Download - Shortening the distance to research evidence
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Shortening the distance to research evidence
The librarian as knowledge translation activist
Raechel Damarell
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Outline• Search filters
– Research– Implementation– Dissemination– Evaluation
• Flinders Filters: a new research initiative and opportunity for librarians
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What is a search filter?• Tool to retrieve specific subset of literature • Much more than an expert search
– Developed experimentally following a strict (and usually transparent) research methodology
– Has a known level of performance in the database for which it was developed
• The InterTASC Information Specialists' Sub-Group Search Filter Resource
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Why use a search filter?
Searching without a filter
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Why use a search filter?Searching with a filter
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Types of search filters• Methodological vs subject-based
– Cochrane HSSS; PubMed Clinical Queries
• 1st, 2nd, and 3rd generation – subjectively derived/effectiveness unknown– subjectively derived/effectiveness known– objectively derived/effectiveness known
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Subject-based filters• Diagnostic imaging techniques• Heart failure• Nephrology• Return to work • Alcohol-impaired driving• Sleep• Ultrasound for DVT• Knowledge translation• Cardiovascular biology• Occupational origin of disease• Nurse staffing research• Palliative care
• Patient safety• Mental health• Spanish studies• Measurement properties of
measurement instruments• Administrative data studies• Primary health care• Occupation health
interventions• Evidence based nursing
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Methodological filters• Adverse effects• Diagnostic studies• Economic evaluations• Epidemiological studies• Etiology• Guidelines• Health services research• Observational studies• Prognosis• Qualitative research• Quality of life• RCTs and other trials
• Systematic review• Therapy studies
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Basic filter methodology• Establish an Expert Advisory Group
– Scoping conceptual boundaries– Preliminary consensus on potential search terms– Advice on Gold Standard Set
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The Gold Standard Set• Set of representative citations of known
relevance indexed in the database of interest
• Target set: all citations in it should be retrieved by final filter
• Provides means of iteratively improving a search strategy
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Gold Standard Set options• Journal ‘hand search’ (e.g. Palliative Care Filter)• Included references of:
– Clinical Practice Guidelines (Heart Failure)– Systematic Reviews (Lung Cancer)– All citations from range of specialty journals on topic (PHC)
• Others:– Delphi study method (Best Supportive Care)– Set retrieved by a search on the topic
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Basic filter methodology• Establish an Expert Advisory Group • Division of Gold Standard Set
– Term Identification Set – Filter Development Set– Filter validation Set(s)
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Performance measures
Sensitivity (or Recall)The number of relevant citations retrieved by the search filter from the gold standard as a proportion of the total number of relevant citations (100% = all relevant citations retrieved)
PrecisionThe number of relevant records retrieved as a proportion of the total number of records retrieved (100% = all citations retrieved relevant)
Specificity Number of irrelevant citations not retrieved (correct exclusions)
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Basic filter methodology• Establish an Expert Advisory Group
– Scoping conceptual boundaries– Preliminary consensus on potential search terms– Advice on Gold Standard Set
• Division of Gold Standard Set– Term Identification Set; Filter Development Set; Filter
Validation Set(s)
• Implementation: making it available
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Why PubMed?• Accessibility: Largest freely available
biomedical database • Currency: PubMed’s ‘in process’ and ‘as
supplied by publisher’ citations• Immediacy: Search filter can be saved as
hyperlink for one-click searching • Implementable: Can be embedded in any
webpage
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The Palliative Care Filter• Developed in 2004 based on 1999-2001
dataset • Specificity = 99% but sensitivity <50% • Combined with 60+ topics of clinical
importance to palliative care clinicians• Subject of three published studies (4th
currently being written up)
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What the users don’t see((advance care planning[mh] OR attitude to death[mh] OR bereavement[mh] OR terminal care[mh] OR hospices[mh] OR life support care[mh] OR palliative care[mh] OR terminally ill[mh] OR death[mh:noexp] OR palliat*[tw] OR hospice*[tw] OR terminal care[tw] OR 1049-9091[is] OR 1472-684X[is] OR 1357-6321[is] OR 1536-0539[is] OR 0825-8597[is] OR 1557-7740[is] OR 1552-4264[is] OR 1478-9523[is] OR 1477-030X[is] OR 0749-1565[is] OR 0742-969X[is] OR 1544-6794[is] OR 0941-4355[is] OR 1873-6513[is] OR 0145-7624[is] OR 1091-7683[is] OR 0030-2228[is]) AND Medline[sb]) OR ((advance care plan*[tw] OR attitude to death[tw] OR bereavement[tw] OR terminal care[tw] OR life supportive care[tw] OR terminally ill[tw] OR palliat*[tw] OR hospice*[tw] OR 1049-9091[is] OR 1472-684X[is] OR 1357-6321[is] OR 1536-0539[is] OR 0825-8597[is] OR 1557-7740[is] OR 1552-4264[is] OR 1478-9523[is] OR 1477-030X[is] OR 0749-1565[is] OR 0742-969X[is] OR 1544-6794[is] OR 0941-4355[is] OR 1873-6513[is] OR 0145-7624[is] OR 1091-7683[is] OR 0030-2228[is]) NOT Medline[sb]) AND English[la]
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The Heart Failure Filter• Developed in collaboration with Centre for
Cardiovascular & Chronic Care (UTS) • Gold standard: Evidence based guidelines• Sensitivity: 97%; Precision: 75% • Methodology article published in
BMC Medical Research Methodology• Innovative methodology for PubMed translation
(article in progress)• Combined with 40+ topics of clinical importance to
heart failure/palliative care clinicians
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The Heart Failure Filter• Developed in collaboration with Centre for
Cardiovascular & Chronic Care (UTS) • Gold standard: Evidence based guidelines• Sensitivity: 97%; Precision: 75% • Methodology article published in
BMC Medical Research Methodology• Innovative methodology for PubMed translation
(article in progress)• Combined with 40+ topics of clinical importance to
heart failure/palliative care clinicians
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What the users don’t see((heart failure[tw] OR ventricular dysfunction, left[mh:noexp] OR cardiomyopathy[tw] OR left ventricular ejection fraction[tw]) AND Medline[sb]) OR ((heart failure[tw] OR left ventricular dysfunction[tw] OR cardiomyopathy[tw] OR left ventricular ejection fraction[tw] OR cardiac resynchronization[tw] OR LV dysfunction[tw] OR left ventricular systolic dysfunction[tw] OR left ventricular diastolic dysfunction[tw] OR cardiac failure[tw]) NOT medline[sb]) AND english[la]
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Palliative Care Filter effectiveness studies
Study 1• Compiled more recent gold standard based on
included studies in 29 palliative care systematic reviews
• Found that Palliative Care Filter performed better in more recent dataset than in original one (˃ 5%)
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Palliative Care Filter effectiveness studies
Study 2• Real life PubMed searches of pc clinicians for pc
literature (n=37) analysed • Each run in gold standard set and retrieval compared
with that of PCF• Results highlighted difficulties in searching:
– Very limited number of search terms used for complex topic– Incorrect search construction– Negative correlation between stated confidence and actual
performance (i.e. overconfidence is issue)– Search filter retrieved 68% of gold standard; average
clinician search retrieved 25%
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Palliative Care Filter effectiveness studies
Study 3• Were palliative care clinicians aware of topic
searches built on the PCF?• Of those aware:
– Were they using them? If yes, what did they think? If no, why not?
• If not aware: – What did they think after using search? (intervention study)
• Follow up study– Were they still using searches after 6 weeks?
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Flinders Filters
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Flinders Filters
• Established in 2012 as Flinders co-funded research venture
• Committed to producing over 2 years:– Two health filters – Two non-health filters– Four research papers that make a
contribution to search filter methodology
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Flinders Filters
Completed projects: • Primary Health Care Search Filter (PHCRIS)
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Flinders Filters
PHC Search Filter launch
All welcome
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Flinders Filters
New projects: • ‘Indigenous health’ and ‘Australian Aboriginal health’ filters
(Lowitja Institute)• Best Supportive Care (Duke University)• Dementia• Sexual health
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Flinders Filters
Urgent issues for FF:• Non-health filters: What? Who with? Where
appropriate? • Finding time to write for publication • More librarians needed to join team
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Thank you
Questions?