Download - Searching for and finding the Evidence
Searching for & finding the evidence
Grainne McCabe, Mercer Library, [email protected]
RCSI Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn
In this session we will cover.....
• 5S approach to searching for the evidence– clinical summaries; systematic reviews; – primary studies
• Grey literature• Database search process
– Scoping topic; identifying search terms; testing searches; saving searches; setting up alerts
• Complex search strategy (from Cochrane Library)– “unpick” the elements of the search: keywords / subject
headings– Display it on the CINAHL database
Image: http://commons.wikimedia.org/wiki/File:Magical_books.jpg
Evidence-based healthcare
The practice of evidence based medicine
means integrating individual clinical expertise with
the best available external clinical evidence from
systematic research.
Source: Sackett, D.L. et al. (1996) Evidence based medicine: what it is and what it isn't. BMJ 312, 71-2.
StrategySystematicCriteriaExplicitReliableReproducibleDocumented
Searches
Where do YOU go to search for the evidence?
• Google?
CLINICAL SUMMARIESDynaMed / UptoDate /
Clinical Evidence
Cochrane Library
MEDLINE / CINAHL / databases for primary studies
Grey literature
Evidence Based MedicineEvidence Based Nursing
ACP Journal Club
B Haynes EBM v11 Dec 2006
Summaries - evidence-based digests
• Designed for use at point-of-care: wards, family practice• Summarise the evidence • Continually updated• However....may not deal with all aspects of a topic or
with very specialised topics• Each clinical summary has a different emphasis
Armstrong, DG . Basic principles of wound management. UptoDate [updated 28 Jan 2014 cited 24 Apr 2014]. Available from http://www.uptodate.com
Armstrong, DG . Basic principles of wound management. UptoDate [updated 28 Jan 2014 cited 24 Apr 2014]. Available from http://www.uptodate.com
CLINICAL SUMMARIESDynaMed / UptoDate /
Clinical Evidence
Cochrane Library
MEDLINE / CINAHL / databases for primary studies
Grey literature
Evidence Based MedicineEvidence Based Nursing
ACP Journal Club
B Haynes EBM v11 Dec 2006
Syntheses – systematic reviews
What is a systematic review?
• Identifies, appraises and synthesizes the evidence that meets pre-specified eligibility criteria to answer a given
research question.
• Explicit methods are used, aimed at minimizing bias, and producing more reliable findings.
CLINICAL SUMMARIESDynaMed / UptoDate /
Clinical Evidence
Cochrane Library
MEDLINE / CINAHL / databases for primary studies
Grey literature
Evidence Based MedicineEvidence Based Nursing
ACP Journal Club
B Haynes EBM v11 Dec 2006
Studies – primary journal articles
• Databases: a selection– Medline - PubMed, Ovid Medline, Ebsco Medline .....– CINAHL – Nursing & Allied Health– PsycInfo – psychology & psychiatry – Embase – particularly good for pharmacology topics, European
studies– Web of Science
• Good for conference abstracts• Citation searching
Studies – grey literature
• OpenGrey (System for Information on Grey Literature in Europe) www.opengrey.eu
• NLM (Nat Lib Med) www.nlm.nih.gov/nichsr/db.html – Databases:
• Health Services & Sciences Research Resources• Health Services Research & Health Care Technology• Health Services Research Projects• Health Services Technology Assessments
– LocatorPlus – NLM catalogue
• Reports• Official
Publications• Conference
Papers• Dissertation
s• Patents
Studies – grey literature
• Institutional repositories: digital collections of scholarly output from academic and professional organisations
OpenDOAR (www.opendoar.org)International
Bielefeld Base (www.base-search.net) European
CORE (http://core.kmi.open.ac.uk/search) UK
RIAN (http://rian.ie/) Irish
• Websites of relevant professional organisations– EWMA; American Professional Wound Care Association; Wound
Management Association of Ireland
Theses & Dissertations
• Repositories – see previous slide
• Networked Digital Library of Theses & Dissertations (NDLTD) (http://www.ndltd.org/home)
• DART-Europe E-theses portal (http://www.dart-europe.eu/basic-search.php)
Scoping the topic – background searches
• Overview – places your work in the context of research already published
– Size of the literature– Identify gaps – Types of studies / research designs– Spread of publications– Testing the search strategy on a group of documents – look for
other search terms / subject headings – What is missing from your search results?– What is included which is peripheral to your research?
Concepts
• Break the topic into concepts– Is zyban effective in smoking cessation? Two principal
concepts. Search for each separately, then combine
OR • Use the PICO framework:
– Patient / population / problem– Intervention: cause, prognostic factor, treatment– Comparison (if appropriate)– Outcome
• May need to look beyond PICO
Identifying search terms
• Using key papers – Find on the database– What words/phrases (keywords) & subject headings are used?
• Adapting other people’s strategies: • Be critical• Amend for your topic
Wound cleansing for pressure ulcers
ACTIVITY:
Wound Cleansing: – think of different ways of describing this concept– Include solutions used in wound cleansing
Pressure Ulcers:– think of different ways of describing this concept
Wound Cleansing Pressure Ulcers
Appendix 5. EBSCO CINAHL search strategyS28 S22 and S27S27 S23 or S24 or S25 or S26S26 TI (bed sore* or bedsore* ) or AB (bed sore* or bedsore*)S25 TI decubitus or AB decubitusS24 TI (pressure ulcer* or pressure sore*) or AB (pressure ulcer* or pressure sore*)S23 (MH ”Pressure Ulcer“)S22 S1 or S2 or S3 or S4 or S5 or S6 or S7 or S8 or S9 or S10 or S11 or S12 or S13 or S14 or S15 or S16 or S17 or S18 or S19 or S20or S21S21 TI ( wash* or scrub* or swab* or shower* or bath* or soak* or irrigat* or whirlpool ) or AB ( wash* or scrub* or swab* or shower* or bath* or soak* or irrigat* or whirlpool )S20 TI ( wound clean* or wound cleans* ) or AB ( wound clean* or wound cleans* )S19 (MH ”Hydrotherapy+“)S18 (MH ”Bathing and Baths“)S17 (MH ”Irrigation+“)S16 AB ( normal saline or hypochlorit* or iodophor* or povidone or iodine or chlorhexidine or hibitane or betadine or antiseptic* or disinfectant* or antiseptic* or detergent* or soap* or hydrogen peroxide or benzoyl peroxide or gentian violet or eusol or dakin* or permanganate or water or alcohol*1 or solution* )S15 TI ( normal saline or hypochlorit* or iodophor* or povidone or iodine or chlorhexidine or hibitane or betadine or antiseptic* or disinfectant* or antiseptic* or detergent* or soap* or hydrogen peroxide or benzoyl peroxide or gentian violet or eusol or dakin* or permanganate or water or alcohol*1 or solution* )S14 (MH ”Solutions+“)S13 (MH ”Alcohols+“)S12 (MH ”Water+“)S11 (MH ”Gentian Violet“)S10 (MH ”Hydrogen Peroxide“)S9 (MH ”Soaps“)S8 (MH ”Detergents+“)S7 (MH ”Disinfectants“)S6 (MH ”Antiinfective Agents, Local+“)S5 (MH ”Povidone-Iodine“)S4 (MH ”Chlorhexidine“)S3 (MH ”Saline Solution, Hypertonic“)S2 (MH ”Sodium Hypochlorite“)S1 (MH ”Sodium Chloride+“)
Moore ZEH, Cowman S. Wound cleansing for pressure ulcers.
Cochrane Database of Systematic Reviews 2013, Issue 3. Art. No.:
CD004983. DOI: 10.1002/14651858.CD004983.pub3
Subject Headings (added by indexers) v Keywords (authors’ words)
S14 (MH ”Solutions+“)S13 (MH ”Alcohols+“)S12 (MH ”Water+“)S11 (MH ”Gentian Violet“)S10 (MH ”Hydrogen Peroxide“)S9 (MH ”Soaps“)S8 (MH ”Detergents+“)S7 (MH ”Disinfectants“)S6 (MH ”Antiinfective Agents, Local+“)S5 (MH ”Povidone-Iodine“)S4 (MH ”Chlorhexidine“)S3 (MH ”Saline Solution, Hypertonic“)S2 (MH ”Sodium Hypochlorite“)S1 (MH ”Sodium Chloride+“)
Wound Cleansing
solutions – subject
headings (MH)
S16 AB ( normal saline or hypochlorit* or iodophor* or povidone or iodine or chlorhexidine or hibitane or betadine or antiseptic* or disinfectant* or antiseptic* or detergent* or soap* or hydrogen peroxide or benzoyl peroxide or gentian violet or eusol or dakin* or permanganate or water or alcohol*1 or solution* )
S15 TI ( normal saline or hypochlorit* or iodophor* or povidone or iodine or chlorhexidine or hibitane or betadine or antiseptic* or disinfectant* or antiseptic* or detergent* or soap* or hydrogen peroxide or benzoyl peroxide or gentian violet or eusol or dakin* or permanganate or water or alcohol*1 or solution* )
Wound Cleansing
solutions – title /
abstracts
S21 TI ( wash* or scrub* or swab* or shower* or bath* or soak* or irrigat* or whirlpool ) or AB ( wash* or scrub* or swab* or shower* or bath* or soak* or irrigat* or whirlpool )
S20 TI ( wound clean* or wound cleans* ) or AB ( wound clean* or wound cleans* )
S19 (MH ”Hydrotherapy+“)
S18 (MH ”Bathing and Baths“)
S17 (MH ”Irrigation+“)
Wound Cleansing
methods –
subject headings
title/abstract
S22 S1 or S2 or S3 or S4 or S5 or S6 or S7 or S8 or S9 or S10 or S11 or S12 or S13 or S14 or S15 or S16 or S17 or S18 or S19 or S20 or S21
All wound cleansing searches combined
into one set
S27 S23 or S24 or S25 or S26S26 TI (bed sore* or bedsore* ) or AB (bed sore* or bedsore*)S25 TI decubitus or AB decubitusS24 TI (pressure ulcer* or pressure sore*) or AB (pressure ulcer* or pressure sore*)S23 (MH ”Pressure Ulcer“)
Pressure ulcers:Subject headings;
title / abstracts
All combined into one set (S27)
S28 S22 and S27 Final set -
All results have to discuss wound
cleansing (S22) AS WELL AS pressure
ulcers (S27)
Putting that into practice!
https://www.flickr.com/photos/shindotv/3835365695/in/photolist-dQEffh-bKSERv-cL7gTW-P7XEF-ayTAnE-7Frdi-cL7gJs-bB8RAe-9nXSy4-9nXSqX-5W6qxG-6QVfAK-7DUk5-fKow7d-2xQ9VT-czfWj7-9hhbsY-9he4ax-9he44P-hWT88P-cNX7ZA-4b5Zk7-7odfak-3DEACY-75txKd-4dyNMq-cNX7Xy-8gAKm1-8iedyK-dYVCmw-85Rwed-aupZZW-61cUps-6T2aCS-sUnH-67TuU9-8K
CINAHL – the basicsIn this search, we are looking
for articles which discuss
medication adherence amongst asthma
sufferers
Leave Search Options /
Limits till later
AND = both ASTHMA
as well as MEDICATION ADHERENCE have to be in the results
Could we have missed some results?
In this approach, we will think of different ways to describe
medication adherence
Separate searches
OR = Either
COMPLIANCE or else
ADHERENCE has to be in the results
Appendix 5. EBSCO CINAHL search strategyS28 S22 and S27S27 S23 or S24 or S25 or S26S26 TI (bed sore* or bedsore* ) or AB (bed sore* or bedsore*)S25 TI decubitus or AB decubitusS24 TI (pressure ulcer* or pressure sore*) or AB (pressure ulcer* or pressure sore*)S23 (MH ”Pressure Ulcer“)S22 S1 or S2 or S3 or S4 or S5 or S6 or S7 or S8 or S9 or S10 or S11 or S12 or S13 or S14 or S15 or S16 or S17 or S18 or S19 or S20or S21S21 TI ( wash* or scrub* or swab* or shower* or bath* or soak* or irrigat* or whirlpool ) or AB ( wash* or scrub* or swab* or shower* or bath* or soak* or irrigat* or whirlpool )S20 TI ( wound clean* or wound cleans* ) or AB ( wound clean* or wound cleans* )S19 (MH ”Hydrotherapy+“)S18 (MH ”Bathing and Baths“)S17 (MH ”Irrigation+“)S16 AB ( normal saline or hypochlorit* or iodophor* or povidone or iodine or chlorhexidine or hibitane or betadine or antiseptic* or disinfectant* or antiseptic* or detergent* or soap* or hydrogen peroxide or benzoyl peroxide or gentian violet or eusol or dakin* or permanganate or water or alcohol*1 or solution* )S15 TI ( normal saline or hypochlorit* or iodophor* or povidone or iodine or chlorhexidine or hibitane or betadine or antiseptic* or disinfectant* or antiseptic* or detergent* or soap* or hydrogen peroxide or benzoyl peroxide or gentian violet or eusol or dakin* or permanganate or water or alcohol*1 or solution* )S14 (MH ”Solutions+“)S13 (MH ”Alcohols+“)S12 (MH ”Water+“)S11 (MH ”Gentian Violet“)S10 (MH ”Hydrogen Peroxide“)S9 (MH ”Soaps“)S8 (MH ”Detergents+“)S7 (MH ”Disinfectants“)S6 (MH ”Antiinfective Agents, Local+“)S5 (MH ”Povidone-Iodine“)S4 (MH ”Chlorhexidine“)S3 (MH ”Saline Solution, Hypertonic“)S2 (MH ”Sodium Hypochlorite“)S1 (MH ”Sodium Chloride+“)
Moore ZEH, Cowman S. Wound cleansing for pressure ulcers.
Cochrane Database of Systematic Reviews 2013, Issue 3. Art. No.:
CD004983. DOI: 10.1002/14651858.CD004983.pub3
Back to the advanced search...
CINAHL search
S24 TI (pressure ulcer* or pressure sore*) or AB (pressure ulcer* or pressure sore*)
Keyword search:
Authors’ words
S25 TI decubitus or AB decubitus
Keyword search:
Authors’ words
S26 TI (bed sore* or bedsore* ) or AB (bed sore* or bedsore*)
Keyword search:
Authors’ words
Subject Heading Search
Click on “Pressure Ulcer”
for more information
Deep Tissue Injury & Heel Ulcer are narrower
headingsTick EXPLODE box to
include them
S23 (MH ”Pressure Ulcer“)
S27 S23 or S24 or S25 or S26
An abbreviated version for demo purposes - the full strategy should be run (S1-S21)
Record your searches
Reproducible & documented
• Set up personal accounts• Save searches • Set up alerts - email advising you of new results• Set up alerts for journal table of contents
• Image: http://commons.wikimedia.org/wiki/File:Power_of_Words_by_Antonio_Litterio.jpg
Appendix 5. EBSCO CINAHL search strategyS28 S22 and S27S27 S23 or S24 or S25 or S26S26 TI (bed sore* or bedsore* ) or AB (bed sore* or bedsore*)S25 TI decubitus or AB decubitusS24 TI (pressure ulcer* or pressure sore*) or AB (pressure ulcer* or pressure sore*)S23 (MH ”Pressure Ulcer“)S22 S1 or S2 or S3 or S4 or S5 or S6 or S7 or S8 or S9 or S10 or S11 or S12 or S13 or S14 or S15 or S16 or S17 or S18 or S19 or S20or S21S21 TI ( wash* or scrub* or swab* or shower* or bath* or soak* or irrigat* or whirlpool ) or AB ( wash* or scrub* or swab* or shower* or bath* or soak* or irrigat* or whirlpool )S20 TI ( wound clean* or wound cleans* ) or AB ( wound clean* or wound cleans* )S19 (MH ”Hydrotherapy+“)S18 (MH ”Bathing and Baths“)S17 (MH ”Irrigation+“)S16 AB ( normal saline or hypochlorit* or iodophor* or povidone or iodine or chlorhexidine or hibitane or betadine or antiseptic* or disinfectant* or antiseptic* or detergent* or soap* or hydrogen peroxide or benzoyl peroxide or gentian violet or eusol or dakin* or permanganate or water or alcohol*1 or solution* )S15 TI ( normal saline or hypochlorit* or iodophor* or povidone or iodine or chlorhexidine or hibitane or betadine or antiseptic* or disinfectant* or antiseptic* or detergent* or soap* or hydrogen peroxide or benzoyl peroxide or gentian violet or eusol or dakin* or permanganate or water or alcohol*1 or solution* )S14 (MH ”Solutions+“)S13 (MH ”Alcohols+“)S12 (MH ”Water+“)S11 (MH ”Gentian Violet“)S10 (MH ”Hydrogen Peroxide“)S9 (MH ”Soaps“)S8 (MH ”Detergents+“)S7 (MH ”Disinfectants“)S6 (MH ”Antiinfective Agents, Local+“)S5 (MH ”Povidone-Iodine“)S4 (MH ”Chlorhexidine“)S3 (MH ”Saline Solution, Hypertonic“)S2 (MH ”Sodium Hypochlorite“)S1 (MH ”Sodium Chloride+“)
Moore ZEH, Cowman S. Wound cleansing for pressure ulcers.
Cochrane Database of Systematic Reviews 2013, Issue 3. Art. No.:
CD004983. DOI: 10.1002/14651858.CD004983.pub3
You may be asked to record number of
results also....
Limits
• Vary from database to database• “Weaken” the evidence?• Examples:
– Publication date– Language– Age group– Type of publication: review; randomised controlled trial; letter to
the editor/editorial; clinical query (studies relating to therapy/diagnosis/aetiology/prognosis)
• Use with caution
Translating searches into other databases• Each platform (eg EBSCO, OVID): different structure
– EBSCO (eg CINAHL, Medline): default search is keyword– OVID (eg Medline, PsycInfo): default search is subject heading– PubMed (Medline): default search is a combination of both
• Subject headings vary / or no headings at all– More detailed nursing subject headings on CINAHL– Web of Science doesn’t use subject headings – you rely on
authors’ words
• KNOW the database structure
• Take your time!
CLINICAL SUMMARIESDynaMed / UptoDate /
Clinical Evidence
Cochrane Library
MEDLINE / CINAHL / databases for primary studies
Grey literature
Evidence Based MedicineEvidence Based Nursing
ACP Journal Club
B Haynes EBM v11 Dec 2006
Sources of help.....
• Cochrane Handbook for Systematic Reviews of Interventions– www.cochrane-handbook.org
• Centre for Reviews and Dissemination, University of York. Systematic Reviews: CRD’s guidance for undertaking reviews in health care– www.york.ac.uk/inst/crd/index_guidance.htm
• Your Librarian
Thank you!
Grainne McCabe
Mercer Library, Royal College of Surgeons in Ireland
www.rcsi.ie/library