Poor Quality Anyone can publish anything on the Internet Anyone can publish anything on the Internet We need to be careful not to degrade our work by using poor quality information. We need to be careful not to degrade our work by using poor quality information. Quality ?? How to evaluate Internet resources ?? How to evaluate Internet resources ??

Who has access to the following databases ? General search engine: Pub-med (Medline) Pub-med (Medline) Clinical Evidence Clinical Evidence Cochrane Cochrane Best Evidence Best Evidence Best Treatment Best Treatment Trip database Trip database Bandolier Bandolier EBM Guidelines: NICE SIGN PRODIGY Others

Aim & Objectives Aim: To create an awareness of useful sites on webs To create an awareness of useful sites on webs At the end of the session, the participants would be able to: At the end of the session, the participants would be able to:

Objectives Understand useful general search techniques Understand useful general search techniques Use Med-line data-base effectively Use Med-line data-base effectively Differentiate between primary and secondary sources of evidence Differentiate between primary and secondary sources of evidence Aware about use of secondary sources of evidence Aware about use of secondary sources of evidence Utilize the KSU databases Utilize the KSU databases

Contents Introduction Introduction Primary & Secondary sources Primary & Secondary sources Med-line Data-base Med-line Data-base Other data-bases Other data-bases KSU Databases KSU Databases Conclusion Conclusion

General Terms General Terms

URL ’ s Uniform Resource Locator Uniform Resource Locator The web “ address ” that connects you with a website The web “ address ” that connects you with a website Goes in the address bar. Goes in the address bar. Gives you information about the website. Gives you information about the website.

Parts of a URL transfer protocol : transfer protocol : the language computers use to “ talk ” to one another the language computers use to “ talk ” to one another www — world wide web: www — world wide web: the body of information connected by the cables and computers of the Internet the body of information connected by the cables and computers of the Internet. medicalteacher — domain name:. medicalteacher — domain name: the structured, alphabetic-based, unique name for a computer on a network the structured, alphabetic-based, unique name for a computer on a network. org — top level domain:. org — top level domain: gives an idea of where the document is stored gives an idea of where the document is stored / home — file name: / home — file name: a folder within a website a folder within a website. html — hypertext markup language:. html — hypertext markup language: the computer language used to format documents the computer language used to format documents

Top Level Domains.org — general noncommercial organization.org — general noncommercial organization.edu — higher education.edu — higher education.gov — government agency.gov — government agency.com — commercial.com — commercial.mil — military.mil — military.net — computer network.net — computer network.k-12 — elementary and secondary schools.k-12 — elementary and secondary schools

Searching the Net ?? Searching the Net ??

Before you search, you need to: Prepare Prepare Organize Organize Combine Combine

Prepare What do you need to know about your topic? What do you need to know about your topic? Make a list of all the terms connected with your topic. Make a list of all the terms connected with your topic.

Organize Make a list of the words that are critical to your search. Make a list of the words that are critical to your search. Exchange/add some words if needed. Exchange/add some words if needed. Note terms that you don ’ t want to see appear. Note terms that you don ’ t want to see appear. Discard the rest. Discard the rest.

Combine Use Boolean operators to combine your most important terms. Use AND to connect the terms you want to see. Use AND to connect the terms you want to see. Use NOT to exclude terms you don ’ t want. Use NOT to exclude terms you don ’ t want. Use OR to include similar terms. Use OR to include similar terms. Use quotation marks around names or phrases Use quotation marks around names or phrases Use lower case for all proper nouns, except for acronyms Use lower case for all proper nouns, except for acronyms

Boolean Operators A AND B

Boolean Operators A OR B

Limit your keyword search Read the directions for each search engine. Read the directions for each search engine. Use words like AND and OR to limit your search and get more specified information. Use words like AND and OR to limit your search and get more specified information.

Scenario A 4-year-old child, brought by his mother with history of fever of one day. Clinically he was diagnosed to have acute otitis media. A 4-year-old child, brought by his mother with history of fever of one day. Clinically he was diagnosed to have acute otitis media. We would like to give treatment?? We would like to give treatment?? Example

Scenario A 4-year-old child, brought by his mother with history of fever of one day. Clinically he was diagnosed to have acute otitis media. A 4-year-old child, brought by his mother with history of fever of one day. Clinically he was diagnosed to have acute otitis media. We would like to give treatment?? We would like to give treatment?? Example

USEFULNESS OF MEDICAL INFORMATION?? (Relevance X validity) (Relevance X validity)Work

Examples of some Search Examples of some Search

Medline search Medline search Medline search Medline search

Scenario A 4-year-old child, brought by his mother with history of fever of one day. Clinically he was diagnosed to have acute otitis media. A 4-year-old child, brought by his mother with history of fever of one day. Clinically he was diagnosed to have acute otitis media. We would like to give treatment?? We would like to give treatment?? A case for searching answer

Scenario A 4-year-old child, brought by his mother with history of fever of one day. Clinically he was diagnosed to have acute otitis media. A 4-year-old child, brought by his mother with history of fever of one day. Clinically he was diagnosed to have acute otitis media. We would like to give treatment?? We would like to give treatment?? Example

How to search for this case ? How to search for this case ?

SEARCHING FOR THE EVIDENCE

Medline search Medline search Medline search Medline search Let us look at OM question by medline

PubMed PubMed: Web-based retrieval system PubMed: Web-based retrieval system By the “ National Center for Biotechnology Information ” (NCBI) at the National Library of Medicine. By the “ National Center for Biotechnology Information ” (NCBI) at the National Library of Medicine. Updated weekly Updated weekly Contains approximately 13 million citations Contains approximately 13 million citations Citations are taken from over 4,000 journals Citations are taken from over 4,000 journals

Type of Clinical Question The questions : The questions : diagnosis, diagnosis, prognosis, prognosis, treatment, treatment, iatrogenic harm, iatrogenic harm, quality of care, quality of care, or health economics or health economics etc etc

Identifying The Evidence Primary Sources Secondary Sources Medline Embase Systematic Reviews Clinical Guidelines

Where to Find the Best Evidence ? Using Prefiltered sources

Secondary Sources (Prefiltered)? Focus on relevant information Evaluate its validity Come up with valid conclusion for busy clinicians

Secondary sources of Evidence Examples:

The Cochrane Library

Review Groups Acute respiratory infections Acute respiratory infections Airways Airways Anaesthesia Anaesthesia Back Back Breast cancer Breast cancer Colorectal cancer Colorectal cancer Consumers and communication Consumers and communication Cystic fibrosis and genetic disorders Cystic fibrosis and genetic disorders Dementia & cognitive improvement Dementia & cognitive improvement Depression, anxiety & neurosis Depression, anxiety & neurosis Developmental, psychosocial and learning problems Developmental, psychosocial and learning problems Drugs and alcohol Drugs and alcohol Ear, nose and throat disorders Ear, nose and throat disorders Effective practice and organisation of care Effective practice and organisation of care Epilepsy Epilepsy Eyes and vision Eyes and vision Fertility regulation Fertility regulation Gynaecological cancer Gynaecological cancer Heart Heart Hepato-biliary Hepato-biliary

Clinical Scenario A 40 year old smoker, would like to quit smoking, he tried to do that, several times, but he could not tolerate the withdrawal symptoms. A 40 year old smoker, would like to quit smoking, he tried to do that, several times, but he could not tolerate the withdrawal symptoms. Recently he read that some medications are used to help smoker to quit. Recently he read that some medications are used to help smoker to quit. He would like your advise about this issue! He would like your advise about this issue!

Clinical Scenario A 40 year old smoker, would like to quit smoking, he tried to do that, several times, but he could not tolerate the withdrawal symptoms. A 40 year old smoker, would like to quit smoking, he tried to do that, several times, but he could not tolerate the withdrawal symptoms. Recently he read that some medications are used to help smoker to quit. Recently he read that some medications are used to help smoker to quit. He would like your advise about this issue! He would like your advise about this issue!

SECONDARY SOURCES

SECONDARY SOURCES A Unique Source … Produced by the BMJ Publishing Group Produced by the BMJ Publishing Group Driven by questions Driven by questions It is updated every 6 months. It is updated every 6 months. Incomplete (230 topics) Incomplete (230 topics)

Clinical Question A 45-year-old asymptomatic man no risk factors, asking for the use of aspirin to reduce the incidence of cardiovascular events. A 45-year-old asymptomatic man no risk factors, asking for the use of aspirin to reduce the incidence of cardiovascular events.

Bandolier

Bandolier Bandolier is an Oxford based appraisal site with lots of good material. Search for systematic reviews and abstract them Include NNT tables & LHR /

TRIP Database The TRIP Database searches >100 sites of high-quality medical information. The TRIP Database searches >100 sites of high-quality medical information. The site is updated monthly. The site is updated monthly.

Guidelines Evidence Based Guidelines

Guidelines NICE :

KSUDATABASE

Death Cirtificate /case_7/frmst.html /case_7/frmst.html /case_7/frmst.html /case_7/frmst.html response.chance.berkeley.edu/graduate/certificates.html response.chance.berkeley.edu/graduate/certificates.html response.chance.berkeley.edu/graduate/certificates.html response.chance.berkeley.edu/graduate/certificates.html rtificate/GAWJAN/Death%20Certificate/secname,ad/ad2,i/ad3,g /ad5,g/ad6,i rtificate/GAWJAN/Death%20Certificate/secname,ad/ad2,i/ad3,g /ad5,g/ad6,i rtificate/GAWJAN/Death%20Certificate/secname,ad/ad2,i/ad3,g /ad5,g/ad6,i rtificate/GAWJAN/Death%20Certificate/secname,ad/ad2,i/ad3,g /ad5,g/ad6,i

Conclusion Cont. « Be specific about your questions or search. « Practice using different sites for search « Be familiar with some common sites « Be familiar with secondary resources

USEFULNESS OF MEDICAL INFORMATION?? (Relevance X validity) (Relevance X validity)Work

These Skills are enough?? We need to improve our searching skills??

Virtual Training Suite

Virtual Training Suite 61 subject specific online tutorials on Internet Information skills. 61 subject specific online tutorials on Internet Information skills. Authored by specialists with subject and Internet expertise. Authored by specialists with subject and Internet expertise. Free to access (no need to register). Free to access (no need to register). Take a light hearted approach Take a light hearted approach

Thank You com