Presentation on theme: "Efficient Searching of the Literature & Critical Appraisal Rick Wallace March 9, 2007."— Presentation transcript:
Efficient Searching of the Literature & Critical Appraisal Rick Wallace March 9, 2007
Public Service Professional Librarians Nakia Carter, MLS Maylene Qiu, MLS Rick Wallace, MLS
My Philosophy of the Literature- EBM: 6 Steps Patient/Problem Question Search Critical Appraisal Application Evaluation
Before You Search You must have a patient/problem- Step #1 You must have a searchable question- Step #2
Clinical Scenario- Patient & Question In pediatric patients with acute asthma exacerbation, does the inclusion of inhaled steroid improve outcomes such as hospitalization rates, length of stay, etc.
PICO the Question P OPULATION/ PATIENT I NTERVENTION C OMPARATIVE INTERVENTION O UTCOME
ANSWERABLE Well-Built, ANSWERABLE Clinical Question In pediatric patients with acute asthma exacerbation (P), do inhaled steroids (I/C) improve hospitalization rates (LOS, etc.), and general morbidities (relief of symptoms, reduction of side effects, etc.) (O) ?
Secondary Database- Clinical Evidence Asthma Asthma and other wheezing disorders in children Corticosteroids (high dose inhaled)
Secondary Database- Cochrane Database of Systematic Reviews asthma AND (child OR adolescent OR infant) AND (steroid* OR corticosteroid*) AND (inhale* OR nebulize*) AND (exacerbat*) – searched as tw #23. Corticosteroids for hospitalised children with acute asthma Note: we have already searched CDSR by searching other databases Also DARE and CCTR
Secondary Database- National Guideline Clearinghouse asthma AND inhale* AND Exacerbate*
Secondary Database- ACP Journal Club
Secondary Database- FirstConsult
Primary Databases “raw”- not pre-validated Not transparent Not summarized- lots of work- work equation All levels of evidence- well done RCT with 10,000 pts. versus individual case study
Primary Databases- PubMed PICO- MESH
MeSH- Medical Subject Headings What? Thesarus used to index citations in MEDLINE MEDLINE vs PubMed Updated to reflect changes in medicine Why? Higher retrieval of relevant articles Synonyms Search stop words: Hepatitis A
MeSH Major/ non-major Explosions Sub-headings Boolean Tree structure Pass out thesari
Pearl Searching Do a text word search Look at the citation display Do subject search with MeSH
Example Question: Is the development of breast cancer affected by the intake of dietary fat? Text word search- breast cancer fat Relevant article- Browse MeSH- review scope note, subheadings, etc.
Narrowing retrieval Combine sets Use Boolean AND Limits- human, age, gender, language, publication type, date range
Example In patients with asthma do steroids affect the outcome? Search- asthma/ drug therapy Major Mesh, English, human, last 5 years
Searching for Evidence Use a publication type Use a hedge Use clinical queries filter
Other My NCBI Related Items Displays Save SFX LoansomeDoc Details- automatic mapping
Exercises Take a clinical scenario PICO it Construct a well-built clinical question List type of clinical question List best type of literature to answer it Do a search – save search strategy and results- try at least one secondary database and PubMed