physiotherapy: searching for evidence

Physiotherapy: Searching for Evidence

La Trobe University Library

Latrobe.edu.au/library

http://www.latrobe.edu.au/library

La Trobe University Library 2

The Research Question• You cannot conduct an effective search without a well

formulated question.

• Think about the concepts within your research question

• Identify and list the keywords and their synonyms that identify the concepts

• Consider the ‘level of evidence’ to be sought – the research methodologies that will help eliminate bias


Levels of Evidence


Developing a search strategy: PICO1. Break the research question down into concepts:• Population• Intervention• Comparison • Outcome• Research / Study design - Consider adding another column

for the Research Design ie. which study type will give the highest level of evidence to answer the question

2. Identify for each facet:• Synonyms• Spelling variants• Subject headings


PICO exampleDo water therapies reduce or relieve pain in people with rheumatoid arthritis?

Note: The PICO formula doesn’t always apply and that all elements don’t always need to be present. It is a useful way to structure and focus your question – makes it easier to identify search concepts

Population/Problem

Intervention Comparison Outcome Research Design

(if applicable)

rheumatoid arthritis

water therapy n/a pain If applicable: which study type will give the highest level of evidence to answer the question?


Useful search tips• Spelling variations: paediatrics or pediatrics

• Terminology: physiotherapy or physical therapy

• truncation *: rehabilitat* will find rehabilitate/s, rehabilitated or rehabilitation

• Wildcard (? or #): Depending on the database a wildcard can be either ? or # symbol e.g. organi?ation

• phrase searching “….”: e.g. “cerebral palsy”

• check the database online help guide for further information


Linking terms: BOOLEAN operators

• AND retrieves records containing both of two terms:– Back pain AND exercise

• OR retrieves records containing any of the terms (OR retrieves more records):– Back pain OR back ache

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Example of a completed PICO map

La Trobe University Library

Population/Problem

Intervention Comparison Outcome Research Design

(if applicable)

“rheumatoid arthritis”

orRA

“water therap*”

orhydrotherap*

or“aquatic therap*”

n/a pain or

ache

Therapy

AND

OR


Databases

• Electronic Indexes that help you identify journal articles in your research area

• NO single database indexes every journal possible in a subject area - only those that match their selection criteria

• Efficient, effective and less biased searching therefore requires multiple database searching


Types of databases• Citation databases:

Entries have the citation, subject headings and often an abstract, sometimes they link to full text. Examples: CINAHL, Embase, MEDLINE

• Full Text databases: Entries have the citation and abstract and in most cases the full text of an article. Examples: Health & Medical Complete (Proquest), Informit Health

• Pre-appraised evidence databases:

– The Cochrane Library is a multi-database resource which varies in output e.g. the Cochrane Database for Systematic Reviews contains complete systematic reviews

– BMJ Best Practice incorporates Clinical Evidence which summarises the current state of knowledge and uncertainty about the prevention and treatment of clinical conditions, based on thorough searches and appraisal of the literature.


Accessing Physiotherapy databases

• On Campus: – Library Web Page

> Databases

> Subject Area - Health Sciences> Physiotherapy

• Off Campus: authentication as a La Trobe University student required: – University username and password


Systematic Searching

• Systematic searches are a combination of using the terminology of the database (Subject Headings) combined with free text or keyword searching (alternate terms encountered in the literature).

• While there may be some overlap, you will also find many different articles when using both ways of searching for the same concept.

• Comprehensive systematic searching requires subject heading and keyword searching!

Systematic searching: Why use both methods?

Controlled Vocabulary (Subject Searching) Keyword Searching

MEDLINE, Embase, CINAHL (amongst others) are indexed by subject experts who assign a subject heading (or ‘tag’) that best describes the article. These subject headings are from a fixed list of terms that are arranged in a hierarchical structure that show the relationships between terms. This allows searching at various levels of specificity.

Words not taken from a specific list. Can use words that you would normally use when searching. Need to account for variations for spelling, terminology & clinical descriptions.

More efficient & precise way of searching where you retrieve only those records which list the subject heading for your concept.

Broader way of searching where you will retrieve records which mention your keywords but may or may not be specifically about your concept.

Searches only the subject field. Searches words used by the author in other fields such as the title or abstract.

Provides consistency in the description of the content of the articles.

Useful for searching for a specific term or phrase when there is not an appropriate subject heading.

Do not need to think of synonyms for your topic. Useful for searching topics that use new concepts or terminology (subject headings take a while to be developed)

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Database aids: Controlled vocabulary & scope notes

• Subject Headings (Controlled vocabulary or Thesauri): used to overcome differences in individual authors’ use of terminology. e.g. back pain (CINAHL and MEDLINE), backache (Embase)

– Click on the Subject Heading, scroll down to the ‘used for’. Provides ideas for other keywords to use!

• Scope note: describes how the term is used in the database, the “scope” of the term; the history of the indexing

• ‘Exploding’ a term: results will include the ‘exploded’ term (e.g. back pain) plus the conceptually narrower terms in the tree (low back pain)


Use limits to refine your search

For example:• Clinical Queries• Time frame• Language, gender, age, population• Publication types

– CINAHL e.g. clinical-trial; masters-thesis; research; review; systematic-review

– MEDLINE - e.g. controlled clinical trial; meta analysis; randomised controlled trial; review literature; review, academic; review


Decreasing resultsToo many results?

• Apply limits

• Use keywords which are more specific

• Ask for help with finding subject headings.

• Search for keywords in particular fields like abstract or title.


Increasing results

Not enough results?

• Try another keyword(s)• Use broader search term(s)• Remove the least important concept• Consider possible variants of terms and use

truncation or wildcard• Remove a date limit or any other limits you have

selected• Try another database


Search results – finding the full text!

• Some databases will have the Full Text Finder icon or pdf link

• If not, search by the title of the journal via the Journal tab on the library home page and follow the links to the full text: – sometimes the library may only have a print copy

• If not held by the Library, request the article via Document Delivery Services

http://www.latrobe.edu.au/library/borrowing-and-ebooks/borrow-from-other-libraries/document-delivery


Cochrane Library• To access a variety of search options, click on Search, Search Manager or

Medical Terms (MeSH) to be directed to the appropriate search tab.

• Further information at: latrobe.libguides.com/healthdatabases > Cochrane


PEDro - www.pedro.org.au

• PEDro is the Physiotherapy Evidence Database with over 23,000 randomised trials, systematic reviews and clinical practice guidelines in physiotherapy

http://www.pedro.org.au/


Clinical Evidence (a)• Access ‘BMJ Best Practice’ from A-Z

database list

• Select Resources > BMJ Clinical Evidence


Clinical Evidence (b)

Browse or search for conditions


Google Scholar - scholar.google.com/

• Search scholarly literature for articles, theses, books, abstracts, professional societies, online repositories, universities and other web sites across the world of scholarly research.

• You can access items held in the Library through Google Scholar. See instructions

http://scholar.google.com/

http://www.latrobe.edu.au/library/assignment-thesis-support/search-tools/google-scholar


Useful library guides

• Physiotherapy• Critical Appraisal

• EndNote

• Grey Literature for Health Sciences

• Systematic Reviews

• Health Databases

http://latrobe.libguides.com/physio?hs=a

http://latrobe.libguides.com/healthgreyliterature

http://latrobe.libguides.com/healthgreyliterature

http://latrobe.libguides.com/systematicreviews

http://latrobe.libguides.com/systematicreviews

http://latrobe.libguides.com/healthdatabases

http://latrobe.libguides.com/healthdatabases

physiotherapy: searching for evidence

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