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BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
Finding Relevant Evidence
Using Search Engines and Databases
Susan FowlerMedical Library
St. Louis Children’s [email protected]
314-454-2768
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
Outline
• Search Strategy• Pulling Keywords from Your PICO Question• Boolean, Truncation, and Wild Cards• Hierarchy of Evidence and Study Design• AACN Procedure Manual for Pediatric Acute and
Critical Care• National Guidelines Clearinghouse• Cochrane Database of Systematic Reviews• PubMed• SLCH Medical Library Services• Becker Medical Library Services
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
The Search Strategy
• Develop PICO question• Identify keywords and terms from PICO• Identify standardized subject headings• Combine subject headings and keywords
to narrow or broaden your search• Evaluate your search results• Revise the search in light of your results
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
Pulling Keywords from Your PICO Question
• What are the main topics of your PICO?• Brainstorm – what other words could you
use to describe your topic?• What are some synonyms for the words
you’ve come up with?
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
Evaluate the Search Results
• Don’t be afraid if you have zero (0) or thousands of results, play around with search strategies – you wont break anything!• Read the titles and abstracts of “hits” in your
search to get a feel for their relevance• Identify relevant MeSH and Keywords used to
index particularly relevant “hits”• If your search yields too many or too few hits,
modify it and try again
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
Revise the Search in Light of your Results
• Narrow the search by combining search terms and applying limits
• Broaden the search if the results are too limited by removing keywords and limits
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
Boolean
• AND• OR• NOT
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
Boolean
strawberry AND vanilla AND chocolate
Strickland, Jennifer and Henderson, John R. (October 10, 2005). Boolean Logic. Retrieved September 22, 2007, from http://www.ithaca.edu/library/course/expert.html.
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
Boolean
strawberry OR vanilla OR chocolate
Strickland, Jennifer and Henderson, John R. (October 10, 2005). Boolean Logic. Retrieved September 22, 2007, from http://www.ithaca.edu/library/course/expert.html.
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
Boolean and Nesting
• (strawberry OR vanilla) NOT chocolate
Strickland, Jennifer and Henderson, John R. (October 10, 2005). Boolean Logic. Retrieved September 22, 2007, from http://www.ithaca.edu/library/course/expert.html.
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
Truncation and Wild Cards• Truncation is a searchable shortened form of a word.
• adolescen* will include• adolescence• adolescent• adolescents, etc…
• Wild card characters are useful because of alternate spellings and other quirks in the English language. • behavio?r, will include
• behaviour • behavior
• Wom*n, will include• women • woman
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
Hierarchy of Evidence and Study Design
As you move up the pyramid the amount of available literature decreases, but increases in its relevance to the clinical setting.
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
AACN Procedure Manual for Pediatric Acute and Critical Care
• A print manual available in the reference section of the SLCH Medical Library
• This manual cannot be checked out but you are welcome to make free copies of practice guidelines
• Look up your topic in the Index, if it isn’t there, think of synonyms
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
National Guidelines Clearinghouse
• Freely accessible database of evidence-based clinical practice guidelines and related documents.
• Initiated by the AHRQ in partnership with the American Medical Association and America's Health Insurance Plans.
• Now maintained by the Agency for Healthcare Research and Quality (AHRQ) and the U.S. Department of Health and Human Services.
• If you have developed a good practice guideline, consider submitting it to the NGC
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
Searching NGC
• http://www.guideline.gov/
Click Detailed Search
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
NGC Detailed Search
Enter Keyword
Sort Results by Publication
Date
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
NGC Detailed Search cont…Limit search to age of target population.
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
NGC Search Example
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
NGC
• Pros• Freely accessible practice guidelines that have
undergone rigorous acceptance standards by the AMA, AHIP, AHRQ, and the U.S. Department of Health and Human Services
• Cons• Limited content• Limited search capabilities
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
Cochrane Database of Systematic Reviews
• “Gold Standard” for systematic reviews
• Free database, but requires Wash U network access to access most content
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
Accessing Cochrane
• http://becker.wustl.edu
Choose Cochrane from
Quick Links
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
Cochrane
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
Cochrane Search Example
• Enter search keywords
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
Cochrane Search Example cont…You are only interested in
Cochrane Reviews
Click “Record” to view details of review and
access full text if available.
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
Cochrane Systematic Reviews
• Pros• Compiled through rigorous standards • Review process has already been done so you
don’t have to
• Cons• Limited content• Limited search capabilities• Access to most full-text content requires you to
be on a Wash U networked computer
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
PubMed
• Created and maintained by the National Institute of Health (NIH) and the National Library of Medicine (NLM)
• Considered one of the most comprehensive databases of published scientific research articles
• Free database, but requires Wash U network access to access most content
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
Accessing PubMed
• http://becker.wustl.edu
Choose PubMed from Quick Links
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
MeSH = Medical Subject Headings
Choose MeSH from Pull Down Menu
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
MeSH in PubMed
• Enter your search term
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
PubMed MeSH cont…
Choose the most applicable MeSH term
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
PubMed MeSH cont…
• Use subheadings to further define your search.
“analysis” should capture the concept
of “monitoring”
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
PubMed MeSH cont…
Click box for subheading or main
MeSH term
Send to Search Box
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
PubMed MeSH cont…• Enter your second term, “Neonate.” Choose the topic that best suits your inquiry by
reading the brief definitions.
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
PubMed MeSH cont…• At this point, you have not searched the literature yet. You have built a search. Once
you are satisfied with the search you have built, click “PubMed Search.”
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
PubMed Search Example
• Whoa! 1360 results! It is time to apply Limits.
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
PubMed Limits
• Click the “Limits” tab
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
PubMed Limits cont…• For Practice Guidelines, always limit to “Humans,” “English,” and “Type of Article”
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
PubMed Search Example
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
PubMed
• Pros• Freely accessible database• Strong search capabilities
• Cons• Vast amount of data requires application of
limits• Some content will require Wash U Network
access or inter-library loan
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
SLCH Medical Library• 24/7 hour Badge Access• Online access to a vast online collection via (4) Wash U
Networked Computers• (4) BJC Networked Computers• Journals, Books, and Databases• Free Copying and Printing• Free Fax• Citation Assistance• Bibliographic Instruction• Free Interlibrary Loan• Literature Searches• Reference Questions• Collection Development – Is there a book, journal, online
resource that you think should be available at the library? Ask for it!
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
Bernard Becker Medical Library
Becker welcomes your requests• SLCH employees have Borrowing Privileges• Articles, send requests to [email protected],
let them know you work at SLCH • Reference Assistance
• 314-362-7085 • [email protected]
• Hours Mon-Thurs: 7:30 a.m. - 12:00 a.m.
Friday: 7:30 a.m. - 10:00 p.m.Sat: 8:30 a.m. - 6:00 p.m.Sun: 12:00 p.m. - 12:00 a.m.
BERNARD BECKER MEDICAL LIBRARYWashington University School of Medicine
Need Help?
Contact a librarian, we are here to help!
SLCH Medical Librarian• Susan Fowler
• [email protected]• 314-454-2768
Becker Clinical Resources Librarian• Will Olmstadt
• 314-362-4734 • [email protected]