nurs201 - may 2013
DESCRIPTION
Discusses the search process and EBPTRANSCRIPT
Roy Brown, MLIS
Education and Research Librarian
Tompkins-McCaw Library, VCU Libraries
Database Basics:Performing a Good Search
CONFIDENCE IN YOUR SEARCHING SKILLS
WHAT MAKES A GOOD SEARCH?
WHERE TO TURN WHEN YOU NEED INFORMATION
Goals: • Be aware of the process for doing an effective search • Understand the difference between keyword and subject
heading searching• Know how to use Boolean operators & limits• Be able to identify appropriate databases for different information
needs • Be able to better use PubMed & CINAHL (Friday)
Effective Searching = Less Time & Reading
Why do you need to search efficiently?
1979 estimated that 2 million articles were published in biomedical literature annually and increasing. If a
practitioner were to attempt to keep up with literatrue by reading 2 articles per day, in 1 year they would fall 55
centuries behind. Another way to put it would be that if physicians were to read everyting of possible relevance,
they would need to read 5500 articles per day....Haynes, R., McKibbon, K., Fitzgerald, D., Guyatt, G., Walker, C., & Sackett, D. (1986). How to keep up with the medical literature: why try to
keep up and how to get started. Annals Of Internal Medicine, 105(1), 149-153.
Physically impossible to read everything that is published in that literature, which now means attempting to read nearly 90,000 journals per year. Estimated that if you
read two articles a day every day, by the end of the year you would be over a year behind in your reading.
Lawrence, D. (1997). Literature searching and critical appraisal of the literature for the practicing chiropractor. Chiropractic Technique, 9(4), 151-156.
Since 2005, between 2,000-4,000 completed references are added each day to PubMed
Levels of Evidence
Evidence Based Practice Guidelines
Meta- Analysis / Systematic Review
Critically Appraised Topics [Evidence Syntheses]
Critically Appraised Individual Articles [Article Synopses]
Randomized Control Trials (RCT’s)
Cohort Studies / Cross-Sectional Study
Case Controlled Studies/Case Reports
Reviews
Background Information / Expert Opinion
Filtered Information
Unfiltered Information
Qua
lity
of E
vide
nce
Start of
Search
(Idea
l)
Rea
lity
EBP Objective:Clinical Knowledge Bedside
THE SEARCH PROCESS
Tompkins-McCaw Library for the Health Sciences, VCU Libraries
The Search Process2.
5. Evaluate the Results
6. Good Results = Use the Data • Bad = Start Over
3. Choose the appropriate database(s) or resource for
your topic
4. Perform the Search
1. Problem/ Construct Question
Image: http://evidencebasedhealth.blogspot.com/
Formulate Your Search Strategy
• Synonyms for Search Terms• Subject Heading vs. Keyword• Boolean Operators & Limits
THE SEARCH PROCESS Step 1: Starts with Problem or Need for Information/ Developing a Clear Research Question
Tompkins-McCaw Library for the Health Sciences, VCU Libraries
The Search Process2.
5. Evaluate the Results
6. Good Results = Use the Data • Bad = Start Over
3. Choose the appropriate database(s) or resource for
your topic
4. Perform the Search
1. Problem/ Construct Question
Image: http://evidencebasedhealth.blogspot.com/
Formulate Your Search Strategy
• Synonyms for Search Terms• Subject Heading vs. Keyword• Boolean Operators & Limits
The Problem……….
• Helping a older, female patient to deal with the
pain or other issues related to fibromyalgia
• Improve Quality of Life
Question - Brings Focus to Search of the Literature
Chronic Pain / Fatigue / Sleep Issues
Formulate Your Question
Question Is therapeutic touch or guided
imagery more effective when treating a patient with fibromyalgia?
P(Problem, Patient,
Population, Program)
I(Intervention)
C(Comparison)
O(Outcome)
T(Type of
Question)
T(Type of Study)
Type of Question/ Best Type of Study
Type of Question
Best Type of Study
TherapyHow to select treatments to offer patients that do more good than harm and that are worth the efforts and costs of using
them
Randomized Control Trial (RCT)
PreventionHow to prevent a disease or condition RCT/ Cohort Study / Case Control
PrognosisHow to estimate the patient's likely clinical course over time
and anticipate likely complications of disease
Cohort Study/ Case Control/ Case Series or Case Report
DiagnosisHow to select and interpret diagnostic tests Blind RCT Compared to the Gold Standard
(best treatment/test for diagnosis)Etiology/Harm
How to identify causes for disease RCT/ Cohort Study /Case ControlCost analysis
Economic costs of all facets of a intervention or disease treatment
Economic Analysis
Evidence
Based Prac.
Guidelines,
Meta-
Analysis
& Systematic
Reviews
15
PICO & Breaking Search Into Concepts
Main Concepts Break Search in Groups/Concepts
Fibromyalgia | Guided Imagery & Therapeutic Touch
These concepts will be used to search the databasesFind Synonyms/ Related Terms for Concepts
Different Databases Use Different Terms
P(Problem, Patient,
Population, Program)
I(Intervention)
C(Comparison)
O(Outcome)
T(Type of
Question)
T(Type of Study)
Patient with Fibromyalgia
FemaleOlder/Aged
Therapeutic Touch
Guided Imagery
Alleviating the
symptoms of Fibromyalgia
Therapy RCT
Background
Informatio
n
What are some alternative terms…
• Guided Imagery
• Fibromyalgia
• Therapeutic Touch
Fibromyalgia Therapeutic Touch Guided Imagery
• Fibromyalgia• Chronic Fatigue
Syndrome• Diffuse Myofascial
Pain • Fibromyalgia-
Fibromyostitis Syndrome
• Postviral Fatigue Syndrome
• Therapeutic Touch• Massage• Zone Therapy • Reiki
• Guided Imagery• Hypnosis • Directed Reverie
Therapy• Imagery(Psychotherapy)
Alternative Terms…
Ways to Find Alternative Terms/ Background Information • Good Sources:
1. Point-of-Care Tools • First Consult• Up to Date
2. Government Sites • Medline Plus• PubMed Health
3. Controlled Vocab. Entry Terms
4. Google ScholarTerm/Concept
Mining
Google vs. Google Scholar
main purpose of is to hunt for text in Web pages
Displays results based on Page Rank
Does not really cover information contained in library catalogs, official government documents, phone books, etc.
• Indexes the full text of scholarly literature across an array of publishing formats and disciplines
• Includes most peer-reviewed online journals of Europe and America's largest scholarly publishers
• Tends to put weight on citation counts when displaying search results
Falagas, M. E., Pitsouni, E. I., Malietzis, G. A., & Pappas, G. (2008). Comparison of PubMed, scopus, web of science, and google scholar: Strengths and weaknesses The FASEB Journal : Official Publication of the Federation of American Societies for Experimental Biology, 22(2), 338-342. doi:10.1096/fj.07-9492LSF Vine, #., & Rita. (2006). Google scholar Journal of the Medical Library Association, 94(1), 97–9. Wikipedia contributors.Google search Retrieved, 2012,
THE SEARCH PROCESS Step 2: Formulating Your Search Strategy
Partly Based
on the
Database Used
The Search Process2.
5. Evaluate the Results
6. Good Results = Use the Data • Bad = Start Over
3. Choose the appropriate database(s) or resource for
your topic
4. Perform the Search
1. Problem/ Construct Question
Image: http://evidencebasedhealth.blogspot.com/
Formulate Your Search Strategy
• Synonyms for Search Terms• Subject Heading vs. Keyword• Boolean Operators & Limits
KEYWORD SEARCHING
Tompkins-McCaw Library for the Health Sciences, VCU Libraries
Natural Language
How to search…Keyword or Controlled Vocab/Subject Heading?
Neoplasm
Pressure Ulcer
Contusion
Myocardial Infarction
Cancer
Bed Sores
Bruise
Heart Attack
V.A.P. Ventilator-Associated
Pneumonia
V.B.A.C. Vaginal Birth After Cesarean
DESCRIBE THE FOLLOWING ITEM
Person 1
• Aluminum Can• Coke Can • Can with Condensation
• Soda Can
Person 2
• Pop Can • Soda Can
• Can That is Sweating • Red Aluminum Can
Person 1
• Aluminum Can• Coke Can • Can with Condensation
• Soda Can• Red Can
Person 2
• Pop Can • Soda Can
• Can That is Sweating • Red Aluminum Can
Describe This Can ……
Keyword• Also called natural language searching• Search for words or phrases found in title, abstract, or
other parts of articles• Keyword searching used for
• New terminology• Rare terms• Other terms that have no related subject heading• Spelling variations
• Truncation - Train*• Trained, Trainer, Training, etc.
• Grouping Using “Guided Imagery”• Use Quotation Marks • Without Quotes – AND Terms Together
Perspective
Synonyms
WHERE THE DATABASE SEARCHES FOR KEYWORDS In the Citation
All searched when searching by keyword
All Places that are searched when doing a keyword search in PubMed
SEARCHING WITH SUBJECT HEADINGS/ CONTROLLED VOCABULARYMeSH - PubMed
CINAHL Headings - CINAHL
Tompkins-McCaw Library for the Health Sciences,
VCU Libraries
Pepsi
Coke
Pop
Soda Soda
Pop
Subject Headings/ Controlled Vocabulary • Controlled Vocabulary – Thesaurus
• Help to return results that directly apply to subject of the search
• Hierarchy – Tree Structure • Broad –Specific
• Minor / Major Heading • Major Heading - Focuses your search
results to returning articles that specifically address the topic• PubMed – have stars beside them• CINAHL – Divided into Major & Minor
Headings
• Scope Note – Term Definition
Soda Pop
Soft Drink
Examples of Hierarchy PubMed CINAHL
May need to move backward in order to move forward……
Good Choice • Broad
• Commonalities between people
Issue: Breastfeeding practices of adolescent mothers in Vietnam.
Too Broad
10 Articles
Tip: Sometimes Need to Back Up to Move Forward
WHERE THE DATABASE SEARCHES FOR CONTROLLED VOCABULARY/ SUBJECT HEADINGS In the Citation
Subject Heading Field in CINAHL
Subject heading field in PubMed
BOOLEAN OPERATORS/ COMBINING TERMS AND, OR, NOT
Tompkins-McCaw Library for the Health Sciences,
VCU Libraries
Boolean Operators - AND
• Combines concepts
• Relationship
• Retrieves records that contain BOTH terms entered
Soda Pop Weight Gain
Boolean Operators - OR
• Combines synonyms or like concepts
• No Relationship Necessary
• Retrieves records that contain EITHER term entered
Coke Pepsi
When Searching………..Combining Terms Together
Group 1
Combine Terms with OR
Group 2
Combine Terms with OR
AND AND
Group 3
Combine Terms with OR
Fibromyalgia Therapeutic Touch Guided Imagery
"Fibromyalgia“ [Subject Heading]
OR
"Fatigue Syndrome, Chronic“
[Subject Heading]
OR
Fibromyalgia [Keyword]
OR
Chronic Fatigue Syndrome
[Keyword]
“Therapeutic Touch “ [Subject Heading]
OR
Therapeutic Touch [Keyword]
OR
Massage [Keyword]
"Imagery (Psychotherapy)“
[Subject Heading]
OR
Guided Imagery [Keyword]
OR
Hypnosis[Keyword]
Good Search – Combination of Subject Headings and Keywords
AND AND
Keep in Mind – Doing A Good SearchBreak Your Search into Concepts –
Don’t Marry Early/ Let Them Date!!!!
Start Your Search Broad and Then Focus – Don’t Put Blinders on the Horse Too Soon !!
Be sure to come up with alternative or related terms for your topic
Always search in at least two databases.
Use Controlled Vocabulary When PossibleMeSH/CINAHL Headings
WAYS TO INCREASE OR DECREASE RESULTSExploding, Subheadings, Limits
Tompkins-McCaw Library for the Health Sciences,
VCU Libraries
Explode Option:
Increases Number
Includes Chosen Term and All of those Below it
in the tree
PubMed – Done Automatically
CINAHL – Must Choose to Explode A
Term
• Provide More Focus/ Detail
• Decrease the Number of Articles Returned
Subheadings
Using Limits • Language• Age Group• Time Period/ Date• Gender/Sex• Publication Type
• Systematic Reviews• Meta Analysis• Randomized Control Trials• Practice Guidelines • Reviews
Not Finding Enough?Ways to Expand Your Results
Finding Too Many Articles?
Ways to Focus Your Results (Ways to Get More Articles)
Try To :• Explode Your Terms• Keyword Searching• Look At Related or Citing
Articles
(Ways to Get Fewer Articles)
Try Using:• Major Concept/Subject• Subheadings• Limits
Other Things to Think About…..
Selecting the Right Resource
• Research Guides • Nursing Research Guide
• Important Databases• PubMed/Medline (Free) • CINAHL• APA PsycNet/PsychInfo• Cochrane Library • TRIP Database (Free)• National Guidelines
Clearinghouse (Free)• PubMed Health (Free)• Medline Plus (Free)
http://guides.library.vcu.edu/nursing
Evidence Based
Practice Guidelines
Meta- Analysis / Systematic
Review
Critically Appraised Topics
[Evidence Syntheses]
Critically Appraised Individual Articles
[Article Synopses]
Randomized Control Trials (RCT’s)
Cohort Studies / Cross-Sectional Study
Case Controlled Studies/
Case Reports
Reviews
Background Information / Expert Opinion
Filtered Information
Unfiltered Information
Qua
lity
of E
vide
nce
Quick Review….
1. What is the advantage of using subject headings/controlled vocabulary over keywords when doing a search?
3. What is one way you could decrease the number of articles you get in a search when using subject headings/controlled vocabulary?
2. Will truncation increase or decrease the amount of articles you in get in a search?
Break Time…………
If You Need Help……..• Get in touch with Me…..
Roy Brown, MLIS
Education and Research Librarian
Tompkins-McCaw Library, VCU Libraries
[email protected] / Ph. 804-828-1592
Evidence Based
Practice Guidelines
Meta- Analysis / Systematic
Review
Critically Appraised Topics
[Evidence Syntheses]
Critically Appraised Individual Articles
[Article Synopses]
Randomized Control Trials (RCT’s)
Cohort Studies / Cross-Sectional Study
Case Controlled Studies/
Case Reports
Reviews
Background Information / Expert Opinion
Filtered Information
Unfiltered Information
Qua
lity
of E
vide
nce