this strategy Make sure you pick up a handout from the back – they’re dead useful. Axe questions as we go along New HDAS: http:// temp.library.nhs.uk/default.aspx
- Problem for all healthcare staff: enormous range of sources of information to help with patient care decision making and research. Need to know which sources to use and how to make most effective use of them. 5 main areas to be looked at today; focusing on what is available to you.
- Firstly - Internet Need an awareness of quality; no controls over content. EU published draft guidelines on 6 quality criteria for health websites. Transparency (who is site provider; target audience; transparency of funding); Authority (names & credentials); Privacy (security; confidentiality); Currency (clear & regular updating); Accountability (feedback; editorial policy); Accessibility (searchability; readability). eEurope 2002:Quality criteria for health related websites. Some standards already exist: Health on the Net Foundation HON Code of conduct. Use gateways ; have explicit criteria for quality content. Some examples of gateways (hubs/portals) are TRIP, National Electronic Library of Medicine and NHS Evidence…
- Secondly – An example of a gateway – originally NLH, then renamed Health Information Resources, latterly known as Evidence: a national web based digital library for the NHS and the public. Books, databases and journals Drug information Patient information NICE Pathways
- Home page of evidence gateway. Can do a simple search on this page - that would be best for looking for guidelines, reports etc. It won’t search the deeper content within journals and databases. Menu on the right – Journals and Databases – main one today.
- As researchers you need to be familiar with this - access point for searching the healthcare databases and therefore the journal content. You will need an NHS Athens account to access the databases – this gives you a username and password to authenticate that you are a member of staff. Get this from the link here, or get in touch with your local library/information service You will find details of journal articles that may be available to you in either print or electronic format – there will be live hyperlinks to fulltext where available.
- 7 8 32 So, on to 3 rd area – reviews/review articles. Reviews of research are Helpful for developing research ideas. They can help you formulate or refine your query in the early stages of your search process, often suggesting when further research is required Estimated - over 2 million articles are published annually in over 25,000 biomedical journals . Reviews will help you get a handle on literature in your field and their references will direct you to relevant research. Reviews can save you time if work of searching out all relevant literature has already done. It’s worth bearing in mind that reviews can come from many sources. Some studies may be in internal reports or so called ‘grey literature’ [def], and be hard to locate as they are not indexed by databases, and so not included in the massive figures I just reported. They can vary in form also, from subjective or more informal discussions of previous research, to robust, exhaustive systematic reviews
- 10 11 10 Single best source for reviews and good quality studies. Called Library as contains several databases including those shown here. Cochrane Library covers mainly systematic reviews of controlled trials by the Cochrane Collaboration. DARE covers systematic reviews produced by other people. Register of controlled trials is compiled from work done on reviews, also from Medline, Embase and hand searching of journals.
- Home page of Cochrane Library. Can be searched at top left – simple search or better still use the advanced search feature. If your first visit – browse content by subject areas.
- 13 14 Now 5th area: MEDLINE and other databases. The healthcare Databases advanced search tool provided by NHS Evidence gives you access to these 8 healthcare databases. Use most appropriate not most familiar . Each database’s coverage is detailed in the about links, and we have included more information in the handouts… Medline is biggest database, the force behind Pubmed. As researchers, it is very important that you also search EMBASE, though its coverage overlaps with Medline’s it does index article from some journals not included by Medline, so you will uncover extra results.
- This illustrates the database’s place amongst the wide range of sources of information that may need to be considered. May be a useful resource – you can use it as a checklist Note citation indexes – ISI’s web of knowledge lets you see what previous research a paper has referenced and also what subsequent research has made reference to it… Again, the handout contains sources from these many different fields. Importance of colleagues… Amongst these, your local library service can help you retrieve info from all these sources
- 16 17 17 you can be a more effective and efficient searcher if you learn how to devise a search strategy and when searching for evidence in databases, it helps to understand the structure of the database .
- 17 18 Let’s look first at developing a strategy. One of the most important steps is being able to turn your problem, clinical query or research idea into a focused question. Good starting point just to have a blank sheet of paper and brainstorm in your own words the terms that you think you need to use when searching. Then think about synonyms, variant spellings or terminology (regional), old and new terminology, brand names or generic names (for drugs), lay and medical terminology Also start to think about Descriptors (subject headings) that apply… more later… Think about the parameters or limits of your search – is there a particular gender or age group etc that your query relates to?
- 18 19 May find it useful to consider the PICO framework – [background]. Well formed clinical question can be built around these 4 points. Taking time to submit your ideas to this framework can pay dividends when it comes to analysing applicability of your search results.
- 21 22 In order to search effectively, you need some idea of how the database is structured. *majority of* Articles added to MEDLINE get indexed with information in all these fields to help searchers retrieve relevant papers. Explain thesaurus terms . Key to retrieval is the bottom field – the thesaurus terms. These index the content of articles using a controlled vocabulary/thesaurus. The thesaurus used in MEDLINE is called MeSH. Different databases use different controlled vocabularies/thesauri. EMBASE uses thesaurus called EMTREE, for example. So for example, in MEDLINE, all articles that contain information on heart attacks, will be indexed with the Medical Subject Heading ‘Myocardial Infarction’, and you can retrieve ALL articles that have been indexed with this heading by searching for it in the database’s thesaurus. Searching using thesaurus terms will ensure that you retrieve articles that use variant spellings etc. that you identified earlier. Details in your handouts, Julie will demonstrate this later…
- Julie will demonstrate some important search techniques. To improve your free text searches (that’s normal searching with text like you’d do on google), you can use… truncation – this is when you enter the root of a word followed by an asterix, to include different permutations of the word. So nurs* would retrieve articles that contain nurse, nurses, nursing etc. and phrase searching – allows you to search for an exact phrase when your free text search term has more than 1 word. and she will show you how to ‘map’ these to appropriate thesaurus terms/subject headings, and how to use Boolean operators – use OR to combine synonymous freetext and thesaurus terms to broaden a search Use AND to combine different concepts and narrow it down. The majority of the 8 healthcare databases contain clearly sign-posted filters that allow you to narrow your search by including, for example only certain types of literature. But we wont use them today, and here’s for why…
- 28 29 To ensure you find any and all relevant papers, it is important to make your search strategy sensitive rather than specific, broad rather than narrow. A search that uses free text searching as well as thesaurus terms will yield a larger number of results. Though some of the results may be irrelevant, it will ensure that you have not excluded any relevant results Using freetext as well thesaurus terms is important because not ALL articles added to the databases will be indexed with subject headings – new articles added to MEDLINE take a while to get indexed with subject headings, so if you want to include the most recent research in your results, you’ll need to use free text searches to retrieve them… What we call ‘high recall’ can be important at the early stage of the research process. Searching the literature is often an iterative process and this may help to develop idea. As your research question becomes more focused, you may need to re-define your literature search.
- 29 30 So, before we have a break. Here is a recap in the form of our top ten tips for searching… ‘ Search one database at a time’ As I mentioned, it is best to search using keywords as well as thesaurus terms, and different databases use different thesauri. Though the HDAS tool I showed you lets you search multiple databases using free text simultaneously, you cannot search the thesaurus terms of multiple databases simultaneously because of the different vocabulary, so go one-at-a-time ‘ Search for one concept at a time’ Though it’s tempting to bang your whole question straight into the database, DON’T! Search for each part of your PICO-modelled search separately and combine the different parts later
- ‘ Always ‘explode’ your term’ Unfortunately not as exciting as it sounds. When you search using thesaurus terms, you can hit a button that says ‘explode’. This will include all related subject headings within your search, increasing the sensitivity ‘ Know how to use AND/OR’ The Boolean operators AND and OR will narrow and broaden your search respectively Use OR to combine synonymous free text or subject heading searches to broaden your search Use AND to combine different concepts and narrow your search ‘ Be cautious about limiting results’ With the 8 databases available you can limit the results you receive by factors such as year published, or the language the article is written in. Be aware that when you do this you may exclude relevant results – perhaps a seminal and important piece of research or a Attend a training course It’s always best to learn by doing, and your local library and information service can help by providing or directing you to training in searching the literature. ANY QUESTIONS? Thank you for listening. NEXT… Brief brake - if you want to get a drink, go the toilet Please reassemble in your colour groups, we’re going to give each group a clinical query and ask you to formulate a search strategy, then we will come back together and Julie will perform a search to demonstrate a good strategy.