determinants of community health power searching fall 2003 2003, faculty of medicine, university of...

DETERMINANTS OF DETERMINANTS OF COMMUNITY HEALTHCOMMUNITY HEALTH

POWER SEARCHINGPOWER SEARCHING

Fall 2003

2003, Faculty of Medicine, University of Toronto

GOALGOAL

To design search strategiesTo design search strategies

that find the best researchthat find the best research

OUTLINEOUTLINE

IntroductionIntroduction MEDLINEMEDLINE

practicepractice

PsycINFOPsycINFO practicepractice

Questions and discussionQuestions and discussion

STEPS IN A SEARCHSTEPS IN A SEARCH

Choose a databaseChoose a database

Formulate a search questionFormulate a search question

Identify primary topicsIdentify primary topics

Identify searchable termsIdentify searchable terms

Relate the conceptsRelate the concepts

FILTER!FILTER!

SELECTED DATABASESSELECTED DATABASES

MEDLINE, 1966-MEDLINE, 1966- CINAHL, 1983-CINAHL, 1983- PsycINFO, 1967-PsycINFO, 1967- Cochrane Library, 1995-Cochrane Library, 1995- EMBASE, 1974-EMBASE, 1974-







FILTER!FILTER!

ORIGINAL QUESTION:ORIGINAL QUESTION:

How can we improve our methadone How can we improve our methadone maintenance program?maintenance program?

FORMULATING A SEARCH FORMULATING A SEARCH QUESTIONQUESTION

precise, testableprecise, testable narrowly focusednarrowly focused phrase as a question or hypothesisphrase as a question or hypothesis


FORMULATING A FORMULATING A SEARCH QUESTIONSEARCH QUESTION

PP

II

EE


PP population or population or problemproblem

II

EE



heroin heroin addictionaddiction

II

EE




II intervention intervention or issueor issue

EE





methadonemethadone

EE





methadonemethadone

EE effect or effect or evaluationevaluation





methadonemethadone


compliancecompliance

What factors affect compliance in a What factors affect compliance in a methadone maintenance program for methadone maintenance program for heroin addiction?heroin addiction?






methadonemethadone






methadonemethadone


effectivenesseffectiveness

What factors affect compliance in a What factors affect compliance in a methadone program for heroin methadone program for heroin addiction?addiction?

Is methadone an effective Is methadone an effective intervention for heroin addiction?intervention for heroin addiction?








FILTER!FILTER!

SEARCH TERMSSEARCH TERMS

PRIMARY TOPICSPRIMARY TOPICS

methadonemethadone heroin addictionheroin addiction effectivenesseffectiveness

SEARCHSEARCH TERMSTERMS

vary with each vary with each databasedatabase

COMBINECOMBINE

METHADONEMETHADONE

COMBINECOMBINE

HEROIN ADDICTION

METHADONEMETHADONE

COMBINECOMBINE

HEROINADDICTION

ANDANDMETHADONEMETHADONE







FILTER!FILTER!

FILTERFILTER

HEROINADDICTIONANDAND

METHADONEMETHADONE

FILTERFILTER

HEROINADDICTIONANDAND

METHADONEMETHADONE

FILTER

FILTER

Is methadone an effective intervention Is methadone an effective intervention for heroin addiction?for heroin addiction?

SAMPLE SEARCH ASSIGNMENTSAMPLE SEARCH ASSIGNMENT

1.1. IDENTIFICATIONIDENTIFICATION

John Smith, Fitzgerald Academy John Smith, Fitzgerald Academy [email protected] [email protected]

Telephone 416-777-7777Telephone 416-777-7777Fax 416-778-5666Fax 416-778-5666

2.2. SEARCH QUESTIONSEARCH QUESTION

My field placement is with the Metropolitan Toronto My field placement is with the Metropolitan Toronto Detox Centre. We want to improve the Detox Centre. We want to improve the effectiveness of the methadone maintenance effectiveness of the methadone maintenance program for heroin addiction. Since compliance program for heroin addiction. Since compliance is a major factor affecting the program’s success, is a major factor affecting the program’s success, we want to focus specifically on barriers to we want to focus specifically on barriers to compliance. I therefore selected as my core compliance. I therefore selected as my core concepts compliance, methadone, and heroin concepts compliance, methadone, and heroin addiction. Rephrased as a question, my search addiction. Rephrased as a question, my search question becomes “What factors affect question becomes “What factors affect compliance in a methadone program for heroin compliance in a methadone program for heroin addiction?”addiction?”

3.3. SEARCH PLANNINGSEARCH PLANNING

DATABASEDATABASE

I decided to search in MEDLINE (Ovidweb), I decided to search in MEDLINE (Ovidweb), because it provides good coverage of the because it provides good coverage of the addictions literature. addictions literature.

PRIMARY TOPICSPRIMARY TOPICS

1.1. MethadoneMethadone

2. Heroin addiction2. Heroin addiction

3. Compliance3. Compliance

3. SEARCH PLANNING (cont’d)3. SEARCH PLANNING (cont’d)

RELATIONSHIP BETWEEN CONCEPTSRELATIONSHIP BETWEEN CONCEPTS

methadone AND heroin addiction AND compliance methadone AND heroin addiction AND compliance

QUALITY FILTERQUALITY FILTER

If the base set is large enough, I will narrow it down If the base set is large enough, I will narrow it down just to studies using questionnaires or surveys. just to studies using questionnaires or surveys. This will give me a subset that is research-based, This will give me a subset that is research-based, using the same type of instrument we want to use using the same type of instrument we want to use in our own study.in our own study.

4.4. DISCUSSIONDISCUSSION

When I typed methadone in Medline, it mapped to the When I typed methadone in Medline, it mapped to the MeSH heading methadone. I exploded methadone to MeSH heading methadone. I exploded methadone to pick up the narrower term, methadyl acetate. I then pick up the narrower term, methadyl acetate. I then typed my second concept, heroin addiction. This typed my second concept, heroin addiction. This mapped to the MeSH heading heroin dependence. I mapped to the MeSH heading heroin dependence. I clicked on the term to see the hierarchy of terms, and clicked on the term to see the hierarchy of terms, and decided to move up to the broader MeSH, opioid-decided to move up to the broader MeSH, opioid-related disorders. I exploded it to include heroin related disorders. I exploded it to include heroin dependence and morphine dependence. My third dependence and morphine dependence. My third concept, compliance, retrieved three terms, one of concept, compliance, retrieved three terms, one of which was patient compliance. The scope note for which was patient compliance. The scope note for patient compliance cited treatment refusal and patient patient compliance cited treatment refusal and patient dropouts as related terms.dropouts as related terms.

4.4. DISCUSSION (cont’d)DISCUSSION (cont’d)

I therefore created sets for all three terms, and I therefore created sets for all three terms, and combined them with OR, so that any of these terms combined them with OR, so that any of these terms would be picked up in the search. I then combined the would be picked up in the search. I then combined the sets for methadone, opioid-related disorders, and the sets for methadone, opioid-related disorders, and the various terms for patient compliance using AND. I various terms for patient compliance using AND. I limited this set to English and human to get a base set limited this set to English and human to get a base set of 41. For my quality filter, I selected the term data of 41. For my quality filter, I selected the term data collection, which can be exploded to include collection, which can be exploded to include questionnaires and surveys; I want articles using questionnaires and surveys; I want articles using these qualitative research tools. When I ANDed data these qualitative research tools. When I ANDed data collection with my base set, I retrieved a final set of collection with my base set, I retrieved a final set of five items. Most of the items in the final set appeared five items. Most of the items in the final set appeared to contain useful information relating to my question. to contain useful information relating to my question.

5.5. SEARCH STRATEGYSEARCH STRATEGY

Database: MEDLINE <1996 to October Week 4 2003>Database: MEDLINE <1996 to October Week 4 2003>

Search Strategy:Search Strategy:----------------------------------------------------------------------------------------------------------------------------------------------------------------1 exp METHADONE/ (834)1 exp METHADONE/ (834)2 exp Opioid-Related Disorders/ (1533)2 exp Opioid-Related Disorders/ (1533)3 1 and 2 (475)3 1 and 2 (475)4 limit 3 to (human and english language) (409)4 limit 3 to (human and english language) (409)5 Patient Compliance/ (3902)5 Patient Compliance/ (3902)6 Patient Dropouts/ (565)6 Patient Dropouts/ (565)7 Treatment Refusal/ (1034)7 Treatment Refusal/ (1034)8 5 or 6 or 7 (5303)8 5 or 6 or 7 (5303)6 4 and 8 (41)6 4 and 8 (41)7 exp data collection/ (130425)7 exp data collection/ (130425)11 6 and 7 (5)11 6 and 7 (5)

6.6. RESULTSRESULTS

<1><1>AuthorsAuthors Cushman P Jr.Cushman P Jr.TitleTitle Ten years of methadone maintenance treatment: some clinical Ten years of methadone maintenance treatment: some clinical

observations.observations.SourceSource American Journal of Drug & Alcohol Abuse. 4(4):543-53, 2002.American Journal of Drug & Alcohol Abuse. 4(4):543-53, 2002.

<2><2>AuthorsAuthors Morral AR. Belding MA. Iguchi MY.Morral AR. Belding MA. Iguchi MY.TitleTitleIdentifying methadone maintenance clients at risk for poor treatment Identifying methadone maintenance clients at risk for poor treatment

response: pretreatment and early progress indicators.response: pretreatment and early progress indicators.SourceSource Drug & Alcohol Dependence. 55(1-2):25-33, 2001 Jun 1.Drug & Alcohol Dependence. 55(1-2):25-33, 2001 Jun 1.

6. RESULTS (cont’d)6. RESULTS (cont’d)

<3><3>

AuthorsAuthors

Belding MA. McLellan AT. Zanis DA. Incmikoski R.Belding MA. McLellan AT. Zanis DA. Incmikoski R.

TitleTitle

Characterizing "nonresponsive" methadone patients.Characterizing "nonresponsive" methadone patients.

SourceSource

Journal of Substance Abuse Treatment. 15(6):485-92, 1999 Nov-Dec.Journal of Substance Abuse Treatment. 15(6):485-92, 1999 Nov-Dec.

<4><4>

AuthorsAuthors

Zanis DA. Woody GE.Zanis DA. Woody GE.

TitleTitle

One-year mortality rates following methadone treatment discharge.One-year mortality rates following methadone treatment discharge.

SourceSource

Drug & Alcohol Dependence. 52(3):257-60, 1999 Nov 1.Drug & Alcohol Dependence. 52(3):257-60, 1999 Nov 1.

determinants of community health power searching fall 2003 2003, faculty of medicine, university of...

Documents

search question slide

database slide

methadone filter slide

evaluation slide

combine methadone slide

discussion slide

issue methadone e slide

issue e slide