1.Session Three ExploringPubMed, Part 2

2. What is MeSH?MeSH (Medical SubjectHeadings) is the NLMscontrolled vocabulary thesaurusused for indexing articlescitations in PubMed.Subject terms can be browsedfromhttp://www.nlm.nih.gov/mesh/meshhome.html 3. MeSH SearchingYou can begin asearch of the MeSHdatabase byselecting the linkfrom PubMedswebpage. 4. Familiar InterfaceYou will see afamiliar searchscreen similar tomost NLMdatabases.Enter your term in tothe search box andpress the Searchbutton. 5. Entering Search TermsWhen entering a terminto the search box aselection of suggestedterms will appear in thedropdown menu.Select the one you wishto use or press theSearch button to startyour search. 6. MeSH Search ResultsThe search resultsdisplayed subjectheadings related toheadache.Searched terms aredisplayed in theSearch details box. 7. MeSH Term DisplayOnce you haveselected a term fromthe results list adefinition (or scopenote) of the subjectdisplays. This providesa brief discussion onuse of the world withinthe MeSH database.Below the note areSubheadings relatedto the term. 8. Indexing TreeBottom of the page revealsan index tree revealing thehierarchical structure ofthe subject heading withinMeSH.MeSH terms are arrangedhierarchically by subjectcategories with morespecific (narrower) termsarranged beneath broaderterms. PubMedautomatically explodessearches to include allSelect an item narrower terms.to see the termsdefinition andindexing tree. 9. MeSH Term Display - One Level UpBy selecting the subjectheading higher on thetree, you haveexpanded the possiblesearch parameters. 10. Select a subheading to thenselect Add to searchbuilder.Select Search PubMed tosee the results.Add Terms to Search Builder 11. First Results SetResults from MeSH search. 12. Add Terms from HistoryCombine MeSH searchesfrom History. 13. Second Results SetCombined terms reduceresults, refines the search. 14. Clinical TrialsWork that is the report of a pre-planned clinical study of the safety, efficacy,or optimum dosage schedule of one or more diagnostic, therapeutic, orprophylactic drugs, devices, or techniques in humans selected according topredetermined criteria of eligibility and observed for predefined evidence offavorable and unfavorable effects. While most clinical trials concern humans,this publication type may be used for clinical veterinary articles meeting therequisites for humans. Specific headings for specific types and phases ofclinical trials are also available.(MeSH Database) 15. Use the FiltersWe are searching forArticle information aboutdistance education andnursing. 16. Different PhasesPhase I (Publication Type)Work that is the report of a pre-planned, usually controlled, clinical study of the safety and efficacy ofdiagnostic, therapeutic, or prophylactic drugs, devices, or techniques based on a small number of healthypersons and conducted over the period of about a year in either the United States or a foreign country.(MeSH Database)Phase II (Publication Type)These studies are performed on several hundred volunteers, including a limited number of patients with thetarget disease or disorder, and last about two years.(MeSH Database)Phase III (Publication Type)These studies are performed on groups of patients large enough to identify clinically significant responses andusually last about three years.(MeSH Database)Phase IV (Publication Type)Work that is a report of a planned post-marketing study of diagnostic, therapeutic, or prophylacticdrugs, devices, or techniques that have been approved for general sale after clinical trials, phases I,II, and III. These studies, conducted in the United States or a foreign country, often garner additionaldata about the safety and efficacy of a product.(MeSH Database) 17. The Other DatabaseClinicalTrials.gov is a Web-basedresource that providespatients, their family members,health care professionals,researchers, and the publicwith easy access to informationon publicly and privatelysupported clinical studies on awide range of diseases andconditions. 18. Evidence Based PracticeA way of providing health care that is guided by a thoughtful integration ofthe best available scientific knowledge with clinical expertise. This approachallows the practitioner to critically assess research data, clinical guidelines,and other information resources in order to correctly identify the clinicalproblem, apply the most high-quality intervention, and re-evaluate theoutcome for future improvement.(MeSH Database) 19. Results for EBPSearching for articles usingMESH headings Evidence-Based Nursing andMyocardial Infarction 20. PubMed HealthSearch for things that work! 21. What is PubMed Health? PubMed Health provides information for consumers and clinicians on prevention andtreatment of diseases and conditions. PubMed Health specializes in reviews of clinical effectiveness research, with easy-to-readsummaries for consumers as well as full technical reports. Clinical effectivenessresearch finds answers to the question What works? in medical and health care. PubMed Health is based on systematic reviews of clinical trials. These clinicaleffectiveness reviews can show what treatments and prevention methods have beenproven to workand what remains unknown. PubMed Health provides summaries and full texts of selected systematic reviews inone place. The reviews were generally published or updated from 2003. There is alsoinformation for consumers and clinicians based on those reviews. 22. What are the Resources?A search on PubMed Health runs simultaneously in PubMed. A filter is used to identify all theindexed scientific articles at the NLM that might be systematic reviews. This search includesarticles from before 2003.Information partners selected by PubMed Health to contribute their clinical effectivenessinformation are: Agency for Health Care Research and Quality (US) (AHRQ) Centre for Reviews and Dissemination (CRD) The Cochrane Collaboration (CC) German Institute for Quality and Efficiency in Health Care (IQWiG) National Cancer Institute (NCI) National Institute for Health and Care Excellence guidelines program (NICE) National Institute for Health Research (NIHR) Health Technology Assessment Programme (NIHRHTA) Oregon Health and Science University's Drug Effectiveness Review Project (DERP) Department of Veterans Affairs' Evidence-based Synthesis Program from the Veterans HealthAdministration R&D (VA ESP) 23. What is a Systematic Review?Definition: A summary of the clinical literature. A systematic review is a critical assessment andevaluation of all research studies that address a particular clinical issue. The researchers use anorganized method of locating, assembling, and evaluating a body of literature on a particulartopic using a set of specific criteria. A systematic review typically includes a description of thefindings of the collection of research studies. The systematic review may also include aquantitative pooling of data, called a meta-analysis.Example: Scientists collected all the published studies that compared types of treatment forprostate cancer that had not spread beyond the prostate gland. They compiled the results ofthese studies in a comparative effectiveness review, which is a type of systematic review.(text from AHRQ) 24. Results of a Search 25. Quality of the ResourcesResources from whichthe information isdrawn, includesSystematic Reviewsfrom PubMed. 26. More to Learn!Helpful resources provideinsight into the materialsprovided through PubMedHealth. 27. PubMed CentralThere are millions of openaccess articles in the PMCdatabase. 28. Browse TitlesEnter journal title and presssearch. If searching for allissues of a journal,including journal titlechanges, select Showpredecessor titles. 29. Search for a Journal TitleHere the search wasconducted for the Journalof the Medical LibraryAssociation.Select the title provides alisting of all currentlyavailable volumes andissues. 30. Full text ArticlesSelect a volume and openan article. 31. NCBI BookshelfA collection of e-books in avariety formats.Acrobat (.pdf)HTMLSearchable HTML 32. Browse the TitlesBrowse through the title.Select the one to view thetext of the book. 33. Searchable OnlySome books are onlysearchable.Search terms arehighlighted in chapters andpages of the book. 34. Search Text within a BookText within books issearchable.Search terms arehighlighted in chapters andpages of the book. 35. Whats next?In the next session we will discuss: Daily Med Drug Information Portal MedlinePlus Images from the History of Medicine International Resources