1. Incorporating Creativity into Literature Searching and Information Retrieval
There are many ways that information specialists (IS) incorporate creativity into their work while still maintaining rigorous HTA standards. Catherine and I will discuss ways in which IS can enhance standard systematic review searches to creatively find additional relevant citations. These and other unique approaches help IS to boost the thoroughness and productivity of literature searches to support evidence-based practice. Audience participation will be encouraged to offer other examples of how creativity can play a role in IS HTA work.
This topic also fits well into the overall conference theme: “Evidence, Value and Decision Making: Science or Art?” by discussing artistic or creative elements within a highly structured and scientific HTA framework.
Presentation by David Kaunelis & Catherine Voutier HTAi 2013: IRG Advanced Skills Workshop June 16th 2013

2. Creativity in Information Specialist Work
Information specialist work is not generally considered to be a creative process. But there is a lot of creativity involved in the creation of systematic reviews and HTA. Our presentations will explore some of the ways in which IS can put their creativity to productive use, particularly in the area of literature searching.

3. Creativity in Database Searching
Ways to incorporate innovative thinking:
During scoping process
Designing search strategies
Managing database references
Database searching offers many possibilities for creative thinking.

4. Creativity During Scoping Process
Focused subject search  Scan titles for relevant keywords
PubMed: creativity [MAJR]
Medline: *creativity/
Scoping may be the best place where creativity can be used by IS. You start with a blank slate and need to populate it with subject headings and keywords.
In either Medline or PubMed

5. Creativity During Scoping Process
Use GoPubMed (gopubmed.org) to find aggregate information for articles found within a search or from a set of articles

6. Creativity During Scoping Process
PubMed special features
Related citations
Related searches
Find related data

7. Creativity In Designing Search Strategies
Many of the examples that will be discussed here were created for rapid review literature searches, but these techniques could also be applied to more rigorous reports.

8. Creativity In Designing Search Strategies
Dental implants
Phrase “dental implants” not always used
Just the word “implants” used in title/abstract
Problem: how to retrieve these articles without also retrieving articles dealing with other types of implants
Lots of relevant subject headings: dental implants; dental implantation; denture, partial; and denture, partial, fixed.
But what if citations are not indexed.
Broaden search but not too broad.
Other implants: heart valves, breast, bone, pacemaker, etc.
Mainly used to retrieve citations not yet indexed (the latest research)
Solution: show search string.
One solution: search implants in title AND dental terms in journal word (based on top dental journal names)

9. Creativity In Designing Search Strategies
Dental implants
implant*.ti.
AND
(dentist* or dental or oral biology or implantology or endodont* or prosthodont* or ((oral or maxillofacial or maxillo-facial or orofacial) and surgery)).jw.

10. Creativity in Designing Search Strategies
Spinal Boards
No MeSH heading, just keywords
Problem: how to incorporate relevant subject headings when no specific MeSH exists. And keep the search results manageable.
One solution: Search spinal boards as keyword, but also selectively incorporate broader subject headings and keywords
Question: What is the clinical evidence regarding patient outcomes associated with the use of spine boards in the pre-hospital setting for the stabilization of patients following trauma?
What are the evidence-based guidelines regarding the use of spine boards in the pre-hospital setting for the stabilization of patients following trauma?
Broaden search but not too broad.
Solution: show search string.

11. Creativity in Designing Search Strategies
S1 OR (S2 AND S3 AND S4)
Set #1: Spinal Boards
(Spine[tiab] OR spinal[tiab]) AND (board[tiab] OR boards[tiab]) OR back board[tiab] OR back boards[tiab] OR backboard*[tiab] OR spineboard*[tiab]
OR spinalboard*[tiab]
Set #2: Pre-hospital setting:
Ambulances[mh] OR pre hospital [tiab] OR prehospital[tiab] OR pre hospitalization[tiab] OR prehospitalization[tiab] OR pre hospitalisation[tiab] OR prehospitalisation [tiab] OR out of hospital [tiab] OR paramedic*[tiab] OR ambulance[tiab] OR out of hospital[tiab]
Set #3: Immobilization
Immobilization[mh] OR "Moving and Lifting Patients"[mh] OR immobile [tiab] OR Immobiliz*[tiab] OR immobilis*[tiab] OR immobility [tiab] OR stabili*[tiab]
Set #4: Spinal Injuries
Spinal Injuries[majr] OR Spinal Cord Injuries[mh] OR Emergency Treatment[mh] OR trauma, nervous system[mh] OR “wounds and injuries”[mh] OR trauma* [tiab] OR injury [tiab] OR injuries [tiab] OR back injury[tiab] OR back injuries[tiab] OR back trauma* [tiab]
Broaden search but not too broad.
Basic search = #1
But can use broader headings with #3 and #4 and limit to pre-hospital setting to help manage results.

12. Creativity in Designing Search Strategies
Venous Thrombosis
Two specific MeSH headings exist (venous thrombosis, venous thromboembolism)
Problem: Are there alternate ways to index subject area? Other broader headings exist.
One solution: deconstruct to combine supporting concepts into search strategy:
(Thrombosis/ AND Veins/) OR venous thrombosis/ OR venous thromboembolism/
Specific subject headings: venous thrombosis/ OR venous thromboembolism/
Broaden search but not too broad. Use thrombosis/ AND veins/
Ensures that you don’t need to rely on a specific MeSH term.
Solution: show search string.

13. Creativity in Designing Search Strategies
Pulse oximeters in neonates
MeSH headings exist but are very broad
Problem: Too many search results.
One solution: Use study design search filters. However, there are still too many results so need to use a narrower strategy for lower levels of evidence.
Very common problem in rapid review questions.
Narrow the search but not too narrow.
Solution: show search string.

14. Creativity in Designing Search Strategies
Pulse oximeters in neonates
Set #1a: Pulse Oximetry (broad)
Oximetry[mh] OR oximetry[tiab] OR oximeter[tiab] OR oximetre[tiab] OR oximeters[tiab] OR oximetres[tiab] OR oximetries[tiab] OR PtcO2[tiab] OR TcPCO2[tiab] OR Masimo[tiab] OR Nelcor[tiab] OR Oxismart[tiab] OR Mindray[tiab] OR Nellcor[tiab]
Set #1b: Pulse Oximetry (narrow)
Oximetry[majr] OR oximetry[ti] OR oximeter[ti] OR oximeters[ti] OR oximetries[ti] OR Masimo[tiab] OR Nelcor[tiab] OR Oxismart[tiab] OR Mindray[tiab]
Set #2: Neonates
Infant[mh] OR infant[tiab] OR infants[tiab] OR baby[tiab] OR babies[tiab] OR newborn[tiab] OR newborns[tiab] OR neonate[tiab] OR neonatal[tiab] OR neonates[tiab] OR preemie[tiab] OR preemies[tiab] OR infancy[tiab] OR NICU[tiab]
(S1a AND S2) AND (SR filter OR RCT filter) OR
(S1b AND S2) AND (CCT filter OR Observational filter)
Broader oximetry filter matched with SR and RCT filter (higher quality evidence)
Narrower oximetry filter matched with CCT and observational filter (lower quality evidence)
CADTH creates its own study design filters, which helps tremendously in saving time when searches need to be narrowed.

15. Creativity in Designing Search Strategies
When PICO Doesn’t Cut It
Questions dealing with:
health human resource
health systems
patient reported outcomes
Reference: Moulton K, Ford C. When PICO doesn’t cut it: formulating well-built research questions, literature search processes, and parameters for unique healthcare topics. Poster presented at 2012 CADTH Symposium, Ottawa. Available at:
PICO doesn’t always provide IS with everything needed to run an effective search. Searches are often more complicated and need to consider additional concepts.
Vague search terms – how to find relevant material, but exclude as much noise as possible.
Examples from previous Rapid Response reports.

16. Creativity in Designing Search Strategies
When PICO Doesn’t Cut It
Example topics: patient transfer; care models; wellness screening.
Problem: “soft” concepts, more than one population, atypical intervention, very large search results.
Solution: show sample search strategies.
Solution: Be creative!

17. Creativity in Designing Search Strategies
When PICO Doesn’t Cut It: Patient Transfer
Set #1: Transitions with patients
Patient transfer[MH] OR “patient transfer”[tiab] OR “patient transfers”[tiab] OR “patient dumping”[tiab] OR Personnel turnover[MH] OR “shift change”[tiab] OR “shift changes”[tiab] OR “handover”[tiab] OR “handovers”[tiab] OR “handoff”[tiab] OR “handoffs”[tiab] OR “hospital transfer”[tiab] OR “facility transfer”[tiab] OR “hospital transfers”[tiab] OR “facility transfers”[tiab]
AND
Set #2: Communication
Communication[MH] OR communication[tiab] OR communicative[tiab] OR Continuity of Patient Care[MH] OR Medication errors/prevention and control[MH] OR “continuity of patient care”[tiab] OR “continuity of care”[tiab]
Major problem: the word transfer – could be dealing with physical transfer of patients (such as by ambulance) or the transfer of patients information. CADTH has done reports on both.
In this case, we reviewed effective health care provider communication at key transition points of care including shift-changes, end-of-service, and change of service.
Solution: need to focus tightly on patient transfer (not transferring in general), plus need to add string for communication. And add study design filters.

18. Creativity in Designing Search Strategies
When PICO Doesn’t Cut It: Wellness Screening
(S1 AND S2) NOT S3
Set #1: Screening/Tests
*mass screening/ or *diagnostic tests, routine/ or (screening adj3 (tool* or instrument* or program* or test* or examination* or polic* or set* or routine* or practice* or protocol*)).ti. or (clinical screening* or community screening* or developmental screening* or health screening*).ti.
Set #2: Primary Care
primary health care/ or physicians, primary care/ or family practice/ or (primary care OR primary healthcare OR primary health care OR primary service* OR primary practice* OR general practitioner* OR family practice* OR family doctor* OR general practice OR primary physician* OR primary doctor* OR family physician* OR family medicine OR primary medicine OR family clinic*).ti,ab.
Set #3: Mental Health
(Mental health or depress* or psycho* or personalit* or psychiat* or dementia* or social-emotional or anxiety* or bipolar* or suicide* or mental stress* or
cognitive* or mood* or violen* or Alzheimer* or alcohol*).ti.
Report addresses: the use of a standardized set of health and wellness screening tools to monitor primary care patients?
Several techniques used here: (1) Did not even search on health and wellness, too vague (first-level screening only way to handle this aspect). (2) Medline used for adjacency searching. (3)Very focused search for screening set: major headings, title only. (4) Search results NOTted with Mental health (too much on that area, not relevant).
Appropriate for rapid review, but probably not applicable to HTA/SR searching.

19. Creativity in Designing Search Strategies
Searching the Scopus database
Problem: there are a large number of PubMed citations in Scopus. What’s the most efficient way to deal with this duplication?
One solution: Search for all PubMed citations using: PMID(0* OR 1* OR 2* OR 3* OR 4* OR 5* OR 6* OR 7* OR 8* OR 9*)
Then combine with original search using AND NOT.
Scopus says there is no official way to remove Medline citations.
But there is a field for a citation’s unique PubMed number (PMID).
Can only be run as an advanced search.
This searches for anything that has a number in the PMID field.

20. Creativity in Managing References
Getting rid of duplicates using Ovid instead of bibliographic software
Used when searching multiple Ovid databases
Prepare and save individual database searches separately
Open all databases you have created searches for (multifile search)
Then run the following search…
Hard to be creative managing references, but there are some ways.

21. EMBASE search [1974-present with daily updates] Line 1. creativ*.ti,ab
Line 2. creativity.hw
Line 3. or/1-2
Line use oemezd [field code for Embase database]
Then run the next database search with all databases still open.
MEDLINE search [1946-present with daily updates]
Line 5. creativ*.ti,ab
Line 6. *creativity/
Line 7. or/5-6
Line use pmez [field code for Medline database]
Line or 8
Line 10. remove duplicates from 9
Show strategy.
Field codes found in Ovid database field guides.
Every database segment has different field code.

22. In Conclusion
There is room for creativity in designing literature searches while still being systematic and rigorous.

23. Creativity in Literature Searching
June 2013

24. Being creative
‘What it boils down to is one per cent inspiration and ninety- nine per cent perspiration’ Thomas Edison (1929)
Once you know a system, you can think creatively within it = Csikszentmihalyi’s theory of creativity
Henry, J. Creative Management and Development, 3rd ed. Sage Publications, 2006
Sean McEntee

25. Accessing content Databases or journals inaccessible – network!
Local content not available in commonly used databases
Australian university repositories - ARROW
Local databases and peak bodies e.g. Informit, AIHW
There is a ponderous amount of literature from the US and the majority of commonly used databases are North American. Finding local evidence can be difficult.
ARROW is now integrated into TROVE, the National Library of Australia’s comprehensive Australian publications catalogue.

26. Google Scholar Use Google commands to filter results
site:au, site:[name of resource] etc

27. Contacting authors When additional information is needed…
Google has disabled searching for s
@ is now associated with searching twitter
Institutional staff directories – what do to if there isn’t one or if the site is in another language?
PubMed for corresponding authors
Methods for obtaining unpublished data Cochrane SR Taryn Young, Sally Hopewell states that contacting authors of recent studies by has the best chance of success when you have to obtain unpublished or other information. This can be tricky for common surnames. If they are non-English studies, it can be even trickier. I had an experience recently when I had to find the addresses of poster presenters, each with the same surname – Kim. Hovering on the surname Kim brings up the organisation but no contact details. [ Department of Physical Medicine and Rehabilitation, Yeungnam University Hospital, Daegu, Republic of Korea ] PubMed brought up a generic for SH Kim. Another paper including SH Kim (full name) with a work for a colleague. I also tried searching for Daegu Colleage of Medicine and came up with the format – you could try to construct the .

28. Searching acronyms
PubMed allows two letter acronym searches, EBSCO doesn’t
Get around this by using truncation but it will return many results
Some databases have weird searching obstacles. EBSCO Medline will not recognise MS, despite the fact it is a well-known acronym for multiple sclerosis. How do you get around it?

29. Thank you Catherine Voutier - Clinical Librarian Melbourne Health
mh.org.au