1. Information Tools for USC Primary Care Physician Assistant Students Adrian Follette, MLIS Evans Whitaker, MD, MLIS Norris Medical Library Keck School of Medicine University of Southern California Los Angeles, CA 90089-9130

2. Introductions Introduce personnel ASK QUESTIONS! Make this session useful to you I am the liaison to the Physician Assistant Program from Norris Medical Library However, you may contact any of us if you have questions

3. Questions before we start… How many of you have searched with Ovid before? How many of you have searched with PubMed before? Do you use MeSH when you search MEDLINE? How many of you are familiar with UpToDate? How many are familiar with EBM?

4. Outline for today 1. Norris Medical Library – Access and Resources 2. Clinical Information Tools 3. EBM Tools 4. Primary literature (another way to say MEDLINE) 5. Other topics as time and interest allow A. Google B. Scirus C. Citation management software D. How to stay above water in the information deluge 6. Final tips, summary, closure, evaluation forms

5. Norris Medical Library— Access and Homepage Tour

6. Norris Medical Library Use the proxy server. (You can see it at https://libproxy.usc.edu/login ). https://libproxy.usc.edu/login Do not use VPN. Log in with USC email information; user name (email up to @) and password. Use Norris Library home page as your starting point when searching for biomedical information -- Bookmark it!

7. The Norris Homepage Highlights…Moving from Left to RightNorris Homepage Journals All USC eJournals – includes all electronic journals in the USC system Databases Ovid MEDLINE PubMed @USC – don’t go directly to pubmed.gov as lose links to USC holdings UpToDate Key Resources for: Students  Physician Assistants – Portal to commonly used resources (Let us know what additions you want!) Catalogs HELIX -- Norris Medical and Wilson Dental Libraries (try “goodman and gilman”) ADVOCAT -- USC Law Library HOMER -- All other USC libraries QuickLinks -- many common resources listed in dropdown menu. HELP – Email, Phone, and IM connections to medical librarians. We can help with devising searches, finding information sources, troubleshooting, etc. IM and phone hours are M-F 9-5. There is one working day turnaround on email questions. SEARCH

8. QuickLinks Clinical information tools UpToDate – not off campus ACP Pier Essential Evidence Plus Pharmacy References Epocrates Lexi-Comp Online Databases Ovid MEDLINE - includes much more than MEDLINE PubMed@USC - don’t use pubmed.gov

9. QuickLinks 2 DocRetriever – Interlibrary loan system of Norris Library. Set up free account, the system is “self-serve”. Charges for items from libraries outside USC -- $11 for book or article. Multi eBook Search – Use to find information in multiple electronic books simultaneously. Easy to use and searches >700 electronic books simultaneously!

10. Clinical Information Tools

11. UpToDate – fast, easy, good quality. Is it really evidence- based? Or is it expert opinion? Do we care?– QuickLinks. Great for background information. ACP Pier – QuickLinks. Similar content to UTD but not as nice an interface. Essential Evidence Plus – “InfoRetriever” until recently – QuickLinks. Same comments as ACP Pier Try a search in ACP Pier, Essential Evidence, and Clinical Evidence. Call out if you need help or have questions. Topics (if you need them): Common cold and antibiotics Suicide risk with SSRI’s in teens. Steroid injection for lateral epicondylitis. Calcium channel blockers for migraine prophylaxis.

12. Search Tips for Clinical Information Tools Keep your searches simple Be prepared to reword your search (There is no mapping of terms to a standardized vocabulary in these resources, unlike OvidMEDLINE or PubMed)

13. Evidence-Based Medicine

14. Evidence-Based Medicine/Practice Resources Ovid Cochrane Database ACP Journal Club DARE (Database of Abstracts of Review of Effects) Clinical Evidence National Guidelines Clearinghouse (guideline.gov)guideline.gov TRIP (Turning Research Into Practice; tripdatabase.com) tripdatabase.com SUMSearch.uthscsa.edu Try “common cold” and “antibiotics” as search for these databases

15. Primary Medical Literature

16. MEDLINE MEDLINE a subset of PubMed. >16.5 million citations in MEDLINE. >18.2 million citations in PubMed. Difference due to articles not yet indexed or those that never will be as not biomedical Updated daily Two major ways to access: OvidSP to which USC subscribes. PubMed (free, USC’s version = PubMed@USC includes links to USC holdings).

17. OvidSP Navigate to Ovid: Norris homepage  Databases tab  Ovid MEDLINE. (FOR TODAY ONLY) Sign into training account ovidsp.ovid.com. User Name: sci001 Password: medical Differences between training and USC Basic is default in training No full text links in training Search history box closed in training Limits box closed in training

18. OvidSP Ovid databases: MEDLINE choices are at the top EBM sources in the middle of the page Other databases in Ovid MEDLINE 1996-2008, and MEDLINE 1950-2008. Avoid first MEDLINE choice. Set up a free personal account to save searches, annotate articles, and receive new articles on a search topic by email.

19. OvidSP Two “flavors” of Ovid since February, 2008  Basic and Advanced. OvidSP Basic is a “Google-ized” version of Ovid. It is a “natural language search engine” which allows one to enter keywords, a phrase, or sentence in standard English. Advanced Ovid Search feels familiar to those familiar with Ovid before recent addition of Basic Search.

20. Ovid Basic Basic takes your “natural language” and attempts to “map” (library-speak for “translate”) your words to MeSH terms. No need to enter concepts separately and combine. Limits may be applied to searches.

21. Ovid Basic Search Tips All Basic searches typically yield 500+ hits. Do not panic or throw your mouse in disgust! The “good stuff” is found within the first 20-30 hits. If nothing good is found within 20-30 hits, reword your question or move on to Advanced Ovid Search.

22. What is Ovid Basic good for? Great for quickly finding a few good articles. Good for discovering proper terms to use in Advanced Ovid Search.

23. Basic Practice PRACTICE: “ice cream headache” Complete reference PRACTICE: “rotavirus vaccine complications”

24. Advanced Ovid Search Feels familiar to PubMed and “old Ovid” users. Concepts are entered one at a time. MeSH (Medical Subject Headings) terms are preferred search terms. MeSH is a standardized vocabulary of the NLM used to index MEDLINE articles. With each MeSH concept decide on Explode, Focus, and Subheadings. AND, OR are used to combine concepts. A variety of limits may be used to narrow your search. HINT: Place limits as the last step in formulating your search.

25. Advanced Ovid Tips See Flow Sheet Create a free, no spam associated account with Ovid. There you can save searches to re-run at a future time, and annotate articles for future reference

27. What is Advanced Ovid good for? Good for leaving “no stone unturned”, as when preparing for scholarly presentation. Advanced Ovid allows precise searching

28. Limitations of Advanced Ovid Takes time and practice to become skilled Advanced Ovid works best with MeSH terms. New drugs, procedures, devices, and concepts are likely not in the MeSH database (yet). Use keyword searching to find articles about terms not yet in MeSH.

29. Advanced Ovid Practice Selenium (or lycopene) for prostate cancer prevention, what is known? For children with asthma what is the effect of air pollution on their respiratory status?

30. Ovid MEDLINE Take Home Messages Use Basic to inform Advanced. Minimize use of subheadings and limits. Rule of thumb is to “focus” only one concept (usually the disease or condition) and “explode” all concepts in a search. Apply limits as the last step. In Advanced mode Ovid will attempt to translate your terms into MeSH headings. Lessons learned from Advanced Ovid will help you learn PubMed

31. PubMed@USC Databases tab at Norris homepage Insures full text links through FindIt@USC. Open PubMed@USC. I will only mention three features today. Single Citation Matcher. Find Similar. MyNCBI Search process is similar to OvidSP Advanced. Use MeSH terms, enter concepts separately, combine concepts, apply limits. Sign up for MyNCBI -- save searches, collections of articles, and have new articles resulting from saved searches emailed to you on a user-determined schedule.

32. PubMed “Single Citation Matcher” any 1-2 pieces of information will allow you to find a citation. Usually will have links to USC holdings. Ovid has the equivalent function. It does not work as well. “Related Articles” is a very effective way of finding closely related articles. Ovid has the equivalent function. It does not work as well. Set up myNCBI account in which you can save searches, articles, and receive email with the latest research in topic areas of interest.

33. Practice In left column of PubMed, find Single Citation Matcher and click on it. Enter British Medical Journal and “parachute” as title word. Enter “Puliafito” as author Choose an article, click on Related Articles to see this functionality.

34. Sign Up for MyNCBI Do this now! For those of you who have not already done so – this is free, easy, and no associated spam. With MyNCBI you may save searches and article collections. If you so designate, your saved searches are rerun periodically. New articles on your topic are emailed or RSS’d to you.

35. Miscellany

36. Google Scholar GoogleScholar limits searches to scholarly sites GoogleScholar Configure GS in Scholar Preferences so that USC library holdings are linked (for personal computer) GS is good for preliminary exploration of an unfamiliar topic. Yields good terms to use in more valid and authoritative search engines. GS will also occasionally find full text of an article in a journal to which USC does not subscribe.

37. Scirus.com A search engine devoted to scientific websites. Easy to use. Higher overall quality of sites than GS. My opinion… “Independent” product of publishing giant Elsevier. I have not seen evidence of bias. Worth a look when exploring a topic.

38. Citation Management Software For saving and organizing your information. USC has RefWorks accountRefWorks Easier to learn EndNoteWeb is free to use EndNoteWeb Desktop version as well

39. How to stay afloat in the deluge…some ideas Subscribe to eTOCs for chosen journals to email or RSS (example NEJM or JAMA)NEJMJAMA Save searches about topics of interest to you in Ovid or PubMedOvidPubMed Updates from Faculty of 1000-MedicineFaculty of 1000-Medicine Check “What’s New” at UpToDateUpToDate

40. Additional Tips Norris as home page, use proxy server, not VPN. Sign up for a free account with Ovid to save searches and annotate articles, and have new articles on topic sent to you. Sign up for a free MyNCBI account, you can save PubMed searches, collect articles, and have alerts emailed to you about new articles from saved searches. Sign up for free Web-of-Knowledge/EndNote accounts. This is a nice way to store, organize, and use citations found in your research. Consider Connotea as well. Consider classes at Norris Medical Library in PubMed, OvidSP, EndNote, etc. Email, call, IM Norris Library for help if you get stuck!! (click the HELP button on the top left of Norris homepage to access)

41. Summary I have attempted to provide: Norris Medical Library basics. OvidMEDLINE update and usage information. Miscellaneous information: GoogleScholar and Scirus.com. Some time to practice with the resources. Thanks for your attention!

42. Questions? Please fill out the evaluation form. Thanks for your Attention!