COLLEEN KENEFICK, MLS, AHIP HEALTH SCIENCES LIBRARY STONY BROOK UNIVERSITY How to Conduct Literature...

COLLEEN KENEFICK, MLS, AHIPHEALTH SCIENCES LIBRARYSTONY BROOK UNIVERSITY

How to Conduct Literature Searches

It All Starts Here

Health Sciences Library Website Provides access to all electronic and print

resources available from the library

Medicine Subject Guide Provides electronic and print resources for all

subject areas of medicine

My students are dismayed when I say to them, “Half of what you are taught as medical students will in 10 years have been shown to be wrong. And the trouble is, none of your teachers knows which half.”

Dr. Sydney Burwell Dean of the Harvard Medical School, 1956

Annual Addition of Articles to MEDLINE (PubMed)

Types of Clinical Questions

Background questions ask for general knowledge about a topic, and generally involves who, what, when, why, where, or how

To answer, use electronic textbooks or other print reference sources: AccessMedicine textbooks such as Harrison’s Online First Consult MDConsult textbooks such as Rosen’s Emergency

Medicine UpToDate

Types of Clinical Questions

Foreground questions apply to a specific patient or problem

To answer, search for peer-reviewed journal articles and other EBM literature The Cochrane Library Ovid MEDLINE or PubMed TRIP Database Web of Science

Four Step Program for Finding the Evidence

Focus your question by using the PICO model

Select appropriate information sources to answer your question

Choose databases or other sources with best coverage of the topic

Devise search strategy using subject terms, thesaurus, or index entries

What is a Well-Built Question?

A well-built question is:

Directly relevant to the problem

Focused and clearly formulated

Sufficiently specific to ensure a clear answer

Articulated to facilitate searching for an answer

The PICO Model

A well framed question addresses a relationship between these four components:

P = the patient or problem being addressed I = the intervention or exposure under

considerationC = a comparison intervention or exposureO = clinical outcome(s) of interest

Four Basic Categories of Clinical Questions

Therapy

Diagnosis

Prognosis

Harm/Exposure or Prevention

Cochrane Library

TRIP Database PubMed Clinical Queries+

PubMed MeSH

Therapy 1 2 3 4

Diagnosis 2 1*

Prognosis 1**

Harm/Exposure or Prevention

1 2***

1=the most high yield place to start+Use Systematic Reviews (click on Clinical Queries under PubMed Tools) to locate systematic reviews, meta-analyses, reviews of clinical trials, evidence-based medicine, consensus development conferences, and guidelines*Use diagnosis category**Use prognosis category***Use MeSH headings and subheadings

Translating a Question into a Database Search

You will need to modify your answerable question (PICO) to formulate a database strategy

Your PICO question may be either too specific or too broad to easily search on MEDLINE (PubMed) or one of the other available medicine databases

Finding a Therapy Answer

Systematic review or randomized controlled study is best feasible study design

First place to look for answer: Cochrane Library TRIP Database PubMed Clinical Queries PubMed MeSH

Finding a Diagnosis Answer

Cross-sectional study is best feasible study design

First place to look for answer:

PubMed Clinical Queries (use diagnosis category and Broad Scope)

TRIP Database

Finding a Prognosis Answer

Cohort study is best feasible study design


PubMed Clinical Queries (use prognosis category and Broad Scope)

These questions share three elements: a qualitative aspect, a quantitative aspect, and a temporal aspect

Finding a Harm/Exposure or Prevention Answer

Cohort study is best feasible study design


Cochrane Database of Systematic Reviews

Next best place is PubMed MeSH

MASR

RCTCohort Studies

Case Control StudiesCase Series / Case Reports

Expert OpinionAnimal Research / In Vitro

StudiesMA=Meta-Analysis, SR=Systematic Review,

RCT=Randomized Controlled Trial

The Evidence Pyramid

Synonyms and Controlled Vocabulary

The main point to remember is that if a database offers a controlled vocabulary, use it in addition to textwords or keywords.

In PubMed (MEDLINE) the controlled vocabulary is called MeSH (Medical Subject Headings)

Using PubMed Clinical Queries

Use the built-in filters for: etiology diagnosis therapy prognosis clinical prediction guides

You must indicate your preference for either:narrow, specific search – will miss a few relevant articlesbroad, sensitive search – will include irrelevant articles

PubMed Clinical Queries

The Top Seven Databases

Cochrane LibraryFaculty of 1000Health & Psychosocial Instruments (HaPI)Journal Citation Reports (JCR)PubMedTRIP DatabaseWeb of Science

Five Steps to Conducting a Systematic Review

Step 1. Frame the questions for your research project Should be in the form of clear, unambiguous and

structured questions before starting Modify your question only if alternative ways of

defining the populations, interventions, outcomes or study designs become apparent

Journal of the Royal Society of Medicine 2003 Mar;96(3):118-21.Five steps to conducting a systematic review.Khan KS, Kunz R, Kleijnen J, Antes G


Step 2. Identifying relevant work Multiple databases should be searched using

study selection criteria already decided upon by the research question

Reasons for inclusion or exclusion is documented Keep your search strategy (in addition to

citations) from each database

Journal of the Royal Society of Medicine 2003 Mar;96(3):118-21. Five steps to conducting a systematic review. Khan KS, Kunz R, Kleijnen J, Antes G


Step 3. Assessing the quality of studies Quality is relevant to each step Use general critical appraisal guides or design-

based quality checklists These will make it easier to decide what to

include or exclude



Step 4. Summarizing the evidence Tabulate study characteristics If you are not doing a meta-analysis, then analyze

the sub-groups separately



Step 5. Interpreting the findings

Publication or other bias is explored Can the overall summary be trusted? Any recommendations should be graded by

strengths and weaknesses of the evidence


Save Citations in Electronic Form

In almost every database, there are four options for saving references once you have found relevant material. Print Email Save to file Export to bibliographic management software such as

EndNote or Zotero (http://www.zotero.org)

Click Here for My NCBI Sign In

Using EndNote X5

Download EndNote Software Here

Any Questions?

COLLEEN KENEFICK, MLS, AHIP HEALTH SCIENCES LIBRARY STONY BROOK UNIVERSITY How to Conduct Literature...

Documents

Transcript of COLLEEN KENEFICK, MLS, AHIP HEALTH SCIENCES LIBRARY STONY BROOK UNIVERSITY How to Conduct Literature...