1. Finding the best evidence 1. Walk through one 2. Do own searches

2. Learning through play Try all buttons Make lots of mistakes Have fun

3. EBM and Systematic Review EBM (quick & dirty) Steps Answerable Question Search Appraise Apply Time: 90 seconds < 20 articles This patient survives! Systematic Review Steps Answerable Question Search ++++ Appraise x 2 Synthesize Apply Time: 6 months < 2,000 articles This patient is dead Find a systematic review!!

4. Start up Start Explorer and enter www.pubmed.gov Put on CAPS lock So that AND and OR are in CAPITALS Start 2nd Explorer window, enter www.tripdatabase.com

5. Using the question to guide searching Scenario - You are interested in checking the hearing of elderly patients, and have heard that the whispered voice test is good. Question Population Indicator (intervention, test, etc) Comparator Outcome

6. Scenario - You are interested in checking the hearing of elderly patients, and have heard that the whispered voice test is good. Question Population – in elderly patients does Indicator – a poor whispered voice test Comparator – a normal whispered voice test Outcome – predict abnormal audiogram 1. Underline the key terms 2. Number the order of importance from 1-4 3. Think of alternate spellings, synonyms, & truncations Using the question to guide searching

7. Scenario - You are interested in checking the hearing of elderly patients, and have heard that the whispered voice test is good. Question Population – in elderly patients does Indicator – a poor whispered voice test Comparator – a normal whispered voice test Outcome – predict poor hearing (audiogram) 1. Underline the (root of the) key terms 2. Number the order of importance from 1-4 3. Think of alternate spellings, synonyms, & truncations 1 2 3 Using the question to guide searching

8. * Means any other letters AND means both terms required Check the question type Check the emphasis

9. Stepwise searching Search with #1 PICO item Whisper* Then go to Clinical Queries: diagnosis Whisper* (again) Add #2 PICO item whisper AND (hear* OR audiogram)

10. Combining terms with Boolean operators – AND chitosan weight weight AND chitosan - has both terms IN CAPITALS

11. Combining terms with Boolean operators – OR chitosan weight weight OR chitosan - has either term

12. Your tasks Search for the best single article (systematic review or trial) for Your question from notes Your own question(s) When you are finished Print just the abstract for each Write your search strategy on the page

14. Boo-le-ans* AND = both terms OR = either term NOT = not this term (ADJacent, NEAR, … = AND + close) * George Boole (a man) is claimed to have invented logic

15. Where to the brackets go? If you want cheese AND fruit Which do you ask for? cheese AND (apple OR pear OR melon) (cheese AND apple) OR pear OR melon What does PubMed do with if AND and OR? Cheese AND apple OR pear (Look at DETAILS tab)

16. General structure of search (Population OR synonym 1 OR …) AND (Intervention OR synonym 1 OR …) AND (Comparator OR synonym 1 OR …) AND (Outcome OR synonym 1 OR …) AND FILTER (for best study type)

18. Medline Embase Cochrane Trials Registry Comparing Databases Medline = Pubmed, Webspirs, OVID, …

19. Search Cascade

20. Shortcuts Meta-search engines www.tripdatabase.com Sumsearch Nelh

22. Other tips: Search on Title only Eg [ti] (Others are [au] - author; [so], [yr], …) Related Articles button (PubMed) previously identified study (PubMed) Look for the MeSH terms MeSH browser

24. Before you finish! Print single most relevant abstract for each question – for both set questions and your own questions