searching medical sources
DESCRIPTION
Searching class conducted on March 23, 2010 for the graduate students in the Faculty of Information and Media Studies at the University of Western Ontario.TRANSCRIPT
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Searching Medical DatabasesMLIS 9320March 23, 2010
Robin Featherstone, BA, MLISClinical Medicine LibrarianAllyn & Betty Taylor [email protected]
Presentation available at: http://www.slideshare.net/featherr
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Agenda
• Sources of Medical Evidence (EBM) & PICO• Free Tools– PubMed– Trip Database
• Subscription databases– EMBASE (Ovid)– CINAHL (Ebsco)
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Level of Evidence Pyramid
Qualitative Studies
Trip searches both
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PICO
P: Patient, population or problem
I: Intervention or exposureC: Comparison (optional)O: Outcome
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PICO Example
A patron calls the desk and asks if you have any information about jet lag. They travel frequently and would like to know more about prevention methods. Have you heard of using melatonin? They’ve also read that exercise can be used to prevent symptoms. What does the medical literature say?
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Use PICO to identify keywords for your search
P: Patient with jet lagI: MelatoninC: ExerciseO: Prevention of symptoms
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FREE TOOLS
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PubMed/MEDLINE• Freely accessible database of biomedical literature from
the US National Library of Medicine• What you’ll find:
– Citations for: Primary research articles, review articles, Cochrane reviews
– Academic, scientific literature written for clinicians, researchers, chemists, biologists, etc...
• What you won’t find:– Plain language materials– Clinically appraised topics– Evidence grading
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Key Features in PubMed
• Medical Subject Headings (MeSH)• Limits• Single Citation Matcher• Clinical Queries• Topic Specific Queries
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PubMed Exercises
• What are the MeSH headings for “tranquilizers?”
• Find an article published in the journal Psychopharmacology by J.M. Nichols in 1993
• Find articles on therapies for Intermittent Explosive Disorder (IED)
• Find a randomized controlled trial on chocolate cravings
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Trip Database
• Freely available clinical search tool from the UK that identifies high quality clinical evidence
• What you’ll find:
• What you won’t find:– Sophisticated search interface– Comprehensive coverage of the medical literature
Evidence Based SynopsesSystematic ReviewsGuidelinesClinical Q&A
Primary ResearcheTextbooksPatient Information News
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Key features in Trip: http://www.tripdatabase.com/
• Allows filtering by level of evidence• Conclusions of systematic reviews available in
the citation• If available, results will include images• Links available to Medline articles
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Trip Exercises http://www.tripdatabase.com/
• Run a search for bipolar disorder. – Limit your results to only the highest quality
evidence. – Identify Canadian guidelines.
• Locate images of hip replacements• Answer the question: Is tea tree oil effective in
treating dermatological conditions?
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SUBSCRIPTION TOOLS
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EMBASE (Ovid)• Subscription database (Ovid) • What you’ll find:
– Citations for: Primary research articles, review articles, Cochrane reviews– Academic, scientific literature written for clinicians, pharmacists,
researchers, etc...– European focus– Good coverage of drug information
• What you won’t find:– Plain language materials– Clinically appraised topics– Evidence grading
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Key Features in EMBASE:
• Guided search in Ovid• EMTREE (Subject Headings)• Limits– Routes of drug administration
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EMBASE Exercises:
• Find citations on use of gabapentin for patients with fibromyalgia
• Find citations on intracameral administration of lidocaine
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CINAHL (Ebsco)
• Subscription database (Ebsco)• Nursing and allied health literature• What you’ll find:
– Citations for: Primary research articles (mix of qualitative and quantitative), review articles, opinion papers, editorials, letters
– Allied health information for nurses, physiotherapists, occupational therapists, etc...
• What you won’t find:– Clinically appraised topics– Evidence grading
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Key Features in CINAHL
• CINAHL Headings (Subject Headings)• Search history• Combining your searches
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CINAHL Exercises
• Find citations about hydrotherapy for patients with arthritis– Limit your results to research articles only
• Find citations about depression following mastectomy– Limit to Quality of Life Studies
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Summary
• Use PICO when answering health-related information requests
• Be conscious of the levels of evidence – aim for the highest level which still answers the patrons needs
• PubMed and Trip as high-quality free resources• EMBASE (Ovid) for drug-related questions• CINAHL (Ebsco) for allied health questions
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Challenge Exercise
A patron asks you to help her find a recent article (just published) about beta blockers versus calcium-channel blockers in preventing stroke. She remembers that the article discussed blood pressure variability.
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QUESTIONS