Presentation on theme: "1 WORK ON COMPUTERS Summer Semester 2009 5. From MEDLINE to the Cochrane Library - the reliable source of evidence for healthcare. 6. Critical appraisal."— Presentation transcript:
1 WORK ON COMPUTERS Summer Semester 2009 5. From MEDLINE to the Cochrane Library - the reliable source of evidence for healthcare. 6. Critical appraisal of medical literature. 7. How to read medical journal articles. Worked examples. 8. Bibliometrics. Science Citation Index, journal impact factor.
2 Topic 5 FROM MEDLINE TO COCHRANE LIBRARY Jarmila Potomková Medical Librarian Jan Strojil Department of Pharmacology Palacky University Faculty of Medicine Olomouc, Czech Republic Updated February 2009 firstname.lastname@example.org
3 MEDLINE via PUBMED National Library of Medicine (USA) Premier bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the health care system, the preclinical sciences, and some other areas of the life sciences. Bibliographic citations and author abstracts over 18 million records dating from the 1950s Free online access at http:// www.pubmed.com PubMed provides links to some full-text Open archives Providers (subscription, licence)
4 Searching for Best Evidence „Well-built Questions“ Are compression stockings effective in preventing travel-related deep vein thrombosis?
5 Foreground Question: PICO Format P/Patient, population, problem air travellers; deep vein thrombosis I/Intervention wearing compression stockings C/Comparison travelling without stockings O/Outcome prevention of disease
6 Background Question What is Deep Vein Thrombosis? Deep venous thrombosis (DVT) is the presence of coagulated blood = a thrombus, in one of the deep venous conduits that return blood to the heart. The clinical „puzzle“ is that symptoms (pain and swelling) are often nonspecific or absent. However, if untreated, the thrombus may become fragmented or dislodged and migrate to obstruct the arterial supply to the lung, causing a potentially life-threatening pulmonary embolus (PE). Merck Manual of Diagnosis and Therapy. Available from:http://www.merckmanual.com
8 PubMed Search Consolidation Search Strategy Selection of search terms Keywords Phrases Synonyms Combination of search terms Boolean logic Application of limits Occurrence of search terms Title, Title/Abstract, All fields Types of articles Age groups Etc.
9 Boolean logic AND: Combines terms to limit your search as both concepts must be present in all retrieved articles Example: compression stockings AND deep vein thrombosis AND flight OR: Widens your search as either term can be present in all retrieved articles Example: vein thrombosis OR venous thrombosis OR venous thromboembolism NOT: Limits your search by excluding a concept as one term must be present and the second term must not be present
10 Truncation * PubMed finds all terms that begin with a given text string Example thrombo* PubMed retrieves: thrombosis, thromboses, thromboembolism,,,,,,,,,
11 Search Strategy Suggestions Step 1 vein thrombo* OR venous thrombo* Limits: Title/Abstract Step 2 compression stocking* OR elastic stocking* OR flight sock* All fields Step 3 airline OR air travel* OR flight* OR aircraft All fields Step 4 Combine searches #1 AND #2 AND #3
14 History Registers & holds all your search strategies and search results search statements numbers can be combined or used again Displays each search query numbers (#1, #2…….), number of records (Results) Automatically lost after 8 hrs of inactivity.
15 PubMed Search Results Types of articles All : 33 Reviews: 14 Traditional („narrative“) Systematic + Meta-analysis (pre- determined criteria of study inclusion) Cochrane (systematic + regularly updated with new data)
16 Example of Systematic Review (1) Philbrick JT, Shumate R, Siadaty MS, Becker DM. Air travel and venous thromboembolism: a systematic review. J Gen Intern Med. 2007 Jan;22(1):107- 14. Review.
18 Example of Systematic Review (2) Sajid MS, Tai NR, Goli G, Morris RW, Baker DM, Hamilton G. Knee versus thigh length graduated compression stockings for prevention of deep venous thrombosis: a systematic review. Eur J Vasc Endovasc Surg. 2006 Dec;32(6):730-6. Epub 2006 Aug 23. Review.
19 Example of Systematic Review (2) Structured Abstract
22 Cochrane Review Clarke M, Hopewell S, Juszczak E, Eisinga A, Kjeldstrøm M. Compression stockings for preventing deep vein thrombosis in airline passengers. Cochrane Database Syst Rev. 2006 Apr 19;(2):CD004002. Review. Update? http://www.cochrane.org
23 1993 – Cochrane Collaboration 50 Collaborative Groups Worldwide experts interested in developing and maintaining systematic reviews relevant to a particular health area http://www.cochrane.org Cochrane Library/Advanced Access Cochrane Library/Advanced Online access to structured abstracts of Systematic Reviews Full versions of systematic reviews for fee Palacky U licence:http:// www.infozdroje.cz/EBM Reviews
33 COCHRANE COLLABORATION International non-profit and independent organisation, dedicated to making up-to-date, accurate information about the effects of healthcare readily available worldwide
34 THE NAME & FACE BEHIND COCHRANE COLLABORATION Professor Archibald Cochrane (1909-1988) British epidemiologist Best known for his book Effectiveness and Efficiency:Random Reflections on Health Services (1972) Resources for health care will always be limited They should be used to provide effective forms of care Importance of using evidence from randomized controlled trials.
36 COCHRANE COLLABORATION 1993 The major product published quarterly: The Cochrane Library Most frequently used DBs Cochrane Database of Systematic Reviews (5,676 items) Central Register of Controlled Trials (564,387 items) Health Technology Assessment Database (7,591 items) NHS Economic Evaluation Database (24,432 items) And others.
37 The Cochrane Database of Systematic Reviews (Cochrane Reviews; EBM Reviews)) Growing list of regularly updated summaries of the best available evidence prepared by members of the Cochrane Collaboration Complete reviews (topic reviews) Full-text articles reviewing the effects of specific health care interventions; Highly-structured, systematic; Evidence included/excluded on the basis ofpre-determined quality criteria. Protocols Information about reviews in preparation, including the background, rationale and methods.