1 Searching the Literature for Evidence-Based Medicine Medical Research Training 10-12/3/2014
2 Learning Objectives Identify how the search terms you enter into a search Formulate a search in the database and run the search in recourses Find the highest levels of evidence Find the evidence-based in resources
3 How to Literature Search 1. Evidence based practice THE LEARNING CYCLE Identify clinical questions (ask) -> Answer these questions -> Make clinical decisions -> Evaluate the outcome of clinical decisions 2. Reflect on clinical knowledge and learning needs 3. Identify the question : PICO 4. Find evidence : Journals 5. Searching journals using the internet 6. Obtaining the full-text article 7. Critical appraisal: judging the quality of research articles
10 Subject headings and keywords Subject headings describe the content of each item in a database. Use these headings to find relevant items on the same topic. Searching by subject headings (a.k.a. descriptors) is the most precise way to search article databases. Keyword searching is how you typically search web search engines. Think of important words or phrases and type them in to get results.
11 Boolean operators Boolean operators form the basis of mathematical sets and database logic. They connect your search words together to either narrow or broaden your set of results. The three basic boolean operators are: AND, OR, and NOT. Example: second creation (title) AND wilmut and campbell (author) AND 2000 (year)
12 Truncations Truncation, also called stemming, is a technique that broadens your search to include various word endings and spellings. Enter the root of a word and put the truncation symbol at the end. The database will return results that include any ending of that root word. Examples: child* = child, childs, children, childrens, childhood genetic* = genetic, genetics, genetically Truncation symbols may vary by database; common symbols include: *,!,?, or #
13 Wildcards Similar to truncation, wildcards substitute a symbol for one letter of a word. This is useful if a word is spelled in different ways, but still has the same meaning. Examples: wom!n = woman, women colo?r = color, colour Company Logo
14 General Search Strategy Search Strategy by Cochrane Review
15 1. Define text words Developing a Search Strategy 2. Determine synonyms for the text words 3. Control for different spellings or using appropriate truncations 4. Consider brand names 5. Perform test searches - I 6. Identify keywords ( controlled vocabulary provided by databases) 7. Decide on whether to perform an exploded or a focused search 8. Spell check ALL search terms 9. Combine logically all search terms 10. Perform test searches II 11. Customize the syntax of your search strategy to the specific databases
16 1. Define text words Developing a Search Strategy Focus on the disease and the two interventions/procedures you want to compare; do not search for outcomes, age groups of patients etc. Make a list of words representing the study population (disease) and the intervention(s)
17 1. Define text words Developing a Search Strategy Create a search statement using keywords Search Statement: Exp. Identify potential stem cell methodology that could be used for changing valine to glutamic acid in hemoglobin of people with sickle cell disease Do not type in stem cell methodology for changing valine to glutamic acid in hemoglobin Concept 1 Concept 2 Concept 3 sickle cell anemia hemoglobin stem cell methodology
18 Developing a Search Strategy 1. Define text words : Identify Related Keywords Concept 1 Concept 2 Concept 3 sickle cell anemia hemoglobin stem cell methodology Sickle cell disease Beta chain Stem cells Hemoglobin S disease Beta-globin gene Gene silencing globulinopathies codon nucleotide 6 Gene splicing (middle) AT Gene transfer techniques Valine Targeted gene repair Glutamic acid Genetic engineering RNA antisense
19 Developing a Search Strategy 2. Determine synonyms for the text words Think of, or search for, synonyms of your search terms Use MeSH database for identification of synonyms: check the entry terms in the description of a specific MeSH-term Medical Subject Headings (MeSH) is a controlled vocabulary thesaurus of terms created by the National Library of Medicine and used for PubMed (MEDLINE) article records. The MeSH Database is freely available for searching in PubMed (MEDLINE). See The Basics of Medical Subject Headings (MeSH) for more information.
20 Developing a Search Strategy 2. Determine synonyms for the text words
21 Developing a Search Strategy 3. Control for different spellings or using appropriate truncations For the same disease In English In different languages Think of meaningful truncations for e.g. singular/plural; noun/adjective form of search term Use wildcards to replace differences (specific syntax for different databases!)
22 Developing a Search Strategy 3. Control for different spellings or using appropriate truncations
23 Developing a Search Strategy 4. Consider brand names If you search for specific drugs, it is advisable to include very common brand names. Think of the possibility of combination drugs (and their brand names) and whether you would like to include them. Be careful about using abbreviations! Check the results of a test search if there are too many irrelevant hits.
24 Developing a Search Strategy 5. Perform test searches - I Type in text words and / or index terms Monitor the number of hits after truncations, substitution of wildcards etc. Use correct syntax for each database!
25 Developing a Search Strategy 6. Identify keywords ( controlled vocabulary provided by databases) Map (your list of) text words to the database of controlled vocabulary (e.g. MeSH, EMTREE) Study the neighboring hierarchic levels of your keyword for their usefulness as search terms
26 Developing a Search Strategy 7. Decide on whether to perform an exploded or a focused search Are there other terms in the stems or branches that should be included (e.g. as text words?) Instead of searching all parallel branches of one category, add exp to the upper term (closer to the stem) Are there terms in the lower branches that will definitely increase the noise in your search? Are there terms in the tree that may be used interchangeably by indexers?
27 Developing a Search Strategy 7. Decide on whether to perform an exploded or a focused search
28 Developing a Search Strategy 8. Spell check ALL search terms 9. Combine logically all search terms Structure your search terms: group both text words and keywords for the disease, the intervention(s) and the control, respectively. Combine all relevant text words and keywords; disease of interest, intervention(s), control(s) by OR Combine disease AND intervention (AND control ) Add Cochrane RCT filter: disease AND intervention (AND control ) AND RCT
29 Developing a Search Strategy 10. Perform test searches II Type in your logically combined search terms first individually Monitor the number of hits after logical combination of the search terms
30 Developing a Search Strategy 11. Customize the syntax of your search strategy to the specific databases A Medline-search will not find all relevant references in EMBASE and vice versa. A search developed for MEDLINE via OVID does not work in PubMed without rephrasing and reformatting
31 Set Theory of Searching
32 Freely available
33 Freely available TRIP (Turning Evidence into Practice) NHS Evidence Bandolier Intute Best Practice Clinical Evidence HINARI (Access to Research Initiative)
34 Exercise to Searching Identify the question : PICO
39 Checklist for Developing a Search Strategy List 1. Define text words 2. Determine synonyms for the text words 3. Control for different spellings or using appropriate truncations 4. Consider brand names 5. Perform test searches I 6. Identify keywords ( controlled vocabulary provided by databases) 7. Decide on whether to perform an exploded or a focused search 8. Spell check ALL search terms 9. Combine logically all search terms 10. Perform test searches II 11. Customize the syntax of your search strategy to the specific databases or
40 Tripdatabase Company Logo
41 Tripdatabase Step 1. Use PICO to formulate the search strategy; start with the Patient problem(s) and Intervention Company Logo
42 Tripdatabase Step 1. Use PICO to formulate the search strategy; start with the Patient problem(s) and Intervention Company Logo
43 Step 2. Review the results Tripdatabase Company Logo
44 Step 3. Choose the results Tripdatabase Company Logo
45 Tripdatabase Step 4. Make history your searching Company Logo
47 PubMed Step 1. Use PICO to formulate the search strategy; start with the Patient problem(s) and Intervention Company Logo
48 PubMed Step 2. Look at Search Details to verify Medical Subject Heading (MeSH) terms Company Logo
49 PubMed Step 3. Limit to appropriate study design Company Logo
50 PubMed Step 3. Limit to appropriate study design Company Logo
51 PubMed Step 4. Review the results Company Logo
52 PubMed Step 4. Review the results Company Logo
53 Hierarchy of levels of evidence
54 Abstract: How adjust to Purchase article Introduction: explains the background, why it is needed and what it aims to find out Methods: details of how the work was done, data was analyzed Results: shows all the findings, graphs and tables, but with no commentary on them Discussion: interprets the results Conclusion: describes whether, in the author s opinion, the aims of the study have or have not been met
ป ญหาและแนวทางการพ ฒนางานเวชระเบ ยนและว ชาช พเวชระเบ ยนใน ประเทศไทย (Problem and Guideline for Development of Medical Record Department and Medical Record Profession in Thailand) แสงเท ยน อย เถา. (๒๕๕๕).
รายงานการว จ ยฉบ บสมบ รณ การศ กษาค ณภาพการบร การของสถานพยาบาลในระบบประก นส งคม The Study of Service Quality of Hospitals in Social Security System โดย ดร.ปภ ศร ช ยว ฒน และคณะ มหาว ทยาล ยเทคโนโลย พระจอมเกล
Development in Health Care System of Ischemic Stroke and Stroke Services Network in Thailand by Prasat Neurological Institute (PNI) Prasat Neurological Institute Medical services department MOPH 22/01/2015
การพ ฒนากลอนประต อ เล กทรอน กส โดยใช เส ยงและระบบรายงานผ ใช ผ านอ นเทอร เน ต THE DEVELOPMENT OF ELECTRONIC BOLT CONTROL WITH KNOCK SOUND AND CHECKING ON INTERNET SYSTEM นฤเทพ ส วรรณธาดา Naruetep Suwantada
แนวทางการปร บปร งและบร หารจ ดการพ นท ว างก งสาธารณะหน าอาคาร สำาน กงานในย านศ นย กลางธ รก จ Improvement and Management Guidelines of Semi Public Space for Office Building: Central Business Districts of