1. Ovid MEDLINE for KSOM Y1 Pamela M. Corley, MLS, AHIP
Adrian Follette, MLIS
Evans Whitaker, MD, MLIS
Janis Brown, MLS, AHIP
Norris Medical Library
University of Southern California
Los Angeles, CA
Melissa Just, MLIS, EdD
Director, Graff Library
City of Hope Hospital
1500 East Duarte Road
Duarte, California 91010
Handouts:
Ovid SP flow sheet
Trifold Searches to try

2. Administrative Notes Introduction to personnel Synchronize clickers
“Go”, “4”, “1”, “Go”, “1/A” to test
ASK QUESTIONS!
Personal Librarian program – new this year. Contact your “personal librarian” with information questions.
You can work with any of us, but this program gives you a designated contact.
Door code

3. Personal Librarian Program
Student last name
Personal Librarian
Phone
AhnFecht
Pamela Corley
(323)
Fernandez Lee
Eileen Eandi
(323)
LeongPenman
Adrian Follette
(323)
PerrinYasmeh
Evans Whitaker
(323)

4. Additional Business
This PowerPoint and the other documents that go with the two sessions today will be posted to the Medical Student portal on the Norris Medical library website.
Fill out evaluation form; with your feedback we can continue to improve this presentation.
At the end of the session you will be asked to fill in emergency contact information on MyMedWeb site.

5. Introduction OvidSP – new product introduced February, 2008
Used for Literature Search Project -- Phases 1, 2, and 3
Enhanced features
Basic Search added
Advanced Search similar to “old Ovid”
Personal Account (free) allows user to save searches and annotate articles
This class and Literature Search Project 1, 2, and 3 will focus on MEDLINE searching. Other Ovid databases searched similarly
You have heard or will hear about Norris Medical Library resources in another presentation today.
This presentation concerns searching MEDLINE for information.

6. Level of experience?
4 Questions follow
Vote with your clickers

7. Are you comfortable searching for medical information with Ovid MEDLINE or PubMed?
Very comfortable!
Yes
I can do it, but…
Not really
I am more comfortable at the dentist’s office!

8. Do you know how to use MeSH?
Always use MeSH when searching!
I know what it is but don’t use it
I may have heard the term…
Not familiar with it
Yes, surgeons put it in a hernia repair!

9. Are you familiar with the use of subheadings in MEDLINE searching?
Yes, and I use them!
Yes.
Not really.
No.

10. Do you use the MeSH tree when searching?
Yes
No, but I know what it is
I don’t know what that is

11. Ovid vs. PubMed Ovid PubMed
Commercial product, usually in academic libraries
Multiple databases including MEDLINE
Libraries subscribe to an information “package” -- the search engine plus full text of books and journals
PubMed
U.S. governmental bibliographic database
Collaboration of National Library of Medicine (NLM), National Center for Biotechnology Information (NCBI), and the National Institutes of Health (NIH)
Free to use, not easy to use well
It is the only database of its size and scope in the world
Estimated 40,000 biomedical journals world-wide, ~5,000 indexed in MEDLINE
~18 x 106 citations in PubMed, 16.5 x 106 in MEDLINE
OK this is the dry part, hang in there and you will get to do some hands on work later in the hour…

12. PubMed and MEDLINE
OvidSP -- different interface and search engine, same contents as MEDLINE
MEDLINE is a subset of PubMed.
The 1-2 million article difference is made up of both articles that are being processed and will move into MEDLINE, and articles which will never be included in MEDLINE (e.g., outside the scope of the database).
(18.2/16.8 as of 08/07/08)

13. Pros and Cons of Ovid MEDLINE
Easier than PubMed, Advanced is good PubMed training
Automatic “mapping” of search terms is more effective than equivalent function in PubMed
Basic search can be used at the speed of clinical medicine
Basic and Advanced search modes work well together
Cons
Expensive
After your training, it is unlikely you will have access
PubMed is more current; Ovid gets its material from PM
Other
Ovid has a pay-per-use option

14. What Else is in Ovid? EBM (the three below and others)
Cochrane Database of Systematic Reviews
DARE (Database of Abstracts of Reviews of Effects)
ACP Journal Club
CINAHL -- allied health and nursing database
Ovid Healthstar – “contains citations to the published literature on health services, technology, administration, and research.”
Health and Psychosocial Instruments (HAPI) -- information on measurement tools for healthcare
Ovid (almost 400 books included)

15. Basic Ovid MEDLINE

16. How to search OvidSP Basic
“Natural language” search engine
Can combine and limit searches
Good for:
locating a few good articles
finding “the right words” for Advanced Ovid Search
Basic tab is in green
Simple interface
Keep “include related terms” checked

17. Ovid Basic – things to know and tips
Searches yield 500 or more hits
“Good stuff” is in the first If nothing relevant is found in that group, then reformulate search or move on to Advanced
Based on our experience at NML, use keywords without AND, OR, or punctuation. Seems to retrieve the smallest, most focused set of results

18. Advanced Ovid MEDLINE

19. Advanced Ovid Search Default at Norris Medical Library
Good for a thorough, focused search
Resembles previous versions of Ovid
Steps in a search (see flow sheet in handouts)
Enter search concepts one at a time. Ovid translates the users terms into MeSH terms. User may choose MeSH terms, “explode”, “focus”, and apply sub-headings
Combine concepts (AND or OR)
Limit results, e.g. English, humans, publication types, publication years, etc.)

20. Definitions Broaden/Narrow MeSH Focus Explode
Broaden and Narrow refer to how wide you throw your net when searching
Broaden means more to sift through
Narrow means less to search through

21. What is MeSH? Medical Subject Headings
NLM indexers read papers, apply 5-10 agreed-upon terms (“controlled vocabulary”) to describe the content of the papers
By looking up articles using MeSH terms you will find all the articles about a topic.
Remember…MEDLINE is a human enterprise and therefore contains human errors

22. Heart attack Myocardial infarction Coronary, Coronary occlusion
Q wave, non-Q wave, transmural, subendocardial
All of the articles that use these variations are discovered when you search under the MeSH term “myocardial infarction”
Myocardial infarction is separate from MeSH terms “angina” or “acute coronary syndrome”

23. Focus Intuitive Narrows your search
Details: NLM personnel may label some MeSH terms as main topics of an article. These topics are a “focus” of the article

24. MeSH tree/Explode
Hierarchical structure of MEDLINE is similar to a computer folder and file structure
Pets
Dogs
Boxers
Labradors
Chihuahuas
Cats
Manx
Siamese
Persians
Explode broadens your search
Explode pets means you get the contents within the Pets folder.
Choosing pets but not focusing means you get all the material in the pets folder that is not in the dogs and cats folder.

25. Scope Notes Where ever you see  get more information by clicking
Scope Notes define terms

26. Advanced Ovid Search -Tips
SUBHEADINGS narrow searches.
Do not use subheadings unless they match your needs.
Do not overuse subheadings – not all concepts need them, and few concepts need more than one or two.
LIMITS narrow searches.
Do not overuse limits
Apply them once at the end of devising your search rather than using after each concept.
Learn to use the “MeSH tree” and “scope notes”

27. The Search Process

28. Formulate your question
This class is not about EBM or EBP, however many of the same concepts apply.
First, identify the “information need”.
Define the clinical question, remove extraneous details in order to make it “searchable”.
Select concepts that will become search terms.
Choose the most appropriate information source in which to begin your search – it might be a book!
Enter your search terms.
Review results and reformulate search if necessary.
The hardest part of searching is analyzing what you need to know

30. Hands-On: Search 1
Your 63 y.o. patient brings in selenium 200 µg tablets. He had read that selenium helps to prevent prostate cancer.
He wants your advice before he starts taking selenium.
This is really two questions in one:
Does selenium help prevent prostate cancer?
Is selenium safe to take?
Search each question. What is your advice?

31. How to: Search 1 Main concepts:
Prostate cancer (prevention and control as subheading? Adverse effects as subheading?)
Selenium (therapeutic use as subheading?)
Limits: English, human. Middle aged Male?

32. Hands-On: Search 2
62 y.o. male with history of MCA in 20s in which he suffered a knee injury. Developed severe post-traumatic arthritis.
He is now scheduled to have total knee replacement.
No other significant medical problems.
What kind of preventive therapy would you recommend to minimize his risk of blood clots in the leg veins post-operatively?
(Hint: total knee replacement is called Arthroplasty, replacement, knee)
Concepts:

33. How to: Search 2 Disease concept: Additional concepts:
What is best term for blood clots in the leg?
Subheading: Prevention and control?
Additional concepts:
Knee joint replacement surgery (other possible terms “orthopedic procedures” AND “knee”).
Consider add “adverse effects” as subheading.
“Post-operative complications”
Limits: English, humans. Middle age? Male?

34. Hands-On: Search 3
45 y.o. woman with depression, she has not responded to several SSRIs. She continues with counseling, but is not making any substantial improvement.
You want to place her on other antidepressant types…either Wellbutrin, Effexor, or Cymbalta.
What can you find in the literature to predict your chances of pharmaceutical success?
Treatment resistant depression
Depressive disorder vs. depression
Drug names are not in MeSH
Treatment outcome
Can search for “treatment resistant depression”

35. How to: Search 3 Disease concept: Treatment resistant depression
Search as phrase or combine “depressive disorder, major” (with “drug therapy” subheading) AND “drug resistance”
Additional concepts: treatment outcomes
Limits: English, humans. Middle age? Female?

36. Hands-On: Search 4
On your third year surgery rotation you have a patient in the hospital with Kaposi’s sarcoma of the rectum.
Your resident has not heard of this before. Do you have a reportable case?
GoogleScholar did not reveal anything.

37. How to: Search 4 How do you do this search?
A simple way to approach this is to enter “kaposis rectum” in basic search in Ovid. A few good articles appear in the first ten.

38. How to: Search 4
“Complete reference” shows the MeSH terms for these good articles. You choose “neoplasm, rectal” and “sarcoma, Kaposi” this combination used on the 1950-current database reveals several articles, most of which appear pertinent.
You find to your dismay that your case is not unique enough to be reportable.

39. Final Exam (Time allowing)
DIAGNOSIS
1. MRI for breast cancer screening, should this be our method of choice?
2. PSA variations – PSA velocity, PSA density, free PSA ratios – do these add value to prostate cancer screening?
TREATMENT
3. Low back pain patients -- how effective (to decrease pain) are chiropractic and acupuncture therapies? Are there studies that compare these modalities?
4. Operative vs. non-operative treatment for acute Achilles tendon ruptures – which is better?
exp Magnetic Resonance Imaging
exp Breast Neoplasms/pc, di [Prevention & Control, Diagnosis]
exp Mass Screening
1 and 2 and 3
Can use methods for first and third
2. exp Prostate-Specific Antigen
exp Prostatic Neoplasms/pc, di [Prevention & Control, Diagnosis]
exp "Sensitivity and Specificity“
density.mp.
velocity.mp.
free PSA.mp.704
5 or 6
4 and 8
3. Low back pain/therapy rehabilitation
Chiropractic manipulation
Acupuncture therapy
AND all 3
only 3 articles one is relevant.
Can try 1 and 2, or 1 and 3 with larger results
4. exp Achilles Tendon/in
exp Rupture
1 and 2
exp Casts, Surgical
Tendon Injuries
4 or 5
exp Treatment Outcome
3 and 6 and 7

40. Assignment Look at Literature Search Project handout.
You will complete one of seven questions.
Key points:
Use Advanced Ovid.
Use MeSH, focus, explode, subheadings, and limits to get full points on assignment
Pick 5 relevant articles. Do not include comments, letters to the editor, foreign language articles
Include abstracts (default setting)
Display your work and print it, save a copy for backup

41. Summary Ovid provides an easy-to-learn MEDLINE search engine.
Effective information finding and analysis are important skills in modern medicine.
Today’s session presented Ovid MEDLINE, and provided search practice.
Mastery of any skill requires practice and thought; searching is no exception

42. Evaluations
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43. MyMedWeb http://medweb.usc.edu/
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