Systematic Searching for Systematic ReviewsSteven Chang, Senior Research Advisor (Library – Science, Health & Engineering)La Trobe University

Patrick CondronResearch Librarian (Medicine, Dentistry and Psychology)University of Melbourne

Systematic Reviews Growth

CDSR

Systematic Reviews Growth

CDSR

You can get kids to eat more veggies!

Mette Mikkelsen et al. A systematic review of types of healthy eating interventions in preschools. Nutr J 13:56

• Comprehensive interventions were more likely to succeed in behaviour change, especially when targeting children of low income families

• Preschools are a promising venue for increasing fruit and vegetable consumption

• Properly designed interventions, with clear indicators and outcomes are scarce

Successful Multicomponent Programs

Effective communication for systematic reviews

Effective communication for systematic reviews:What do they really want?

Are they really conducting a systematic review?

Or do they want a narrative literature review?

Traditional narrative reviews may be at high risk of bias. Systematic reviews aim to minimise this bias.

Effective communication for systematic reviews:

Effective communication for systematic reviews:the research question

Invest in understanding the question deeply

Takes longer than you expect – may be complex

How is palliative care being used for patients with heart failure?

Is this the same as “terminal care”, or different?

Does this overlap with “heart attack” / “myocardial infarction?”

What study types are we looking for? randomised controlled trials? Or cohort studies? Reviews? Or all of the above and more?

Drug therapy? Or non-pharmacological studies?

Effective communication for systematic reviews:the research question

Effective communication for systematic reviews:service scope

Establish clear expectationsHow deeply into the research process will you go?

Consider…○ Scalability ○ Staff – expert searching competency○ Standards of service ○ Who is eligible?

Effective communication for systematic reviews:articulating our expertise

Effective communication for systematic reviews

○ Workshopping!○ It’s an iterative process○ Line-by-line tinkering○ Encourage trial and error – it’s

a science experiment!

Effective communication for systematic reviews

Effective communication for systematic reviews

○ Reminding ourselves: this is their research, not ours

○ Be mindful of this when encountering disagreements about search strategy

○ Be assertive – but the final decision belongs to the researcher

Effective communication for systematic reviews:co-authorship

○ Do librarians deserve formal co-authorship?

○ Expect uncertainty and pushback

○ Co-authorship is worth itBolsters your professional recordRaises the profile of librarians as experts

Effective communication for systematic reviews:co-authorship

Question to Strategy

◎ Population Intervention Comparison Outcome

◎ Sample ; Phenomenon of Interest ; Design ; Evaluation ; Research type

◎ Expectation ; Client group ; Location ; Impact ; Professionals ; Service

Leeds Institute of Health Sciences : Search Concept Tools https://medhealth.leeds.ac.uk/info/639/information_specialists/1500/search_concept_tools

PICO

SPIDER

ECLIPSE

Concept Development

Medical Education

Performance Assessment

Acronyms to Remember PRISMA, AMSTAR, PROSPERO

Prisma Checklist - Searching

PRISMA Flow Diagram

Sources Used

Average 6 Databases Searched

Sources Used

Database Pediatrics (n=68) Pop Health (n=34)

PubMed/Medline 65 34

PsycInfo 34 14

Cochrane (CENTRAL/DARE/CDSR) 31 15

CINAHL 32 14

Embase 31 17

Web of Science 32 9

Scopus 12 6

ERIC ; Google Scholar 12 3

Ebsco ; Proquest Central ; Proquest Dissertations and Theses ; ScienceDirect

5 to 7

Sources Used

Developing Countries LILACS, WHOLIS, World Bank, Scielo, IMEMR, Global Health, African Index Medicus, PAHO, WPRIM

Evaluation Health Technology Assessments, Health Economic Evaluations Database, Health Policy Reference Center

Grey Literature / Guidelines OpenGrey, Oaister, GreyNet, National Guidelines Clearinghouse, Guidelines International Network

Indigenous Australian Indigenous Health InfoNet, Australian Institute of Aboriginal and Torres Strait Islander Studies, First Nations Periodical Index

Injuries TRANSPORT, SafetyLit

Nutrition CAB Abstracts, Biosis, Food Science and Technology Abstracts

Physical Activity SportDiscus, Pedro

Social/Family ASSIA, Sociological Abstracts, Social Work Abstracts, Campbell Collaboration, SocIndex, NCJRS, Popline, Social Care Online

Trials clinicaltrials.gov, Current Controlled Trials, International Clinical Trials Register (ICTRP), MetaRegister of Controlled Trials

Proximity

(blood or plasma or rbc or wbc) N5 (transfus* or transfer)

(food or nut or treenut or peanut* or milk or dairy) N5 (allerg* or sensitivit* or hypersensitiv*)

Search for terms within five words of one another

◎ Cochrane Library NEAR/5 ◎ Ebsco N5 ◎ Informit %5 ◎ Ovid ADJ5◎ ProQuest NEAR/5 or N/5 ◎ Scopus W/5◎ Web of Science NEAR/5◎ PubMed, Google Scholar None

Unnecessary Truncation

Truncation frenzy !!

◎ nut* nut, nuts / nutrition, nutrients

◎ clot* clot, clots / clothes, clothing

◎ intern* intern, interns / internal medicine

Proximity and Truncation Pitfalls

Proquest proximity + truncation◎ (famil* or parent* or sibling* or relative* or adult* or child* or infant* or

relative*) n/7 (care or caring or home or homes or assist* or support* or train* or partner*)

◎ Consider removing truncation. Search the main terms required.

Informit nested proximity ◎ famil* %7 care or famil* %7 caring or famil* %7 home or famil %7

homes …

◎ Create a simplified search strategy for Informit

Subject Headings

◎ Does the default search include the subject?

◎ Reversed subjects

1 pulmonary hypertension 33,0002 hypertension pulmonary 32,0003 1 or 2 44,000

◎ Subheading codes. Ovid does not index the equivalent term.

suicide prevention Drug therapysuicide/pc dt.fs.

Subject Headings

◎ exp anticoagulants/◎ anticoagul* or “anti coagul*” or warfarin or

acenocoumarol or coumadin or coumarin or phenprocoumon or sintrom or sinthrome or jantoven or marevan or waran or nicoumalone or dicoumarol or dicumarol or …

Avoid Explosion Excitement!!

Medline to Embase subject translation

◎ Significant differences in subject heading usage

Subject Term Medline Embase Difference

Thrombocytopenia 25919 118467357%

Wound Infection 10538 42770306%

Primary Prevention 17262 37540117%

Celiac Disease 18651 2928857%

Attitude to Health 83974 912209%

Disease Management 27095 26946-1%

Clinical Competence 79268 49593-37%

Geriatric Assessment 24002 12640-47%

Medline to Embase Translation

Medline Term Embase TermChest Pain 11570Thorax Pain 70120

Chest Pain 22421

Emergency Medical Services 37710Emergency Health Service 89828

Emergency Medical Services 83300

Varicose Ulcer 4574 Varicosis 27446

Varicose Ulcer 14846

Diet, Gluten-Free 1455 Gluten Free Diet 7285

Diet, Gluten-Free 7285

Rhinitis, Allergic 1820 Allergic Rhinitis 26418

Rhinitis, Allergic 17557

Alternative Embase subjects have different results to using Medline subject.

Publication Type

◎ Exclude publication types where possible

Embase Conference Abstract 2.4 million

Web of Science Meeting Abstract 6.8 million

PsycInfo Dissertation Abstract 420,000

Age Groups

◎PsycInfo

◎ CINAHL

◎ EMBASE

No, they aren’t all doing it!Bianca Klettke et al. Sexting prevalence and correlates : a systematic literature review. Clin Psych Rev 34:44-53 (Deakin University)

• 25 studies with prevalence measures (92% US)

• Lots of variability in age ranges studied

• Adolescents (12 studies, 6 random & representative sampling) : Sent 10.2%-15.5%Received 15.6%-35%

• Adults (13 studies, 9 with undergrad student samples) : Sent 53%Received 56%

Search filters (or “hedges”)What are they?

o Tested, pre-defined search strategies

o This is different from database limits

o Standardise the way we search, based on what we know about the science of expert searching

o Let’s not reinvent the wheel!

Search filters

Cochrane Highly Sensitive Search Strategy for identifying randomized trials in MEDLINE: sensitivity-maximizing version (Ovid)

Search filters

(((((australia[mh] OR australia*[tiab]) AND (oceanic ancestry group[mh] OR aborigin*[tiab] OR indigenous[tw])) OR (torres strait* islander*[tiab])) AND medline[sb]) OR ((((au[ad] OR australia*[ad] OR australia*[tiab] OR northern territory[tiab] OR northern territory[ad] OR tasmania[tiab] OR tasmania[ad] OR new south wales[tiab] OR new south wales[ad] OR victoria[tiab] OR victoria[ad] OR queensland[tiab] OR queensland[ad]) AND (aborigin*[tiab] OR indigenous[tiab])) OR (torres strait* islander*[tiab])) NOT medline[sb]) AND English[la])

• Developed by Lowitja Institute in collaboration with Flinders Filters, Flinders University

• Retrieves 92.9% of reviews on Aboriginal & Torres Strait Islander health

Tieman JJ; Lawrence MA; Damarell RA; Sladek RM; Nikolof A. LIt.search: fast tracking access to Aboriginal and Torres Strait Islander health literature. Australian Health Review. 38(5):541-5, 2014 Nov.

Search filters

• Methodological search filters

• Therapy• Diagnosis• Etiology (causation)• Prognosis• Qualitative

• Subject-based search filters

• Palliative care• Heart failure• Abortion and contraception• Bereavement

Search filters:where to find them

• ISSG search filters

• Flinders Filters (Flinders University)

• SIGN search filters

• HLWiki page on search filters

• Lowitja (indigenous Australians)

Text mining:

What is it?

The analysis of how often terms appear in known relevant records.

Used for:• Search term selection• Ranking output by relevance

Text mining: for search term selection

In a given set of known relevant records, what are the most frequent terms that appear?

Tools:• PubMed PubReMiner• Termine• Yale MeSH Analyzer

Text mining: for search term selectionAnalysis of results from mindfulness for depression search, using PubMed PubReMiner:

Text mining – for ranking outputs

• Text mining for ranking outputs by relevance

• Use EndNote for this

Software for systematic reviews

Building expertise for systematic reviews:staff development

Further resources:impact of librarian supporting systematic reviews

Meert, D., Torabi, N., & Costella, J. (2016). Impact of librarians on reporting of the literature searching component of pediatric systematic reviews. Journal of the Medical Library Association : JMLA, 104(4), 267–277. http://doi.org/10.3163/1536-5050.104.4.004

Rethlefsen, M. L., Farrell, A. M., Trzasko, L. C. O., & Brigham, T. J. (2015). Librarian co-authors correlated with higher quality reported search strategies in general internal medicine systematic reviews. Journal of clinical epidemiology, 68(6), 617-626.

Rethlefsen, M. L., Murad, M. H., & Livingston, E. H. (2014). Engaging medical librarians to improve the quality of review articles. Jama, 312(10), 999-1000.

Further resources:validated search filters

ISSG search filters

https://sites.google.com/a/york.ac.uk/issg-search-filters-resource/home

SIGN search filters

http://www.sign.ac.uk/methodology/filters.html

HLWiki (Health Librarians Wiki) – search filters and hedges

http://hlwiki.slais.ubc.ca/index.php/Search_filters_%26_hedges

Flinders Filters (Flinders University)http://www.flinders.edu.au/clinical-change/research/flinders-filters/

CareSearch filtershttps://www.caresearch.com.au/caresearch/tabid/371/Default.aspx

LIt.searchhttp://www.lowitja.org.au/litsearch

Further resources:text mining

O’Mara-Eves, A., Thomas, J., McNaught, J., Miwa, M., & Ananiadou, S. (2015). Using text mining for study identification in systematic reviews: a systematic review of current approaches. Systematic reviews, 4(1), 1. Chicago

Catherine Voutier’s clinical librarian blog – text mining lessons from Julie Glanville’s visit to Australiahttps://clinicallibrarian.wordpress.com/2015/04/11/text-mining-with-julie-glanville/

Research White Paper: an exploration of the use of text-mining software in systematic reviews

http://effectivehealthcare.ahrq.gov/ehc/products/625/2214/text-mining-report-160419.pdf

Further resources:staff development

Health Libraries Inc http://www.hlinc.org.au/

ALIA Health Libraries Australia https://www.alia.org.au/groups/HLA

Introduction to Systematic Reviews and Meta-Analysis (Coursera)https://www.coursera.org/learn/systematic-review

Yale University videos introducing systematic reviews

http://library.medicine.yale.edu/tutorials/subjects/systematic-reviews

Annual four-day Australian EBP for Librarians Institute (residential event)http://ebp.institute.libguides.com/

Thanks!Any questions?

You can find us at:

Steven ChangTwitter: @StevenPChangs.chang@latrobe.edu.au

Patrick Condronp.condron@unimelb.edu.au

Alexander Drachmann – Question mark in Esbjerg https://flic.kr/p/uUA4G

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