Tips & Tricks in Health Sciences Robin Parker & Melissa Helwig

Part 1 & 2 The Search Reference Questions

Reference questions Things to consider: Background vs Foreground Question 6S pyramid

Background Questions Ask for general knowledge about a condition or thing Tend to have two components: A question root (who, what, when, how, why?) and a verb A disorder, test, treatment or other aspect of health care Examples: What causes SARS? What causes migraines? How often should women over the age of 40 have a mammogram?

Background questions Where to find the answers: Textbooks (ex. Harrisons Principles of Internal Medicine) Handbooks (ex. Handbook of Fluid, Electrolyte & Acid-Base Imbalances) Databases (ex. Dynamed)

Foreground Question Ask for specific knowledge to inform clinical decisions or actions Have essential components: PICO OR PIOx OR PICOT Examples of Foreground Questions: In young children with acute otitis media, is short-term antibiotic therapy as effective as long-term antibiotic therapy? Among family members of patients undergoing diagnostic procedures, does standard care, listening to tranquil music or audiotaped comedy routines make a difference in the reduction of reported anxiety? 

So what does this mean for a search?

Question Example A parent stops by your pharmacy counter, they are concerned that their tween is developing acne and have seen commercials for proactiv and other acne treatments but wonder if they should try something else first? You remember there is a recent guideline published on pediatric acne, and ask them for a few minutes so you can look it up and answer their question.

Question Example A patient returns from working overseas in a malaria region and is excited to learn she is pregnant. She is now entering her 2nd trimester and arrives at the local rural hospital with malaria. The health care team wonders about drug therapy options for the patient?

Before we search don’t forget 6S DiCenso A, Baley L, Haynes RB. (2009). Accessing preappraised evidence: fine-tuning the 5S model into a 6S model. ACP Journal Club, 151(3): JC3-2-3. Available online: http://plus.mcmaster.ca/macplusfs/documentation/Haynes_ 6S_Editorial.pdf

Where to search… Point of care tools Citation Databases Dynamed, Clinical Key, etc Citation Databases PubMed, CINAHL, Web of Science, PsycINFO Specialized/hybrid databases Cochrane Library, Canadian Electronic Library Other resources Association, society websites, government sources, statistics

Search One of your med students has identified a potential mentor for their RIM program with similar area of interest in family practice, specifically related to end of life care. Before meeting with this potential mentor, they want to scope the literature, become familiar with the research in the field, and get some ideas for potential research questions for their RIM project. You open PubMed to start a literature search with the student.

Search - focused In order to have a more focused question, the student decides to look at the role of hydration (fluid therapy) in palliative care at end of life.

Population/ setting Intervention Outcomes Terminal care hydration Quality of life End of life Fluid therapy dementia Palliative care rehydration pain Terminally ill Fluid*