bernard becker medical library washington university school of medicine finding relevant evidence...

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


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


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


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?


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


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


Boolean

• AND• OR• NOT


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.


Boolean

strawberry OR vanilla OR chocolate



Boolean and Nesting

• (strawberry OR vanilla) NOT chocolate



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


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.


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


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


Searching NGC

• http://www.guideline.gov/

Click Detailed Search


NGC Detailed Search

Enter Keyword

Sort Results by Publication

Date


NGC Detailed Search cont…Limit search to age of target population.


NGC Search Example


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


Cochrane Database of Systematic Reviews

• “Gold Standard” for systematic reviews

• Free database, but requires Wash U network access to access most content


Accessing Cochrane

• http://becker.wustl.edu

Choose Cochrane from

Quick Links


Cochrane


Cochrane Search Example

• Enter search keywords


Cochrane Search Example cont…You are only interested in

Cochrane Reviews

Click “Record” to view details of review and

access full text if available.


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


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


Accessing PubMed

• http://becker.wustl.edu

Choose PubMed from Quick Links


MeSH = Medical Subject Headings

Choose MeSH from Pull Down Menu


MeSH in PubMed

• Enter your search term


PubMed MeSH cont…

Choose the most applicable MeSH term


PubMed MeSH cont…

• Use subheadings to further define your search.

“analysis” should capture the concept

of “monitoring”


PubMed MeSH cont…

Click box for subheading or main

MeSH term

Send to Search Box


PubMed MeSH cont…• Enter your second term, “Neonate.” Choose the topic that best suits your inquiry by

reading the brief definitions.


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.”


PubMed Search Example

• Whoa! 1360 results! It is time to apply Limits.


PubMed Limits

• Click the “Limits” tab


PubMed Limits cont…• For Practice Guidelines, always limit to “Humans,” “English,” and “Type of Article”


PubMed Search Example


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


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 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.


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]

bernard becker medical library washington university school of medicine finding relevant evidence...

Documents

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search strategies

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